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elementor-element-populated"></div></div></div></section></div></div></div></div></div></div></div></section></div><main id="content" class="site-main post-4094 page type-page status-publish has-post-thumbnail hentry pmpro-has-access"><div class="page-header"><h1 class="entry-title">Restraint and Seclusion</h1></div><div class="page-content"><div data-elementor-type="wp-page" data-elementor-id="4094" class="elementor elementor-4094" data-elementor-post-type="page"><section class="elementor-section elementor-top-section elementor-element elementor-element-81d166b elementor-section-content-space-between elementor-section-boxed elementor-section-height-default elementor-section-height-default" data-id="81d166b" data-element_type="section"><div class="elementor-container elementor-column-gap-wider"><div class="elementor-column elementor-col-66 elementor-top-column elementor-element elementor-element-0192015" data-id="0192015" data-element_type="column"><div class="elementor-widget-wrap elementor-element-populated"><div class="elementor-element elementor-element-58dea13 noselect elementor-widget elementor-widget-text-editor" data-id="58dea13" data-element_type="widget" data-widget_type="text-editor.default"><div class="elementor-widget-container"><p><span style="font-size: 18pt;"><strong><span style="color: #ad2a1a;"><span class="JsGRdQ">Restraint and Seclusion are cruel, dehumanizing practices that result in life-altering trauma and poor mental health outcomes.<br /></span></span></strong><span style="color: #da621e;"><strong><span class="JsGRdQ">Restraint and seclusion are never therapeutic.</span></strong></span></span></p><p><span style="font-size: 14pt;"><span style="color: #da621e;"><strong><span class="JsGRdQ"><br /></span></strong></span></span><span style="font-size: 14pt;">In their July 25, 2023 report, “<a href="https://disability.royalcommission.gov.au/publications/restrictive-practices-pathway-elimination" target="_blank" rel="noopener">Restrictive practices: A pathway to elimination</a>,” The Royal Commission </span><span style="font-size: 14pt;">into Violence, Abuse, Neglect and Exploitation of People with Disability (Australia) determined that </span></p><ul><li><span style="font-size: 14pt;">Restrictive practices are at odds with international human rights obligations</span></li><li><span style="font-size: 14pt;">Restrictive practices strip people with disability of dignity and have outcomes of trauma, pain, harm, and violation</span></li><li><span style="font-size: 14pt;">Restrictive practice occur within an ecological system of violence, coercion and control</span></li></ul><p> </p><p><span style="font-size: 14pt;">Though the Therapy Neurodiversity Collective understands that in critical emergencies, someone might need to be quickly <em>and briefly</em> restrained to keep themselves or others safe from harm,</span><span style="font-size: 14pt;"><span class="JsGRdQ"> restraint has become part of an established routine in schools, residential homes, treatment centers, and medical settings. </span><span class="JsGRdQ">Restraint should never be used as a “behavior fixer.”</span></span></p></div></div></div></div><div class="elementor-column elementor-col-33 elementor-top-column elementor-element elementor-element-009229f" data-id="009229f" data-element_type="column"><div class="elementor-widget-wrap elementor-element-populated"><div class="elementor-element elementor-element-281f80f elementor-widget elementor-widget-heading" data-id="281f80f" data-element_type="widget" data-widget_type="heading.default"><div class="elementor-widget-container"><h3 class="elementor-heading-title elementor-size-default">What do these organizations have to say about restraint and seclusion?</h3></div></div><div class="elementor-element elementor-element-331d0f6 elementor-widget elementor-widget-toggle" data-id="331d0f6" data-element_type="widget" data-widget_type="toggle.default"><div class="elementor-widget-container"><div class="elementor-toggle"><div class="elementor-toggle-item"><div id="elementor-tab-title-5351" class="elementor-tab-title" data-tab="1" role="button" aria-controls="elementor-tab-content-5351" aria-expanded="false"> <span class="elementor-toggle-icon elementor-toggle-icon-left" aria-hidden="true"> <span class="elementor-toggle-icon-closed"><i class="fas fa-caret-right"></i></span> <span class="elementor-toggle-icon-opened"><i class="elementor-toggle-icon-opened fas fa-caret-up"></i></span> </span> <a class="elementor-toggle-title" tabindex="0">Child Welfare League of America.