If you follow best practices related to the use of restraint and seclusion in mental health or health care, you’re likely aware of the Six Core Strategies to Prevent Conflict and Violence: Reducing the Use of Seclusion and Restraint (6CS).

These strategies were set by the National Technical Assistance Center of the National Association of State Mental Health Program Directors (NASMHPD) to help mental health professionals establish policies to reduce or eliminate the use of restraint or seclusion in mental health treatment organizations.

The Six Core Strategies outline a best-practices approach by highlighting the need for organizational change, data-informed practices, workforce development, and consideration of consumers’ roles in their own care. The strategies, consistent with our Nonviolent Crisis Intervention® training program, call for the use of debriefing techniques as well as alternatives to the use of restraint and seclusion.

The 6CS have been guiding state and private hospitals and agencies in the US and abroad since 2003. Recently, SAMHSA’s National Registry of Evidence-Based Programs and Practices (NREPP) reviewed the clinical model and posted a summary of the 6CS on its website.

The NREPP site is intended to help organizations determine whether particular interventions meet their needs. As such, the NREPP’s review and posting of the 6CS affirms the dedication of numerous advocates who are committed to helping mental health professionals increase safety for both themselves and their consumers.


Check out our alignment [PDF] to learn how our Nonviolent Crisis Intervention® program parallels the Six Core Strategies.

A principal champion of the 6CS is Kevin Ann Huckshorn, the Delaware director for the Division of Substance Abuse and Mental Health (DSAMH) and an international thought leader on mental health and substance use treatment. Kevin Ann was a speaker at our International Instructors’ Conference in 2006. I’d like to commend her here for her hard work in developing the strategies and ensuring that they are available to professionals who are committed to providing care that is trauma informed and person centered.

A large concern of many who work in health care, mental health care, education, and other human services fields is that restraint and seclusion guidelines, regulations, and laws prevent professionals from being able to do what’s necessary to protect the individuals in their care from harming themselves and others.

What I am so proud of about our training and what pleases me so much about the 6CS is that all of our strategies center on ensuring safety for staff and service users alike. Our philosophy of Care, Welfare, Safety, and SecuritySM extends to all people involved in crisis situations.

Here at CPI, we take heart in all the organizations that have reduced or eliminated the use of restraint and seclusion by changing their cultures of care and implementing our offerings. It’s this type of culture change that keeps staff and consumers safe. I invite all mental health organizations to follow suit and use these strategies as a framework for shaping a new culture of care.

Additional Resources