Review of Restraint Data in a Residential Treatment Center for Adolescent Females

Abstract

This paper presents a review of the physical restraints that occurred at a northeastern United States residential treatment facility in the northeastern United States for adolescent females from January 1999 to May 2002. During this period, the facility housed 415 adolescents and reported 1,059 physical restraints involving 155 of them. This report assesses the characteristics of the adolescents housed at the facility, the frequency and nature of the restraints they experienced, and the relationship between the adolescents' characteristics and the frequency with which they were restrained.

A Descriptive Study of the Use of Restraint and Seclusion in a Special Education School

“…This is consistent with the findings of several reports that age is correlated with implementation of restraint and seclusion procedures (Child Welfare League of America 2004; Leidy et al 2006). Many students in this nonpublic school program have developmental disabilities rendering them functionally at the behavioral level of a much younger child.…”

“…Consistent with the CWLA monograph (2004), much of the literature on restraint and seclusion involves inpatient and residential settings (Baker and Bissmire 2000;Leidy et al 2006;Martin et al 2008;McCue et al 2004;Mohr et al 1998). For example, Mohr et al (1998) examined the experience of inpatients who had been restrained as garnered through postdischarge interviews.…”

“…Specifically, Baker and Bissmire (2000) improved staff skills through training, but found no decrease in crisis episodes. Leidy et al (2006) reviewed the restraints that occurred at a residential treatment facility for adolescent females, and found that younger adolescents were restrained more frequently than older adolescents.…”

Antipsychotic Treatment Patterns and Aggressive Behavior Among Adolescents in Residential Facilities

“…Services offered include individual, group, and family therapy; assistance with independent living skills; and therapeutic and recreational activities, which are typical services offered in RTCs. 22 In addition, a 6th through 12th grade curriculum, which includes academics, music, art, business education, pre-vocational, and automotive training, is provided for all residential clients. The facilities were staffed with approximately 36 line staff, 8–12 nursing staff, 12–15 psychologists/social workers, and 4–6 psychiatrists.…”

“…Seclusion/restraint interventions, including intramuscular injections of antipsychotic medications, are reserved for the most severe episodes of acute aggressive behavior when there is concern for safety, and the youth has not responded to other less restrictive interventions, such as removal from milieu or oral medication. 18,19,22 …”