Moving nursing practice from task-based care to relationship-centred approaches was seen as pivotal in helping to develop quality of life for residents living in the participating care homes. The findings have implications for education, nursing practice and research in Lebanon and help start an evidence base for care.

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In this paper, the author argues that, despite the self-image of the mental health nursing profession as innovative, radical and progressive, this is a 'false consciousness'. Mental health nursing is deeply immersed in a crisis of legitimacy which dates from, at least, the publication of Russell Barton's Institutional Neurosis in 1959. However, although mental health nurses responded positively to the insights of Russell Barton, they failed to respond directly to the dissenting voices of the anti-psychiatrists or the damning criticisms of various official inquiries into care in various individual psychiatric hospitals during the 1970s. Instead mental health nursing has uncritically embraced humanistic psychology and vaingloriously promoted a false image of mental health nursing which suggests that it has wholeheartedly embraced sensitive user-centred approaches to care. However, the author suggests that, despite superficial similarities between person-centred psychology and the theories of the anti-psychiatrists, mental health nursing can never develop truly liberating approaches to care unless it widens its focus from purely inter-personal relationships and addresses historical, structural and ideological influences on both mental health services and the causation of mental distress.

This paper begins with an exploration of current attitudes towards the use of physical restraint in psychiatric nursing, and the contributions which the 1985 Ritchie Report and the 1991 Report of the Committee Of Inquiry Into Ashworth Hospital have made to the debate on the use of control and restraint within psychiatric institutions. The main focus of the paper, though, is an evaluation of the ethical justifications for and the ethical and political objections to the use of physical restraint techniques as a response to aggressive and self-injurious behaviour in contemporary mental health nursing practice. The author concludes that the number of situations where control and restraint techniques are used might be reduced by the development of new therapeutic approaches. Such approaches should allow for more negotiation regarding care between clients and nurses, and acknowledge the potential benefits of clients resisting supposedly therapeutic interventions which they find unhelpful.

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