Rethinking Restraint and Seclusion

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 et al., 2021; Versitano et al., 2022). Policy reform and education can provide increased clarity and literacy on policy, aiding stakeholders in implementing the policy as it is intended to be used (GOA, 2022). Concurrently, staff training in specific behavioral management techniques will aid in increasing staff confidence in implementing behavioral interventions and activities centered around evidence-based interventions, such as art therapy, reinforcing an organizational culture of safety (Slatto et al., 2021; Versitano et al., 2022). The alignment of these solutions reflects a systems-level commitment to increased quality of care for youth in residential treatment centers.

Continued efforts to reduce R&S in youth RTCs will depend on the commitment to sustained policy change, continued research, and implementation of evidence-based and trauma-informed practices, such as art therapy, within organizations. Future research is encouraged to focus on adolescent populations in the mental health and residential care contexts, where restrictive interventions remain prevalent yet under examined (Kelly et al., 2023). Expanding the evidence base on art therapies may also provide novel insight into non-restrictive interventions that promote coping skills, such as emotional regulation and identification. By prioritizing research, collaboration, and evidence-based practice, the long-term reduction of R&S in youth RTCs may become a sustainable goal.