Reducing Restraint Through Individualized Positive Behavioral Interventions and Supports in an Inpatient Psychiatric Setting: An Exploratory Study

Abstract

Traditional responses to aggressive behavior in inpatient psychiatric settings have relied heavily on aversive and restrictive practices, such as restraint, despite the fact that such practices demonstrate limited effectiveness and are at odds with a rehabilitative, patient-centered mission. In response to such concerns, a growing number of researchers and practitioners have moved toward proactive, person-centered approaches to addressing challenging behavior, such as Positive Behavioral Interventions and Supports (PBIS). Positive Behavioral Interventions and Supports is a multi-tiered framework for preventing and responding to challenging behavior by addressing environmental and contextual factors. This article describes an exploratory study examining the effect that implementation of individualized PBIS plans had on restraint events in an adult inpatient psychiatric hospital setting in the Northeastern United States. Results indicated a 76% reduction in restraints following implementation of individualized PBIS plans. Implications for future research and practice are explored as a means of improving clinical outcomes and quality of life of individuals in inpatient psychiatric settings.