</a></div><div id="elementor-tab-content-5351" class="elementor-tab-content elementor-clearfix" data-tab="1" role="region" aria-labelledby="elementor-tab-title-5351"><p>“Restraints and seclusion must only be used in emergency situations to ensure the physical safety of the child and all others and should never be used for purposes of discipline, retaliation and convenience. …The use of chemical restraints and mechanical restraints should be prohibited.” – <strong>Child Welfare League of America</strong>.<br />– The Use of Restraints and Seclusion in Residential Care Facilities for Children</p><p> </p></div></div><div class="elementor-toggle-item"><div id="elementor-tab-title-5352" class="elementor-tab-title" data-tab="2" role="button" aria-controls="elementor-tab-content-5352" aria-expanded="false"> <span class="elementor-toggle-icon elementor-toggle-icon-left" aria-hidden="true"> <span class="elementor-toggle-icon-closed"><i class="fas fa-caret-right"></i></span> <span class="elementor-toggle-icon-opened"><i class="elementor-toggle-icon-opened fas fa-caret-up"></i></span> </span> <a class="elementor-toggle-title" tabindex="0">National Mental Health Association </a></div><div id="elementor-tab-content-5352" class="elementor-tab-content elementor-clearfix" data-tab="2" role="region" aria-labelledby="elementor-tab-title-5352"><p>“Overuse and abuse of restraints and seclusion are symptoms of poor-quality care in facilities, poor state oversight, and misdirected public policy. State and federal agencies must take a greater role in assuring the safety and protection of children and adults who experience these interventions.”<br /><strong>National Mental Health Association Position Statement:</strong> The Use of Restraining Techniques and Seclusion For Persons with Mental or Emotional Disorders (NMHA Program Policy P-41)</p><p> </p></div></div><div class="elementor-toggle-item"><div id="elementor-tab-title-5353" class="elementor-tab-title" data-tab="3" role="button" aria-controls="elementor-tab-content-5353" aria-expanded="false"> <span class="elementor-toggle-icon elementor-toggle-icon-left" aria-hidden="true"> <span class="elementor-toggle-icon-closed"><i class="fas fa-caret-right"></i></span> <span class="elementor-toggle-icon-opened"><i class="elementor-toggle-icon-opened fas fa-caret-up"></i></span> </span> <a class="elementor-toggle-title" tabindex="0">Federal Substance Abuse and Mental Health Services Administration (SAMHSA)</a></div><div id="elementor-tab-content-5353" class="elementor-tab-content elementor-clearfix" data-tab="3" role="region" aria-labelledby="elementor-tab-title-5353"><p>The <strong>Federal Substance Abuse and Mental Health Services Administration (SAMHSA)</strong> issued a <a href="http://alt.samhsa.gov/seclusion/SRMay5report4.htm" target="_blank" rel="noopener">National Call to Action in 2003</a> concerning restraint and seclusion. “SAMHSA is committed to working with States, communities, consumers, families, providers, and provider organizations to ultimately eliminate the use of restraint and seclusion. Individuals with mental illness should not be confined, restrained, or retraumatized by the persons and resources put in place to help them.” </p></div></div></div></div></div></div></div></div></section><section class="elementor-section elementor-top-section elementor-element elementor-element-95aa270 elementor-section-boxed elementor-section-height-default elementor-section-height-default" data-id="95aa270" data-element_type="section"><div class="elementor-container elementor-column-gap-default"><div class="elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-26cc625" data-id="26cc625" data-element_type="column"><div class="elementor-widget-wrap elementor-element-populated"><div class="elementor-element elementor-element-6035324 elementor-widget elementor-widget-heading" data-id="6035324" data-element_type="widget" data-widget_type="heading.default"><div class="elementor-widget-container"><h2 