The physical restraint of children: Is it therapeutic?

Bath, Howard

doi:10.1037/h0079497

Cited by 36 publications

(19 citation statements)

References 30 publications

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“…He concurred with the use of these strategies to maintain safety but raised the risk of staff 'counter-aggression' and questioned whether these procedures are therapeutic. Bath, an Australian reviewer, acknowledged a need for intervention to prevent harm [9]. He preferred physical restraint as he considered seclusion to have greater potential to be perceived and used as punishment, perceived as rejection or abandonment and to have greater legal ramifications.…”

Section: Definitions and Rationalesmentioning

confidence: 99%

Seclusion use with children and adolescents: an Australian experience

Fryer¹,

Beech²,

Byrne³

2004

Aust N Z J Psychiatry

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Section: Definitions and Rationalesmentioning

confidence: 99%

Seclusion use with children and adolescents: an Australian experience

Fryer¹,

Beech²,

Byrne³

2004

Aust N Z J Psychiatry

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“…2003, Moylan 2009). Many in the field of adolescent psychiatry consider the use of containment measures to manage aggression in underage patients controversial (Bath 1994, Earle & Forquer 1995, Mesham 1995, Sourander et al . 2002, Ellilä et al .…”

Section: Introductionmentioning

confidence: 99%

“…2008). Some researchers have argued that these procedures constitute an important component in helping adolescents with psychiatric disorders to establish internal control (Bath 1994, Masters et al . 2002), and that containment measures have proved to be an effective technique for helping adolescents to de‐escalate from situations that could be harmful to either themselves, others or property (Masters et al .…”

Section: Introductionmentioning

confidence: 99%

Attitudes towards different containment measures: a questionnaire survey in Finnish adolescent psychiatry

Hottinen¹,

Välimäki²,

Sailas³

et al. 2011

Psychiatric Ment Health Nurs

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Use of containment measures in the treatment of underage patients is controversial, and empirical evidence about which containment methods are preferred is lacking. This study aimed to investigate attitudes of staff towards various containment measures in the field of adolescent psychiatry. The sample comprised 128 Finnish nurses and doctors working in closed wards with 13- to 17-year-old patients. The attitudes were studied using the Attitude to Containment Measures Questionnaire. The three methods with the most approval were as-needed medication, transfer to specialist locked wards and mechanical restraint. The method with the least approval was the net bed. Total approval scores for the various containment measures were very similar among nurses and doctors. The differences appeared in attitudes towards mechanical restraint and constant observation, doctors showing a more critical attitude. Women tended to be more critical than men, but only intramuscular medication and mechanical restraint reached statistical significance. The results emphasize the importance of wide-ranging and in-depth training as well as the difficulty of changing practices in psychiatric wards while attitudes are so strongly pro-containment.

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“…The ''therapeutic'' use of restraints has been touted (Bath 1994), but does not go beyond the theoretical and offers no evidence for their therapeutic benefits. There is a growing body of literature discussing the dangers and unintended consequences associated with use (Mohr et al 2003;Nunno et al 2006).…”

Section: The Elements Of Informed Consentmentioning

confidence: 98%

Black Boxing Restraints: The Need for Full Disclosure and Consent

Mohr

Nunno

2010

J Child Fam Stud

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In this article we discuss the necessity of fully informing patients and their families of what constitutes physical interventions and their attendant risks under the established principles and obligations of informed consent. After a brief review of the elements of informed consent and the nature of the duty to advise patients and their families of treatment risks, we argue that physical interventions are an unvalidated treatment for aggressive and violent behavior and should be used only as a safety intervention. We focus our discussion on the informed consent issues for school aged children, adolescents, and emancipated minors and contend that if restraints are used they must pose less risk than the behavior they are trying to alleviate. We also opine that if restraints are misused by mental health or child welfare treatment settings, then their misuse may be considered a subject of a patient maltreatment, abuse, criminal or civil action. A central thesis of the article is that informed consent must be seen as an integral and dynamic process of treatment. We recommend strategies that gain parental permission and child assent, that view informed consent as a dynamic and individualized process that aids and supports the therapeutic relationship, and that stress the importance of simplicity and clarity.

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The physical restraint of children: Is it therapeutic?

Cited by 36 publications

References 30 publications

Seclusion use with children and adolescents: an Australian experience

Seclusion use with children and adolescents: an Australian experience

Attitudes towards different containment measures: a questionnaire survey in Finnish adolescent psychiatry

Black Boxing Restraints: The Need for Full Disclosure and Consent

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