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Articles Reducing Restraint in Higher-Risk Settings
While positive behaviour strategies and de-escalation are the cornerstones of effective, sustainable behaviour support, practitioners may sometimes need to use restraint or other restrictive practices. This is the case across all education and health and social care providers, but might be more common in secure settings, residential services, special schools, and APs (alternative provisions); in other words, environments that could be considered higher-risk.
Staff might use restraint as a last resort, or as a response to the immediate risk of serious harm. However, we can always look for ways to reduce restraint, and only use interventions that are reasonable, proportionate and necessary – and even then, these should involve the minimum amount of force, for the shortest length of time.
Watch our webinar about reducing the use of restrictive practices.
When we foster a proactive approach to de-escalation, understand all behaviour as communication, and develop a restraint-reduction mindset, we can move towards reducing restraint, and provide care that is safe, dignified and rights-respecting.
While definitions vary, restraint is best thought of as an act that is carried out with the purpose of restricting an individual’s movement, liberty, or freedom to act independently.
There are many different types of restraint, not all of which will be relevant to our individual contexts:
Any direct physical contact where the intention of the person intervening is to prevent, restrict, or subdue movement of the body, or part of the body of another person.
The use of medication, which is prescribed and administered under strict guidelines, for the purpose of controlling or subduing heightened emotional states, commonly referred to as PRN (pro re nata) medicines.
The use of authorised equipment, for example arm splints, to immobilise, restrict, or subdue the movement of a person’s body, or parts of the body.
The use of obstacles, barriers, or locks to prevent a person from moving around freely. Seclusion, although it fits under the broader umbrella of environmental restraint, requires additional authorisation, and should only ever be used in emergencies.
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