class="elementor-heading-title elementor-size-default">Definitions:</h2></div></div></div></div></div></section><section class="elementor-section elementor-top-section elementor-element elementor-element-18f4ca1 elementor-section-boxed elementor-section-height-default elementor-section-height-default" data-id="18f4ca1" data-element_type="section"><div class="elementor-container elementor-column-gap-default"><div class="elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-10aa00f" data-id="10aa00f" data-element_type="column"><div class="elementor-widget-wrap elementor-element-populated"><div class="elementor-element elementor-element-83d11ba elementor-widget elementor-widget-text-editor" data-id="83d11ba" data-element_type="widget" data-widget_type="text-editor.default"><div class="elementor-widget-container"><p><span style="font-size: 14pt;"><span style="color: #ad2a1a;"><strong>Physical restraint</strong></span> immobilizes or reduces the ability of a person to move their torso, arms, legs, or head freely. </span></p><p><span class="JsGRdQ" style="font-size: 14pt;"><span style="color: #ad2a1a;"><strong>Mechanical restraint</strong></span> is any mechanical apparatus, material, device, or equipment attached to or adjacent to a human body that restricts their freedom of movement and normal access to their own body. </span></p><p><span class="JsGRdQ" style="font-size: 14pt;"><span style="color: #ad2a1a;"><strong>Chemical restraints</strong></span> include drugs that restrict the person’s ability to move or control their behavior which was not prescribed by a physical as a standard treatment for the person’s condition, and or that are not administered as prescribed (e.g., a much larger dose is given). The dangers of chemical restraint were documented by the Hartford Courant in 1989. (Jess Butler)</span></p><p><span style="font-size: 14pt;"><span style="color: #ad2a1a;"><strong>Seclusion</strong></span> is the involuntary confinement of a person alone in a room or area from which the person is physically prevented from leaving. </span></p><p style="text-align: center;"> </p></div></div></div></div></div></section><section class="elementor-section elementor-top-section elementor-element elementor-element-f9f70b8 elementor-section-content-space-between elementor-section-boxed elementor-section-height-default elementor-section-height-default" data-id="f9f70b8" data-element_type="section"><div class="elementor-container elementor-column-gap-default"><div class="elementor-column elementor-col-50 elementor-top-column elementor-element elementor-element-5cb400c" data-id="5cb400c" data-element_type="column"><div class="elementor-widget-wrap elementor-element-populated"><div class="elementor-element elementor-element-1fdf6c4 elementor-widget elementor-widget-image" data-id="1fdf6c4" data-element_type="widget" data-widget_type="image.default"><div class="elementor-widget-container"><figure class="wp-caption"> <img fetchpriority="high" decoding="async" width="800" height="374" src="https://therapistndc.org/wp-content/uploads/2021/03/Prone-Restraint-1024x479.jpg" class="attachment-large size-large wp-image-4097" alt="" srcset="https://therapistndc.org/wp-content/uploads/2021/03/Prone-Restraint-1024x479.jpg 1024w, https://therapistndc.org/wp-content/uploads/2021/03/Prone-Restraint-600x280.jpg 600w, https://therapistndc.org/wp-content/uploads/2021/03/Prone-Restraint-300x140.jpg 300w, https://therapistndc.org/wp-content/uploads/2021/03/Prone-Restraint-768x359.jpg 768w, https://therapistndc.org/wp-content/uploads/2021/03/Prone-Restraint-1536x718.jpg 1536w, https://therapistndc.org/wp-content/uploads/2021/03/Prone-Restraint.jpg 2048w" sizes="(max-width: 800px) 100vw, 800px" /><figcaption class="widget-image-caption wp-caption-text">Illustration by Kate Jones</figcaption></figure></div></div></div></div><div class="elementor-column elementor-col-50 elementor-top-column elementor-element elementor-element-9d521fb" data-id="9d521fb" data-element_type="column"><div class="elementor-widget-wrap elementor-element-populated"><div class="elementor-element elementor-element-83eb243 elementor-widget elementor-widget-text-editor" data-id="83eb243" data-element_type="widget" data-widget_type="text-editor.default"><div class="elementor-widget-container"><p><span style="color: var( --e-global-color-text ); font-weight: var( --e-global-typography-text-font-weight ); font-size: 14pt;">Restraint or seclusion is often abused as a violent behavior management tool for noncompliance, perceived disrespect, bad language, property damage, and other minor behaviors that do not constitute imminent, serious, physical harm or bodily injury. </span><span style="font-size: 14pt;">Restraining someone can result in their death.