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Restraints?

2016

My name is Melissa and I am currently in my second-year practicum in Child and Youth Care Counsellor at Mount Royal University.

Throughout my school semester we had an engaging and extremely beneficial CYCC networking event at school. This event was a great way for students in our major to learn what our degree can do for us and the exciting opportunities/jobs we can potentially work for in the future. Our guest speakers for this event were very inspiring and it strongly helped me to reflect and find out what drives me to do this type of work. As I was listening to all the amazing guest speakers and their experiences with jobs, like school counselling, family workers, social workers, group homes, front line and boys and girls club, they went through all their experiences of the good and dilemma they have encountered working in the field. After the event, my classmates and I had the opportunity to meet and interact with the guest speakers and ask them questions.

I was talking to a guest speaker who currently works in an after-school program. He mentioned that there were a few times where he had to restrain individuals who would misbehave.

At my current practicum, I have not yet seen a restraint or been trained to do one since it is not needed at the after-school program. My question around this topic is, for those who have experienced doing a restraint on a youth, how do you maintain a positive therapeutic relationship after such a challenging event for both parties and how do we ensure this as Child and Youth Care practitioners?

Thank you for taking the time to read.

Melissa
...

Hi Melissa,

A good question and a difficult topic. I worked in a residential care centre for about 13 years and in that time I used restraint about 10 times. Looking back, I can only say that 1 or 2 of those were inevitable and necessary. Most of them were as a result of situations that were escalated by the adults responding. I think it more important to be trained in how to de-escalate than how to practice restraining (or whatever you like to call it). When necessary it should be done safely, but it should rarely be necessary. If it happens a lot, something is wrong. As for the relationship, I can’t really answer except to say that in my case the relationship always suffered. Sometimes I was able to repair the rupture in relationship, but not always. I think when restraint is used unnecessarily, it will be very difficult to “repair” such a relationship. I think that appropriate physical containment can even strengthen a relationship, but my personal experience has not seen much of that.

Keep well,

Werner
South Africa
...

Hi Melissa

I would agree completely with Werner's advice. I've always thought that what is called for is self-restraint on the part of the staff.

Restraint can be extremely dangerous, even when used in approved ways: see the report this week in the UK: Approved restraint techniques can kill children, MoJ found.

Adrian Ward
...

Hi,

I agree with Werner. As a past trainer of PART, I noticed that restraining is only taught almost at the end of the course. Most of the course is taught on how to deescalate the situation. Also the most important element of relationships with the young person.

Alfred
...

Hi Melissa,

I agree with Werner, it may be hard to repair a relationship after a restraint, especially if it has been done because a child 'misbehaved' as your guest speaker called it. A restraint should never be a response to misbehaviour, it should be used in response to a dangerous behaviour that would result in the child hurting themselves. Even then, it may be challenging to repair the relationship. I also do not like the term 'restraint'. I use the word 'hold'. For example, I will say to the young person, "I am concerned for your safety, that is why I am holding your arm", etc.,

Unfortunately, I have assisted in several restraints myself. These are never pleasant. The ones I assisted in were a direct response to dangerous behaviours that would have resulted in serious harm otherwise. I mostly worked with non-verbal youth on the Autism Spectrum. Regardless of verbal abilities, I always debriefed with the young person to let them know that I cared about them and that I was there to support them in times of crisis. I let them know that I didn't like holding them and hoped we could work on strategies in the future to avoid it. This kind of life-space interview as soon after the incident as possible is essential in maintaining the therapeutic relationship. When you do your crisis management training this should be a key segment of the training- along with assisting the youth with de-escalation strategies to prevent the restraint.

Hope this helps,

Respectfully,

 Nancy

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