A recent article about excessive use of restraint and seclusion being used in a school has lead me to reflect on two questions. Why is excessive restraint and seclusion still an issue? How are organisations letting this happen. Given that the Restraint Reduction Network has been around for years, why is it that people think their excessive use of restraint is ok? Those two simple questioning words, “how or why?” can tell us a lot. In our experience, these two simple words at the start of a question will tell you a great deal about the organisation. When we are engaged as trainers for organisations we get lots of questions about our training content.
How?
“How?” questions are often mechanical in nature. Such as “How do we hold him if he drops to the floor?” or, “How do we restrain him if he hits his head on the wall?” or even “How do we stop him from escaping when we restrain him on a sofa?”. These are all questions we’ve been asked in the past year of training. They’re legitimate questions from staff who want to know how to keep people safe in a time of crisis. However, if the primary focus of training is on this type of question, all our responses will be based on solving restraint problems. When this happens, then we see a philosophy of control not of support. In the 26 years that the Timian programme has been delivered we’ve been far more interested in dealing with the question “Why is this happening?”
Why?
When we deliver the Timian programme, we spend at least 75% of the time with students talking about why things are happening. We discuss behaviour as communication, we discuss understanding why people might be in crisis. We spend time on looking at cues and triggers to divert away from having to do physical interventions. “Why is he dropping to the floor?” maybe, it’s just to get away from being restrained. “Why is he hitting his head on the wall?”. Unless we spend more time on these questions, we will spend more time on restraining people.
Why and How?
In Timian, our philosophy leans toward the question why, rather than the question how. This leads us to a more balanced “Why and How” approach. We work with many organisations who use the “Why and How” approach. Why is this happening and then how can we improve our approaches to reduce it from happening? Once we understand why something is happening, the ‘how we support people’ becomes much clearer. If you want to discuss our approaches to reducing restrictive practices, then get in touch.
James Hourihan
Director Timian Learning and Development
