Physical restraint and the therapeutic relationship

Abstract

The role of the forensic mental health nurse has led to many debates due to the conflicts between security and therapeutic aspects of their role. Physical restraint is a security element of the role which may have an impact on their ability to work therapeutically with patients. This study examined the impact of physical restraint on the nursing staff–patient therapeutic relationship. This was investigated in a secure unit in the North of England. Eight semi-structured interviews were conducted with patients across the service, and thematic analysis was undertaken. Five themes were identified from the data which highlighted the impact of the physical restraint as a power imbalance, the experience as traumatic, the importance of justification, the negative attributes and motives of some staff and the impact of coping with powerlessness. Clinical implications and research recommendations are discussed further in this article.

Keywords:

• physical restraint
• therapeutic relationship
• therapeutic alliance
• secure services
• forensic mental health nursing

Disclosure statement

No potential conflict of interest was reported by the authors.