Reducing seclusion and restraint in a child and adolescent inpatient area: implementation of a collaborative problem-solving approach

Abstract

Objective:

The aim of this study was to determine whether implementation of a collaborative problem-solving approach would be associated with a decrease in seclusion and restraint in a child and adolescent inpatient unit.

Method:

A collaborative problem-solving (CPS) approach was implemented. Seclusion and restraint, length of treatment, clinician- and patient/parent-rated outcomes and staff utility and acceptability were surveyed pre and post implementation.

Results:

The number of restrictive events significantly decreased, including full restraint, partial restraint and seclusion. Length of treatment and routine clinician-rated outcome measures remained consistent. Patient or parent-rated outcomes showed greater reduction post implementation. Despite some initial scepticism, the staff found this approach useful.

Conclusions:

A CPS approach was successfully implemented, and in this naturalistic study was associated with a significant decrease in seclusions and restraints.

Keywords

seclusion restraint collaborative problem-solving adolescent inpatient

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