Reducing seclusion and restraint during child and adolescent inpatient treatment: Still an underdeveloped area of research

Problem: Half of all youth hospitalized in inpatient psychiatric facilities manifest aggressive behavior. When aggression escalates to the point of danger, measures must be employed to guarantee safety of both patients and staff. In this paper, the current empirical evidence for intervention models to reduce restriction and restraint utilization in children and adolescents is reviewed. Method: PubMed and PsycINFO were searched for English-language articles published between 2006 and 2013. Included were empirical studies of child or adolescent inpatient populations using a pretest and posttest design. Finding: Included in this review are three empirical papers describing two different intervention models that met the inclusion criteria. Conclusions: The review indicates there are two empirical supported intervention models that are helpful in reducing seclusion and restraint utilization in children and adolescents. The promising empirical findings support evidence and application to the child/adolescent population for at least three of the six National Association of State Mental Health Program Directors core strategies for restraint reduction. The modest number of empirical papers reflects that reducing restrictive measures in child/adolescent inpatient treatment remains an underdeveloped area of research.

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