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

This research study from New Zealand concerns the use of collaborative problem-solving in relation to child and adolescent psychiatric inpatient units . Collaborative problem-solving is championed by Think:Kids (based at Massachusetts General Hospital, Department of Psychiatry) who say:

“As applied to challenging kids, the model sets forth two major tenets: first, that these challenges are best understood as the byproduct of lagging thinking skills (rather than, for example, as attention-seeking, manipulative, limit-testing, or a sign of poor motivation); and second, that these challenges are best addressed by teaching children the skills they lack (rather than through reward and punishment programs and intensive imposition of adult will).”

The research study abstract says:

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.”

You can find out more from here.

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