</span></p><p><span style="font-size: 14pt;">People have died while being restrained due to various reasons, including</span></p><ul><li><span style="font-size: 14pt;">Asphyxia: This is when someone can’t breathe. It can happen if they are held face down and someone puts too much weight on their neck, back, or stomach, or if items like blankets are put over their face.</span></li><li><span style="font-size: 14pt;">Aspiration: This is when someone swallows things like spit while they’re held facing upwards.</span></li><li><span style="font-size: 14pt;">Heart problems: These can be caused by too much physical effort, medicine conflicts, or unknown heart issues.”</span></li></ul></div></div></div></div></div></section><section class="elementor-section elementor-top-section elementor-element elementor-element-ac5ca6f elementor-section-boxed elementor-section-height-default elementor-section-height-default" data-id="ac5ca6f" data-element_type="section"><div class="elementor-container elementor-column-gap-default"><div class="elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-31c67ac" data-id="31c67ac" data-element_type="column"><div class="elementor-widget-wrap elementor-element-populated"><div class="elementor-element elementor-element-5f72c03 elementor-widget elementor-widget-spacer" data-id="5f72c03" data-element_type="widget" data-widget_type="spacer.default"><div class="elementor-widget-container"><div class="elementor-spacer"><div class="elementor-spacer-inner"></div></div></div></div></div></div></div></section><section class="elementor-section elementor-top-section elementor-element elementor-element-c59b98e elementor-section-content-space-evenly elementor-section-boxed elementor-section-height-default elementor-section-height-default" data-id="c59b98e" data-element_type="section"><div class="elementor-container elementor-column-gap-default"><div class="elementor-column elementor-col-33 elementor-top-column elementor-element elementor-element-20bc848" data-id="20bc848" data-element_type="column"><div class="elementor-widget-wrap elementor-element-populated"><div class="elementor-element elementor-element-1593477 elementor-widget elementor-widget-image" data-id="1593477" data-element_type="widget" data-widget_type="image.default"><div class="elementor-widget-container"> <img decoding="async" width="300" height="300" src="https://therapistndc.org/wp-content/uploads/2023/12/Did-you-know-300x300.png" class="attachment-medium size-medium wp-image-10648" alt="Did you know?" srcset="https://therapistndc.org/wp-content/uploads/2023/12/Did-you-know-300x300.png 300w, https://therapistndc.org/wp-content/uploads/2023/12/Did-you-know-1024x1024.png 1024w, https://therapistndc.org/wp-content/uploads/2023/12/Did-you-know-150x150.png 150w, https://therapistndc.org/wp-content/uploads/2023/12/Did-you-know-768x768.png 768w, https://therapistndc.org/wp-content/uploads/2023/12/Did-you-know.png 1080w" sizes="(max-width: 300px) 100vw, 300px" /></div></div></div></div><div class="elementor-column elementor-col-66 elementor-top-column elementor-element elementor-element-46fefde" data-id="46fefde" data-element_type="column"><div class="elementor-widget-wrap elementor-element-populated"><div class="elementor-element elementor-element-b7e83c7 elementor-widget elementor-widget-text-editor" data-id="b7e83c7" data-element_type="widget" data-widget_type="text-editor.default"><div class="elementor-widget-container"><p><span style="font-size: 14pt;">Physical restraint has been associated with emotional harm, physical injury to staff and consumers, and has even resulted in death of individuals in care environments.