Journal of Psychology & Psychotherapy
Open Access

Abstract

Paul Sunseri

The use of physical restraint in residential treatment programs for children remains highly controversial. Physically coercive techniques have the potential to worsen a child’s mental health condition, cause psychological trauma, and result in physical injury or even death. Numerous attempts have been made to reduce the use of physical restraint in institutions when children are deemed “out of control”, but no approach has eliminated its use altogether. In this review article, institutional incentives are discussed that make it difficult, if not impossible, for residential programs to stop restraining children. Staff are trained to respond to a dysregulated, aggressive child by staying actively engaged with them (interacting with them), a practice that runs counter to what is recommended by empirically supported treatments. The practice of disengagement, i.e., delaying interaction until the child has completely calmed down, combined with other clinical strategies described in this article, is a more effective alternative. There is no practical way to use disengagement in residential treatment, however, it is successfully used in family- and home-based treatment approaches. Family treatments have over 40 years of documented clinical efficacy with challenging youth and do not use physical restraint, but they are still relatively unknown to the public. The practice of restraining children must end, and family-based treatments offer an effective alternative to residential treatment. Children with serious mental health challenges deserve an opportunity to get better at home with the support of their own families before resorting to more invasive treatments that can harm them.

Received Date: 2024-12-16