Treatment of Childhood Emotion Dysregulation in Inpatient and Residential Settings

Chua, Jaclyn; Bellonci, Christopher; Sorter, Michael T.

doi:10.1016/j.chc.2021.04.004

Cited by 6 publications

(7 citation statements)

References 38 publications

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“…Studies have also been conducted in children and adolescents in residential and acute inpatient settings. These young people often manifest severe psychopathology and dysregulation; therefore, they may benefit from settings and interventions that provide safety and stabilization [15,83]. In such settings, it might be challenging to accurately determine the efficacy of programs for treating ED and improving ER.…”

Section: Children and Adolescentsmentioning

confidence: 99%

“…In such settings, it might be challenging to accurately determine the efficacy of programs for treating ED and improving ER. Nonetheless, it has been shown that behavior-management programs utilizing a social-learning approach (with clear expectations for the child and positively reinforcing positive behaviors) reduce ED [15,83]. Similarly, utilizing a rewards system and individualized behavior plans, modified positive behavioral interventions and supports have been found to reduce the frequency and duration of ED displays [15].…”

Section: Children and Adolescentsmentioning

confidence: 99%

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A Narrative Review of the Efficacy of Interventions for Emotional Dysregulation, and Underlying Bio–Psycho–Social Factors

Easdale-Cheele,

Parlatini,

Cortese

et al. 2024

Brain Sciences

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In this narrative, comprehensive, and updated review of the literature, we summarize evidence about the effectiveness of interventions aimed at reducing emotion dysregulation and improving emotion regulation in children, adolescents, and adults. After introducing emotion dysregulation and emotion regulation from a theoretical standpoint, we discuss the factors commonly associated with emotion regulation, including neurobiological and neuropsychological mechanisms, and the role of childhood adverse experiences and psycho–social factors in the onset of emotion dysregulation. We then present evidence about pharmacological and non-pharmacological interventions aiming at improving emotion dysregulation and promoting emotion regulation across the lifespan. Although our review was not intended as a traditional systematic review, and the search was only restricted to systematic reviews and meta-analyses, we highlighted important implications and provided recommendations for clinical practice and future research in this field.

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Section: Children and Adolescentsmentioning

confidence: 99%

Section: Children and Adolescentsmentioning

confidence: 99%

A Narrative Review of the Efficacy of Interventions for Emotional Dysregulation, and Underlying Bio–Psycho–Social Factors

Easdale-Cheele,

Parlatini,

Cortese

et al. 2024

Brain Sciences

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“…104 Family and parenting interventions helpful for childhood psychiatric disorders often associated with irritable mood and anger outbursts include family-focused therapy (mood and psychotic disorders), 105 multi-family psychoeducational psychotherapy (mood disorders), 106 and parent-child interaction therapy (tantrums and aggression in young children). 107 Adaptations of evidence-based strategies have been used to address youth with emotional and behavioral dysregulation in different settings, including schools, 6 inpatient and residential units, 108 and juvenile justice programs. 109,110 Modules of evidenced-based treatments can be combined into a comprehensive care plan individually tailored to patient and family needs.…”

Section: Treatmentmentioning

confidence: 99%

“…The complex array of symptoms associated with impairing emotional outbursts, including volatile moods, aggression, self-harm, property destruction, substance abuse, treatment nonadherence, and other unsafe provocative and disruptive behaviors, accounts for a disproportionate amount of emergency department visits and hospitalizations as well as negatively impacts placement and service planning in other systems of care, including schools, social welfare, and developmental disability services. 1,6,9,108,124 Impairing emotional outbursts are difficult to treat and challenge therapeutic programming across levels of care. The absence of effective services adds to disparities in referral patterns for mental health services, resulting in disadvantaged and minority youth being disproportionately referred to law enforcement and juvenile justice programs.…”

Section: Systems Of Carementioning

confidence: 99%

Narrative Review: Impairing Emotional Outbursts: What They Are and What We Should Do About Them

Carlson

Singh

Amaya-Jackson

et al. 2023

Journal of the American Academy of Child & Adolescent Psych

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“…The preventive efforts are generally accompanied by an overall stability of the security level within the facility (e.g. Bowers et al, 2015; Brocardt et al, 2011; Celofiga et al, 2022; Chua et al, 2021; Fletcher et al, 2017; Goulet et al, 2017; Hammervold et al, 2019; Hottinen et al, 2020; Huckshorn, 2004; Perers et al, 2021; Putkonen et al, 2013).…”

Section: Introductionmentioning

confidence: 99%

Best practice recommendations on the application of seclusion and restraint in mental health services: An evidence, human rights and consensus‐based approach

Cuyper

Vanlinthout

Vanhoof

et al. 2023

Psychiatric Ment Health Nurs

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Accessible summary What is known on the subject? Seclusion and restraint still regularly occur within inpatient mental health services. The Council of Europe requires the development of a policy on for instance age limits, techniques and time limits. However, they only define the outer limits of such a policy by indicating when rights are violated. Within these limits, many choices remain open. Staff and service managers lack clarity on safe and humane procedures. Research literature provides limited and contradictory insights on these matters. What this paper adds to existing knowledge? The study resulted in 77 best practice recommendations on the practical application of restraint and seclusion as last resort intervention in inpatient youth and adult mental health services, including forensic facilities. To our knowledge, this is the first study in which the development of recommendations on this topic is not only based on scientific evidence, but also on an analysis of European human rights standards and consensus within and between expert‐professionals and experts‐by‐experience. This approach allowed to develop for the first time recommendations on time limits, asking for second opinion, and registration of seclusion and restraint. What are the implications for practice? The 77 recommendations encourage staff to focus on teamwork, safety measures, humane treatment, age and time limits, asking for second opinion, observation, evaluation and registration when applying seclusion and restraint as last resort intervention. The implementation of the best practice recommendations is feasible provided that they are combined with a broad preventive approach and with collaboration between service managers, staff (educators) and experts‐by‐experience. Under these conditions, the recommendations will improve safety and humane treatment, and reduce harm to both service users and staff. Abstract Introduction Seclusion and restraint still regularly occur within inpatient mental health services. Professionals lack clarity on safe and humane procedures. Nevertheless, a detailed policy on for instance age limits, techniques and time limits is required. Aim We developed recommendations on the humane and safe application of seclusion, physical intervention and mechanical restraint in inpatient youth and adult mental health services, including forensic facilities. Method After developing a questionnaire based on a rapid scientific literature review and an analysis of human rights sources stemming from the Council of Europe, 60 expert‐professionals and 18 experts‐by‐experience were consulted in Flanders (Belgium) through a Delphi‐study. Results After two rounds, all but one statement reached the consensus‐level of 65% in both panels. The study resulted in 77 recommendations on teamwork, communication, materials and techniques, maximum duration, observation, evaluation, registration, second opinion and age limits. Discussion Combining an evidence, human rights and consensus‐based approach allowed for the first time to d...

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Treatment of Childhood Emotion Dysregulation in Inpatient and Residential Settings

Cited by 6 publications

References 38 publications

A Narrative Review of the Efficacy of Interventions for Emotional Dysregulation, and Underlying Bio–Psycho–Social Factors

A Narrative Review of the Efficacy of Interventions for Emotional Dysregulation, and Underlying Bio–Psycho–Social Factors

Narrative Review: Impairing Emotional Outbursts: What They Are and What We Should Do About Them

Best practice recommendations on the application of seclusion and restraint in mental health services: An evidence, human rights and consensus‐based approach

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