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Why We Need a Therapeutic Approach to Preventing Harm

By Kendra Stea | Posted on 01.20.2014 | 2 comments
Why We Need a Therapeutic Approach to Preventing Harm
It happened again. Another death. This time a 15-year-old boy in a group home. According to news reports, he died while being restrained.

I’m not writing to critique the event or comment on what happened. I wasn’t there and I don’t know the details.

But on the same day that I learned of this horrible tragedy, I saw a request on a restraint and seclusion listserv I’m on from a reporter looking to interview families who had poor experiences in schools with their child being restrained or secluded.

I understand the need to report news like this. I do. I understand the need to bring to the attention of advocates and lawmakers the dangers that exist with restraint and seclusion and the gaps that exist in regulating their use or requiring training for the staff who serve our most vulnerable populations.

But what I wish for . . . I wish for a day when there are more news articles about organizations that have found a way to eliminate the use of restraint and seclusion. I wish there were more reports of individuals and families with positive treatment experiences. I wish there were more requests for success stories than industry failures.

Children do not need to die in restraints. I have worked and consulted in very challenging and high-risk environments, and I know that it’s possible to take a person-centered, trauma-informed approach and find success in de-escalating or managing the triggers that contribute to an individual who is very prone to dangerous behaviors losing control.

I wish for a day when I don’t have to “fight” with organizations about how much training “costs.” What’s your alternative? Injuries, worker compensation claims, and lawsuits—or a death?

I’m not passing judgment on the organization involved in this most recent situation. I have no knowledge of the policies, procedures, or training requirements for the staff. I have no knowledge of the youth involved. I have no knowledge of the staff involved. I have no doubt that the situation is tragic for all of them.

But I do know that the restraint position as described in the news articles is higher risk than other positions. I “know” from the news article that a situation of refusal occurred before the escalation in behaviors.

These are not easy waters to navigate—I know. I have worked in group homes. I also know that using CPI’s Nonviolent Crisis Intervention® training equips staff to better manage situations of noncompliance or refusal. I know that if a situation occurs where an individual’s behavior becomes so dangerous that other, less restrictive interventions are no longer effective, we have restraint positions that are designed to be safer than others.

And I know that the only 100% safe restraint is the one that never occurs. 

Get tips for making sure your culture of care is trauma-informed.
Kendra Stea
Thanks for your support Kristy.
1/21/2014 9:46:20 AM
Kirsty Esquilant
I agree that this situation is highly traumatic for all of those involved and while we don't know the circumstances of this situation, the author does present valid reasoning and justification as for the need to advocate for training for staff working with vulnerable people.

As she argues "the only 100% safe restraint is the one that never occurs", is totally correct, it is crucial to then look at the pre-events, the levels and behaviours of escalation:
- it is there where our interventions need to be focused
- it is there where staff need to be trained to be confident and competent in knowing how to de-escalate challenging individuals/situations
- it is there where staff will find ways to avoid restraint, and therefore avoid the risk of individuals in our care being injured, or worse.

We regularly train staff in Non-violent Crisis intervention and its philosophies can be seen throughout our policies and procedures. We have committed to a culture of care, welfare, safety and security and I would love to see nothing more than other organisations fighting and ensuring this for the clients in their care.
1/20/2014 6:34:25 PM