Special needs and restraints?/Opinions on restraints?
My name is Monique, and I am at a University in my second year studying youth and family. I am new to the degree, but not new to children and youth.
I am enjoying my practicum placement, and I am working with special needs children.
The place that I am at, practices full restraint of their children and youth. I don't have any experience in this area, nor am I trained in it. I have heard mixed opinions about it depending on the environment that you practice it in.
Last year in my first and second semester, I had an instructor say to me that she does not believe in full restraint, and she also said that she believes there are other ways. I have also spoken to people at my placement, who have been attacked and lunged at, and very much believe in restraining.
My question is, to anyone and everyone, what are the other options to full restraint, and do you think that it makes a difference in the environment that you are in?
My name is Brett Bairstow. I am currently in my 2nd year at Mount Royal university majoring in Child and Youth Counselling.
I have begun my practicum this year, and so far I am loving it. I gain a lot of hands on experience, as well as learn a lot about Child and Youth Care practice. If a situation arises at my practicum placement where a child is causing physical harm to themselves, other children, or the teachers, restraints may happen. It is in no way encouraged, in fact the teachers I talk to dislike restraining the youth, but it’s more of a last resort type option. These restraints happen when nothing else can be done. All the teachers have been trained in restraints, so they are using the correct procedures. Seeing a restraint happen the first time was hard to watch, but after talking to the teachers I realize why youth care workers feel restraints are sometimes necessary. After the restraint takes place the teachers talk with the children about the situation, what happened, why they had to restrain them, and how to avoid it. If the child is okay with it sometimes the teachers will snuggle with, hug or rub their back in efforts to re-create the relationship with the child.
Seeing as how restraint can be a controversial subject, I wanted to know what other’s opinions on restraints are? And also how others rebuild the relationship with the individual after the restraint has happened?
Hey, my name is Sean and I been working for the school board for over four years. I have watched and been involved with lots of restraints. I have worked in a section 23 classroom where every day you are in a restraint. It all depends on the environment and the child you are working with. Some kids I have been able to calm down without the need of restraint and others I have found if you do not do a full restraint someone is going to get injured and that includes the child. It’s only done in a situation where the child or someone else is at risk. Some schools have a special room where you can place the child to calm. I find that works too – it all depends.
I am not all that familiar with the differences between “full restraint” and other types of restraint, I am sure there are others with far more expertise than me. But let me offer the following in an attempt to answer your question.
I have worked in a residential care centre that care for 120 children for 13 years, and in that time I have had to physically hold children to prevent injury about 10 times. There were very few other times beside those 10 times that anyone needed to use restraint.
Of the 10 times or so I can remember, I can honestly say that only about 2 or 3 of them were justified. Only 2 or 3 times was physical holding really needed and could not have been prevented. The other 7 times it could have been prevented if the staff were properly trained in de-escalation. Most of the times that I had to hold a child who were unable to contain themselves physically, upon evaluation after the event we found that the situation was escalated by staff who did not respond appropriately. So in 13 years I think 3 instances of restraint were really justified.
I don’t think it is as important that staff are trained in restraint as it is that they are trained in preventing restraint.
In the instances where I had to hold (restrain) a child, most of those did not contribute positively towards the relationship and was damaging. Only the 3 that were really justified did not result in damage to our relationship, because in those instances the children truly appreciated the fact that I was prepared to hold them when they could not “hold” themselves.
These were expensive lessons for me to learn. It came at expense to me as well as to the children involved. Holding a child who has lost control physically and mentally is traumatic to both, and it has to be done properly and only when really, really needed.
An interesting observation I make – although I have no way of substantiating this – is that restraint seems to be used more often in settings where other forms of touch between staff and children are not allowed, e.g. a pat on the shoulder, a hug, etc.
If staff are really well trained and work together as a team, restraint will very rarely be needed. If staff accept restraint as an “option”, I think it is more likely that they will find reasons to use it. If you “believe in” restraint, I have to wonder exactly what you believe about restraint – and I think this is where you might want to start. Because I also believe in restraint, but I believe it is almost never needed. That means that it is never in my day-to-day “toolkit” for use with children. I don’t consider it, which means I keep looking for other ways to resolve things. If it is something you keep in your toolkit as an option, I would imagine you might use it sooner rather than later. This is the danger as I see it.
So perhaps one way of measuring would be to ask “what is the effect of restraint on the child being restrained?”. How do they feel about things afterwards? Do they experience it as a useful, necessary intervention that helped them in some way?
I think the best training in restraint is the training that teaches you how to do everything else really well.
Hope this helps,
Werner van der Westhuizen
I always find getting out of the way and organizing your environment that puts you at the least amount of risk possible a suitable option opposed to restraint.
I recognize though that might not be possible in certain settings and if it’s to help maintain the SAFETY of the individual and those around them then restraint may be necessary.
A young person that I worked with had school personnel fully restrain him after he started having a meltdown, and was on the second story of the school next to the railing (which overviews the lobby downstairs), he kept going over to the railing and 'draping' his body on it. School staff feared he would (either on purpose or accidentally) flip over the railing to the bottom.
Thank you Lisa, Werner and Sean in response to my restraining question. Your responses were enlightening and informative. This conversation has definitely provoked me to further research.
I have come to know about the book, Gentle Touching, and I think I will try to find a copy. Lisa, I agree, restraining can be used if the child/youth wants to harm themselves or someone else. Werner, I appreciate your honesty about how traumatic restraining can be, especially when some caregivers do not want to talk about these things.
It has been beneficial for short term use, but I question its use long term. From the information that I can read and obtain, restraining has some devastating effects on everyone. To all of you, your thoughts and comments have reduced my fear of this subject, and for that I am grateful.