The Attitudes and Knowledge of Residential Treatment Center Staff Members Working with Adolescents Who Have Experienced Trauma

Abstract

Although many programs are working to reduce and eliminate the use of restraint and seclusion practices, these practices continue to be highly prevalent. A one-hour in-service training on Trauma-Informed Care and sensory-based alternatives for de-escalating behavior was presented to staff members working directly with adolescents with severe emotional and behavioral problems living in a Residential Treatment Center. Staff member attitudes regarding Trauma-Informed Care, the use of restraints, and sensory-based alternatives were measured before and after the in-service training to determine pre-existing staff attitudes and the potential influence of this training on staff attitudes.

Victims, perpetrators, scapegoats and Russian dolls: Narrating violence within secure units for adolescents from a staff perspective

“…Stein (2006) also stresses low levels of staff training as one component that could lead to violence, although as part of a wider issue of failure of management, not the individual. Denison et al (2018) underline that the use of restraint and isolation is often due to lack of training and education, and dosReis and Davarya (2008) observe that staff differ in many ways when dealing with violence at youth institutions. In contrast, Å kerstr€ om ( 2006), in her study of juvenile institutions, found that staff members were skillful and both embraced and resisted new policy through actions that she conceptualizes as "doing ambivalence."…”

Psychiatric staff attitudes toward coercive measures: An experimental design

“…Eskandari et al 6 impacts on psychiatric patients, and a lack of knowledge about other less restrictive alternatives that can be used before taking coercive measures. 7 As mentioned, many previous studies have shown that proper training could play a vital role in changing attitudes, in general, positively. 5,6 This study's concern was about nurses' attitudes toward coercive measures.…”

“…Eskandari et al stated that a change in the attitude of psychiatric nurses toward coercive measures is an important prerequisite to achieving the goal of reducing their usage. The change in attitudes should be coupled with looking into the main causes of coercive measures’ overuse, which might include insufficient training about coercive measures, a decreased awareness about its detrimental impacts on psychiatric patients, and a lack of knowledge about other less restrictive alternatives that can be used before taking coercive measures …”

Correlates of psychiatric staff's attitude toward coercion and their sociodemographic characteristics

“…The nursing workforce in the psychiatric healthcare sector has a specific structure that cannot be ignored and the nurses’ attitudes can play an integral role in many of the compelling challenges facing the quality of psychiatric care. Although psychiatric nurses’ attitude is a significant element of work performance, it is largely understudied in Arabic context and a clear correlation between psychiatric nurses’ attitude toward coercion and their characteristics can give us a deeper understanding of factors that can be taken into consideration to promote the concept of “violence‐free coercion‐free treatment,” then reducing or eliminating the rates of coercive measures usage 17,18 …”

“…The sociodemographic characteristics that were selected to be measured in the current study were based on its reported impact on coercive measures usage. The measured sociodemographics include gender, years of experience in the field of psychiatric nursing, 17 working shift, clinical unit (acute or chronic unit), Gender‐based unit (working with male patients or female patients), understanding the hospital's policy on the use of coercive measures, and previous training on policies about using coercive measures 5,15 …”