Staff members' beliefs about seclusion and restraint in child psychiatric hospitals

Staff members beliefs about seclusion and restraint are influential in determining how and when these interventions are employed. Yet there are few studies of staff beliefs in individual hospitals and no comparative studies across hospitals.

To measure staff members' beliefs about the rationale for and efficacy of the use of seclusion and restraint with children and adolescents.

A survey of staff members (N = 320) from 13 public and private child psychiatric hospitals.

Results indicate a low to moderate level of confidence among all staff groups regarding the efficacy of seclusion and restraint. Staff members from private hospitals were significantly more positive in their assessment of these interventions than were staff members from the public sector.

We hypothesize that the persistent use of coercive interventions in which staff have a low level of confidence reflect both the influence of tradition in the management of aggressive behavior and unacknowledged avoidant/coercive staff responses to patents labeled as deviant. Differences between the public and private sectors and between hospitals within each sector imply that the practice of seclusion and restraint may be idiosyncratic to each institution, and suggest the need for a generally accepted standard for their use.