Physical Restraint of People with Intellectual Disability: A Review of Implementation Reduction and Elimination Procedures

Abstract

Background This review describes procedures to reduce and eliminate physical restraint of people with intellectual disability. One approach is to assess antecedent conditions associated with restraint and change them so that they no longer produce restraint-provoking behaviour. A second approach is to decrease the duration of restraint by establishing a fixed-time release (FTR) criterion. Methods Research supporting these approaches within community-based service settings are presented. Results Physical restraint can be effectively reduced and eliminated using antecedent intervention procedures and FTR contingencies.

Systematic Review of Restraint Interventions for Challenging Behaviour Among Persons with Intellectual Disabilities: Focus on Effectiveness in Single‐Case Experiments

“…Based on the editorials and review‐papers of Harris (), Jones et al . (), Luiselli () and Sturmey (), we identified three broad categories of RIs: personal restraint, mechanical restraint and environmental restraint. Personal restraint, also called physical restraint or manual restraint, involves direct physical contact (i.e.…”

“…; Luiselli ; Sturmey ). Due to several ethical issues (RIs conflict with certain values and ethical standards), lawfulness issues (RIs are only rendered lawful under specific conditions) and effectiveness issues (RIs can provoke additional CB, RIs can maintain CB when they function as reinforcement) issues, their use is controversial (Harris ; Luiselli ). Consequently, several recent papers call for safely reducing RIs among persons with intellectual disabilities (e.g.…”

“…Consequently, several recent papers call for safely reducing RIs among persons with intellectual disabilities (e.g. Deveau & McDonnell ; Luiselli ; Sturmey ; Williams ; Williams & Grossett ). However, because these interventions are still often used in the management of CB among persons with intellectual disabilities (e.g.…”

Best Practice Adherence and Workplace Facilitators and Hindrances for Psychologists Working With Individuals With Intellectual Disabilities and Co‐Morbid Mental Health Concerns

“…Implementation science research in the field of ID is in its infancy. Currently, research in this field have focused on adherence to restrictive practice protocols (Luiselli, 2009), guidelines on the administration of psychotropic medication (Trollor, Salomon, & Franklin, 2016), person centered practices and active support (e.g., Mansell, Beadle-Brown, & Bigby, 2013) and positive behavior supports (e.g., Iemmi, Knapp, & Brown, 2016). Although guidelines on best practice are available, little focus has been paid on examining clinician adherence to the standards and practices laid out by specific national and international practice guidelines developed for this specialist population.…”

Evaluation of a Program Model for Minimizing Restraint and Seclusion

“…Restraint and seclusion traditionally have been used to interrupt or contain harmful behavior or to decrease the frequency of behavior in the future (Jones and Timbers 2002;LeBel et al 2012;Luiselli 2009). Restraint, by definition, limits mobility of parts of the body through the use of a manual method, a physical or mechanical device, material, or equipment (Mohr et al 2010); and seclusion is defined as confinement when a patient is physically prevented from leaving a room where the person is alone without the presence of others (National Council for Behavioral Health 2006).…”