Positive Behavior Support
and
Alternatives to Seclusion and Restraint
●For Children
●For Adults….
……… In all treatment Settings

Efforts to reduce the use of seclusion and restraint have been underway for a decade or more. Over the years, as professionals considered the potential for restraints to retraumatize victims of sexual or physical abuse, as well as, cause staff injuries, many strategies to increase positive behavior support have been explored. Below are resources for agencies and professionals looking to enhance treatment environments that minimize the use of restraints and rely on positive behavior support of the children and adults in their care.

Resources for understanding restraint and seclusion

NEW!  Creating Strength-based and Trauma Sensitive Care: Preventing the Need for Coercive Interventions
Resources from the January 2008 training.

SAMHSA : “Roadmap to Seclusion and Restraint Free Mental Health Services”
http://mentalhealth.samhsa.gov/publications/allpubs/sma06-4055/

• Module 1: The personal experience of Seclusion and restraint

• Module 2: Understanding the Impact of Trauma

• Module 3: Creating Cultural Change

• Module 4: Understanding Resiliency and Recovery

• Module 5: Strategies to prevent Seclusion and restraint

• Module 6: Sustaining Change through consumer & staff

• Module 7: Review and Action Plan

A comprehensive overview of Seclusion and Restraint for use within mental health facilities, educational settings, and general social services.

Learning from Each Other:
Success Stories and Ideas for Reducing Restraint and Seclusion in Behavioral Health
 http://www.psych.org/psych_pract/treatg/pg/LearningfromEachOther.pdf
Introduces practices used by a number of colleagues, and introduces issues, guiding principles, challenges, action plans, leadership and culture change, with regard to restraint and seclusion

Association for Positive Behavior Support  http//:www.APBS.org
Introduces Positive Behavior Support, and describes the appropriate use of, and results from, reducing seclusion and restraint.

CWLA : Child Welfare League of America http://www.cwla.org/
Comprehensive data base for working with children and the child welfare system.

CWLA Residential Group Care Quarterly (Winter 2004)http://www.cwla.org/programs/groupcare/rgcqwinter2004.pdf
Publication introducing 6 articles addressing effectiveness of reducing restraint, effects of restraint upon children, and promising practices in working with children in the child welfare system.
 

Current Rules and Policies 

State of Wisconsin, Department of Health and Family Services, Interim Guidance of Use of Seclusion and Restraints in Certified Day Treatment Programs for Children (9/11/06)
http://dhfs.wisconsin.gov/rl_DSL/Publications/pdfmemos/06-020.pdf           
DHFS description of statutes and rules regarding the use of seclusion and restraint.

Wisconsin Department of Public Instruction’s Guidelines for the Appropriate Use of Seclusion and Physical Restraint in Special Education Programs
http://dpi.wi.gov/sped/doc/secrestrgd.doc
Emphasis on functional behavioral support, expectations, and interventions.

Department of Health and Human Services:
Use of Restraint and Seclusion in Psychiatric Residential Treatment Facilities Providing Inpatient Psychiatric Services to Individuals under 21
http://www.cms.hhs.gov/SurveyCertificationGenInfo/downloads/SCLetter04-13.pdf
General overview of policies, definitions, and use of seclusion and restraint in psychiatric residential treatment facilities (PRTFs).
 

Training Programs available for Reducing the use of Seclusion and Restraint

Therapeutic Crisis Intervention (TCI) Overview http://rccp.cornell.edu/TCIpage1.htm
Overview information regarding five-day training program for helping children learn “constructive ways to handle crisis.”

Therapeutic Crisis Intervention for Families (TCIF) http://rccp.cornell.edu/TCIpage6.htm
Overview of the TCIF training program, objectives, and curriculum

Crisis Prevention Institute (CPI) http://www.crisisprevention.com/program/nci.html
Describes training program, as well as, resourceful information in the news and around the world.

MANDT System home page  http://www.mandtsystem.com/index.php
Training system for de-escalating behavioral problems that arise between co-workers, residents, and clients.