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Continue reading →: Moving Forward: Next Steps in R&S Reduction
Reducing the use of R&S in youth residential treatment centers requires an integrated and comprehensive approach, rather than isolated interventions. R&S reduction efforts must align with policy reform, staff training, and workforce development, and the integration of evidence-based interventions, such as art therapies (GOA, 2020; Naya, 2022; SAHMSA, 2010; Slatto…
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Continue reading →: Solutions to Preventing R&S in RTCs
Reducing restraint and seclusion (R&S) in youth residential treatment centers isn’t about one single solution—it requires coordinated change across policy, staff training, and clinical practice. While R&S is often used to manage immediate safety risks, it carries a significant risk of physical and psychological harm. Below are three evidence-supported solutions…
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Continue reading →: The Six Core Strategies of Restraint and Seclusion Reduction
The Six Core Strategies, created by the National Association of State Mental Health Program Directors (NASMHPD) in alliance with the Substance Abuse and Mental Health Services Administration (SAMHSA) in 2010, is a conceptual framework aimed at creating organizational change that impacts R&S reduction. The framework emphasizes communication between staff, patients,…
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Continue reading →: Why the Current Approach to Restraint and Seclusion Needs Work
Trauma-informed and strength-based care are two promising interventions that have been widely applied throughout treatment settings (Azeem et al., 2017; Perers et al., 2021; Roy et al., 2019). These practices involve utilizing a person-centered approach and an individualized care plan based on individual experience, mental health history, medication management, and…
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Continue reading →: The Ethical and Legal Complexities of R&S in Youth Residential Care
Restraint and seclusion (R&S) remain some of the most ethically charged and legally complicated practices in youth residential treatment care (RTCs) (Matte-Landry & Cllin-Vezina, 2020; Nielson et al., 2020). While these interventions may often be necessary to prevent immediate harm, they carry significant risks – especially for vulnerable youth.…
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Continue reading →: Environmental Risk Factors for R&S
Environmental factors are a key influence in shaping and mitigating harmful behaviors among youth in residential treatment settings. Physical Environment Recent research has highlighted the positive impact of the physical environment on mental health, with the environmental design potentially playing a role in dysregulated behaviors (Czernin et al., 2023; Oostermeijer…
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Continue reading →: Disparities in Care
The demographics of youth in RTCs are diverse; however, significant disparities exist in youth treatment and R&S frequency across race, gender, age, and diagnoses. Race Research has consistently shown that African American youth are more likely to be restrained than other adolescents (Daniels et al., 2023; Javandi et al., 2024;…
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Continue reading →: Impact of Staff Training on Restrictive Practices
Existing training practices got R&S can vary significantly across organizations in terms of content, duration, and delivery method, with many teaching programs being of orr quality or not clearly translating into practical skills (McDonnell et al., 2023). It’s consistently reported that staff often feel that their training in R&S…
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Continue reading →: Why Restraint and Seclusion Practices in Youth Residential Treatment Need to Change – and What We Can Do Instead
In adolescent residential treatment centers (RTCs), restraint and seclusion (R&S) have long been used as a crisis response when youth pose a perceived risk to themselves or others (Belayneh et al., 2024; Braun et al., 2020; Roy et al., 2019). While these practices are intended as last-resort safety measures, the…
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Continue reading →: An Overview of Restraint and Seclusion in RTCs
Restraint and seclusion (R&S) are among the most debated practices over the last decade. These interventions are typically used only when other de-escalation strategies, such as crisis communication or the use of coping skills, have been exhausted and there is an immediate need for emergency safety intervention. What are Residential…
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Rethinking Restraint and Seclusion 