</span><br /><span style="font-size: 14pt;">Various interventions have been implemented within care settings with the intention of reducing instances of restraint. One of the most common interventions is staff training that includes some physical intervention skills to support staff to manage crisis situations. <strong>Despite physical intervention training being used widely in care services, there is little evidence to support the effectiveness and application of physical interventions.</strong></span></p><p>McDonnell, A. A., C., M., J., S., McAulliffe, H., & Deveau, R. (2023). Staff training in physical interventions: A literature review. Frontiers in Psychiatry, 14, 1129039. <a href="https://doi.org/10.3389/fpsyt.2023.1129039" target="_blank" rel="noopener">https://doi.org/10.3389/fpsyt.2023.1129039</a></p></div></div></div></div></div></section><section class="elementor-section elementor-top-section elementor-element elementor-element-97e2914 elementor-section-boxed elementor-section-height-default elementor-section-height-default" data-id="97e2914" data-element_type="section"><div class="elementor-container elementor-column-gap-default"><div class="elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-bd6602b" data-id="bd6602b" data-element_type="column"><div class="elementor-widget-wrap elementor-element-populated"><div class="elementor-element elementor-element-d500265 elementor-widget elementor-widget-spacer" data-id="d500265" data-element_type="widget" data-widget_type="spacer.default"><div class="elementor-widget-container"><div class="elementor-spacer"><div class="elementor-spacer-inner"></div></div></div></div></div></div></div></section><section class="elementor-section elementor-top-section elementor-element elementor-element-2899ef6 elementor-section-content-space-evenly elementor-section-boxed elementor-section-height-default elementor-section-height-default" data-id="2899ef6" data-element_type="section"><div class="elementor-container elementor-column-gap-default"><div class="elementor-column elementor-col-33 elementor-top-column elementor-element elementor-element-5363e61" data-id="5363e61" data-element_type="column"><div class="elementor-widget-wrap elementor-element-populated"><div class="elementor-element elementor-element-92eea61 elementor-widget elementor-widget-text-editor" data-id="92eea61" data-element_type="widget" data-widget_type="text-editor.default"><div class="elementor-widget-container"><p><span style="font-size: 18pt;"><a href="https://therapistndc.org/" target="_blank" rel="noopener">Therapist Neurodiversity Collective</a> is a proud <a href="https://endseclusion.org/about/our-affiliates/" target="_blank" rel="noopener">affiliate</a> of <a href="https://endseclusion.org/2019/09/01/about-seclusion-and-restraint/" target="_blank" rel="noopener">Alliance Against Seclusion and Restraint</a> and aligns with their core beliefs and mission:</span></p><ul><li><span style="font-size: 14pt;">We believe in the reduction and elimination of the use of physical restraint and seclusion wherever they occur.</span></li><li><span style="font-size: 14pt;">We believe in ending the use of corporal punishment in schools and homes across the world.</span></li><li><span style="font-size: 14pt;">We do not support compliance-based approaches to behavioral management, such as behaviorism.</span></li><li><span style="font-size: 14pt;">We support trauma-informed, neuroscience-aligned, relationship-driven, and collaborative approaches.</span></li></ul></div></div></div></div><div class="elementor-column elementor-col-66 elementor-top-column elementor-element elementor-element-b3ed249" data-id="b3ed249" data-element_type="column"><div class="elementor-widget-wrap elementor-element-populated"><div class="elementor-element elementor-element-2a0d4a8 elementor-widget elementor-widget-image" data-id="2a0d4a8" data-element_type="widget" data-widget_type="image.default"><div class="elementor-widget-container"> <a href="https://endseclusion.org/"> <img decoding="async" width="768" height="432" src="https://therapistndc.org/wp-content/uploads/2023/11/We-are-affiliated-with-the-Alliance-Against-Seclusion-and-Restraint-768x432.png" class="attachment-medium_large size-medium_large wp-image-10451" alt="" srcset="https://therapistndc.org/wp-content/uploads/2023/11/We-are-affiliated-with-the-Alliance-Against-Seclusion-and-Restraint-768x432.png 768w, https://therapistndc.org/wp-content/uploads/2023/11/We-are-affiliated-with-the-Alliance-Against-Seclusion-and-Restraint-300x169.png 