Objective: The aim of this study was to determine whether implementation of a collaborative problem-solving approach would be associated with a decrease in seclusion and restraint in a child and adolescent inpatient unit. Method: A collaborative problem-solving (CPS) approach was implemented. Seclusion and restraint, length of treatment, clinician- and patient/parent-rated outcomes and staff utility and acceptability were surveyed pre and post implementation. Results: The number of restrictive events significantly decreased, including full restraint, partial restraint and seclusion. Length of treatment and routine clinician-rated outcome measures remained consistent. Patient or parent-rated outcomes showed greater reduction post implementation. Despite some initial scepticism, the staff found this approach useful. Conclusions: A CPS approach was successfully implemented, and in this naturalistic study was associated with a significant decrease in seclusions and restraints.