[Cognitive milieu therapy and restraint within dual diagnosis populations]

The use of restraint is common practice within psychiatry and is most frequently used with patients with a co-occurring serious mental illness and substance abuse or dual diagnosis. Furthermore restraint has being shown to have a negative impact on treatment outcomes and on the psychological wellbeing of patients. Cognitive behavioural therapy has been shown to contribute to positive treatment outcomes for a range of mental health problems, including schizophrenia and substance abuse.

The following study examined the incidence of restraint within a dual diagnosis inpatient ward before and after the implementation of cognitive milieu therapy.

Data collected over a four-year period showed that the incidence of physical restraint was significantly reduced after the introduction of cognitive milieu therapy, and that this reduction was not offset by increases in other forms of restraint.

The implications of these results are discussed regarding the use of restraint on dual diagnosis populations within psychiatric settings.