300w, https://therapistndc.org/wp-content/uploads/2023/11/We-are-affiliated-with-the-Alliance-Against-Seclusion-and-Restraint-1024x576.png 1024w, https://therapistndc.org/wp-content/uploads/2023/11/We-are-affiliated-with-the-Alliance-Against-Seclusion-and-Restraint-1536x864.png 1536w, https://therapistndc.org/wp-content/uploads/2023/11/We-are-affiliated-with-the-Alliance-Against-Seclusion-and-Restraint.png 1600w" sizes="(max-width: 768px) 100vw, 768px" /> </a></div></div></div></div></div></section><section class="elementor-section elementor-top-section elementor-element elementor-element-8148a85 elementor-section-boxed elementor-section-height-default elementor-section-height-default" data-id="8148a85" data-element_type="section"><div class="elementor-container elementor-column-gap-default"><div class="elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-6d66485" data-id="6d66485" data-element_type="column"><div class="elementor-widget-wrap elementor-element-populated"><div class="elementor-element elementor-element-b5a72d4 elementor-widget elementor-widget-spacer" data-id="b5a72d4" data-element_type="widget" data-widget_type="spacer.default"><div class="elementor-widget-container"><div class="elementor-spacer"><div class="elementor-spacer-inner"></div></div></div></div></div></div></div></section><section class="elementor-section elementor-top-section elementor-element elementor-element-f14fca9 elementor-section-full_width elementor-section-height-default elementor-section-height-default" data-id="f14fca9" data-element_type="section"><div class="elementor-background-overlay"></div><div class="elementor-container elementor-column-gap-default"><div class="elementor-column elementor-col-16 elementor-top-column elementor-element elementor-element-88dfbc6" data-id="88dfbc6" data-element_type="column"><div class="elementor-widget-wrap"></div></div><div class="elementor-column elementor-col-66 elementor-top-column elementor-element elementor-element-7c245d5" data-id="7c245d5" data-element_type="column"><div class="elementor-widget-wrap elementor-element-populated"><div class="elementor-element elementor-element-498fa0e noselect elementor-widget elementor-widget-text-editor" data-id="498fa0e" data-element_type="widget" data-widget_type="text-editor.default"><div class="elementor-widget-container"><h3><span style="font-size: 18pt;">Further Reading:</span></h3><p><a href="https://www.propublica.org/article/national-ban-on-school-use-of-seclusion-and-restraint-of-students-introduced-in-congress" target="_blank" rel="noopener">National Ban on School Use of Seclusion and Restraint of Students Introduced in Congress</a> – ProPublica<br /><a href="https://www.propublica.org/article/new-data-shows-the-use-of-seclusion-and-restraint-increased-in-illinois-schools-during-the-2017-18-school-year" target="_blank" rel="noopener">New Data Shows the Use of Seclusion and Restraint Increased in Illinois Schools During the 2017–18 School Year</a> – ProPublica<br /><a href="https://www.propublica.org/article/how-often-do-schools-use-seclusion-and-restraint-the-federal-government-isnt-properly-tracking-the-data-according-to-a-new-report" target="_blank" rel="noopener">How Often Do Schools Use Seclusion and Restraint? The Federal Government Isn’t Properly Tracking the Data, According to a New Report</a> – ProPublica<br /><a href="https://features.propublica.org/illinois-seclusion-rooms/school-students-put-in-isolated-timeouts/" target="_blank" rel="noopener">The Quiet Rooms</a> – ProPublica<br /><a href="https://www.npr.org/2019/06/15/729955321/how-some-schools-restrain-or-seclude-students-a-look-at-a-controversial-practice" target="_blank" rel="noopener">How Some Schools Restrain Or Seclude Students: A Look At A Controversial Practice</a> – npr<br /><a href="https://www.nasmhpd.org/sites/default/files/R-S%20RISK%20MGMT%2010-10-06.pdf" target="_blank" rel="noopener">RESTRAINT AND SECLUSION – A RISK MANAGEMENT GUIDE</a>: Stephan Haimowitz, J.D., Jenifer Urff, J.D., Kevin Ann Huckshorn, R.N., M.S.N, CAP, ICADC</p><p class="_04xlpA direction-ltr align-start para-style-body"> </p></div></div></div></div><div class="elementor-column elementor-col-16 elementor-top-column elementor-element 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