Seclusion and restraints: a neglected area of research in child and adolescent psychiatry?

Schimmelmann, Benno G.

doi:10.1007/s00787-011-0170-8

Cited by 10 publications

(5 citation statements)

References 7 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…An assumption could be that the issue of restraint has been of greater concern in the U.S. Even though comparing practices between countries is challenging, the lack of studies from other parts of the world is difficult to explain, and more research in this field has been called for [20,24,65].…”

Section: Discussionmentioning

confidence: 99%

Methods and Strategies for Reducing Seclusion and Restraint in Child and Adolescent Psychiatric Inpatient Care

Perers¹,

Bäckström²,

Johansson

et al. 2021

Psychiatr Q

View full text Add to dashboard Cite

Restraints and seclusions are restrictive interventions used in psychiatric inpatient units when there is an imminent risk of harm to the patient or others. Coercive measures are controversial and can lead to negative consequences, including negative emotions, re-traumatization, injuries, or death. The article summarizes the last 10 years of literature regarding methods and strategies used for reducing seclusions and restraints in child and adolescent psychiatric inpatient units, and reports on their outcomes. The literature was reviewed by searching PubMed and PsycInfo for English-language articles published between May 2010 and May 2020. Eighteen articles were found that described methods or strategies aimed at reducing restraint or seclusion utilization in child and adolescent psychiatric inpatient units. The following interventions were evaluated: Trauma-Informed Care (TIC), Six Core Strategies, Child and Family Centered Care (CFCC), Collaborative & Proactive Solutions (CPS), Strength-Based Care, Modified Positive Behavioral Interventions and Supports (M-PBIS), Behavioral Modification Program (BMP), Autism Spectrum Disorder Care Pathway (ASD-CP), Dialectical Behavior Therapy (DBT), sensory rooms, Mindfulness-Based Stress Reduction Training (MBSR) of staff, and Milieu Nurse-Client Shift Assignments. Most of the interventions reduced the use of seclusions and/or restraints. Two child-centered and trauma-informed initiatives eliminated the use of mechanical restraints. This review shows that the use of coercive measures can be reduced and should be prioritized. Successful implementation requires ongoing commitment on all levels of an organization and a willingness to learn. To facilitate comparisons, future models should evaluate different standardized parameters.

show abstract

Section: Discussionmentioning

confidence: 99%

Methods and Strategies for Reducing Seclusion and Restraint in Child and Adolescent Psychiatric Inpatient Care

Perers¹,

Bäckström²,

Johansson

et al. 2021

Psychiatr Q

View full text Add to dashboard Cite

show abstract

“…This review includes three empirical papers that demonstrated how two specific intervention models were employed to reduce the use of restrictive measures during child and adolescent inpatient psychiatric treatment. This modest number of studies and the fact that no randomized controlled research was published indicate that reducing the use of restrictive measures in child/adolescent facilities still is an underdeveloped area of research (Schimmelmann, 2011). This is particularly distressing given the negative outcomes that are correlated with the use of these measures both in patients and staff.…”

Section: Discussionmentioning

confidence: 99%

“…A study of Nunno, Holden, and Tollar (2006) found 45 fatalities between 1993 and 2003 in child and adolescent psychiatric facilities related to restraint (DeHert et al, 2011). Finally, the use of these measures raises ethical concerns and poses a conflict between patients' needs and legal rights (Schimmelmann, 2011).…”

mentioning

confidence: 99%

“…Considering the negative outcomes associated with restrictive measures, clinicians have devised programs and intervention models to minimize the use of these measures. Although most child and adolescent psychiatric facilities have standard procedures on the prevention and use of restrictive measures, their details and effectiveness may vary widely (Schimmelmann, 2011). In their study of prevalence rates, DeHert et al (2011) concluded that particular interventions can indeed decrease the use of restrictive measures with children and adolescents.…”

mentioning

confidence: 99%

See 1 more Smart Citation

Reducing Seclusion and Restraint During Child and Adolescent Inpatient Treatment: Still an Underdeveloped Area of Research

Valenkamp

Delaney

Verheij

2014

Child Adoles Psych Nursing

View full text Add to dashboard Cite

The review indicates there are two empirical supported intervention models that are helpful in reducing seclusion and restraint utilization in children and adolescents. The promising empirical findings support evidence and application to the child/adolescent population for at least three of the six National Association of State Mental Health Program Directors core strategies for restraint reduction. The modest number of empirical papers reflects that reducing restrictive measures in child/adolescent inpatient treatment remains an underdeveloped area of research.

show abstract

“…). Still, there is an underdeveloped commitment to advancing knowledge related to crisis management with children, exemplified by the lack of research literature on the topic (Schimmelmann ; Valenkamp et al . ).…”

Section: Introductionmentioning

confidence: 99%

Children's moral experiences of crisis management in a child mental health setting

Montreuil

Thibeault

McHarg

et al. 2018

Int J Mental Health Nurs

View full text Add to dashboard Cite

The experiences of children related to conflict and crisis management in child mental health settings, especially those aged 12 and below, have been rarely studied. This study examined the moral experiences of children related to conflict and crisis management and the related use of restraint and seclusion in a child mental health setting. A 5-month focused ethnography using a participatory hermeneutic framework was conducted in a day hospital programme for children with severe disruptive disorders within a mental health institute. Children considered restraints and seclusion could help them feel safe in certain instances, for example if another child was being aggressive towards them or in exceptional cases to prevent self-injury. However, their own experiences of being restrained were predominantly negative, especially if not knowing the reason for their use, which they then found unfair. Some of the children emphasized the punitive nature of the use of restraints and seclusion, and most children disagreed with these practices when used as a punishment. Children's perspectives also highlighted the limits of the use of a uniform de-escalation approach by the staff to manage crises. Children considered discussing with the staff and developing a relationship with them as more helpful in case of a crisis then the use of a de-escalation approach or coercive strategies.

show abstract

Seclusion and restraints: a neglected area of research in child and adolescent psychiatry?

Cited by 10 publications

References 7 publications

Methods and Strategies for Reducing Seclusion and Restraint in Child and Adolescent Psychiatric Inpatient Care

Methods and Strategies for Reducing Seclusion and Restraint in Child and Adolescent Psychiatric Inpatient Care

Reducing Seclusion and Restraint During Child and Adolescent Inpatient Treatment: Still an Underdeveloped Area of Research

Children's moral experiences of crisis management in a child mental health setting

Contact Info

Product

Resources

About