Early Identification of Seclusion and Restraint Patterns During Adolescents' Course of Residential Treatment

Abstract

Early identification of youth who will exhibit the most challenging behavior during the course of a residential stay would allow clinicians to allocate limited resources to best manage these youth. Seclusion/restraint procedures were examined for 156 youth in two public residential facilities from July 2000–September 2005. Few seclusion/restraints occurred in the first month, but this peaked in months two and three. Youth subgroups with different trajectories for the frequency of seclusion/restraint use were distinguishable by the first 60 days. By the second month in residence clinicians can identify youth who will continue to exhibit challenging behavior.

KEYWORDS:

• residential care
• seclusion and restraint
• aggressive behavior
• early identification

We are grateful for the support of: Dr. Brian Hepburn, Director, Maryland Mental Hygiene Administration (MHA); Child Mental Health Institute for Children and Adolescents (Gayle Jordan-Randolph, MD, Jean Smith, MD, Holly Sikoryak, MD, David Horn, MD [MHA]; Eileen Hansen, LCSW, Ruth Anne McCormick, RN, C., DNSc, [University of Maryland]; and Jane Walker [Maryland Coalition of Families for Children's Mental Health]). The authors are grateful to Sarah Davarya for her assistance with the data collection. This work was made possible through the financial support of the Maryland Mental Hygiene Administration.