The six core strategies for restraint reduction

James Hourihan, Author

Since the establishment of the Restraint Reduction Network, there is an increased focus on reducing the use of restraint in social, educational, healthcare settings across the UK. It is well known that the abuse of restraint under extreme circumstances can cause serious harm to both the individual and staff on a physical and emotional level. 

Restraint reduction requires a shift in thinking about challenging behaviour. Instead of seeing it as something that needs to be controlled or punished, we view it as an opportunity to learn more about the person and develop more positive alternatives to support them.

In this blog post, we’ll explore each of the core six strategies for restraint reduction in depth and how they work to promote safe, efficient and humane care. 

Six key restraint reduction strategies 

The six restraint reduction strategies were set out by the National Association of State Mental Health Program Directors (NASMHPD) to provide a framework for reducing the use of restraint and seclusion. These are based on research evidence from faculty staff and service users personal experiences in successful reduction events. 

1. Leadership towards organisational change – Positive behaviour support (PBS) teams help organisations develop a necessary infrastructure and philosophy that promotes a positive environment with the involvement of senior management. At Timian, we ensure you and your staff implement restraint reduction policies and practices that are person-centred and measurable for continuous improvement. 

2. Use of data to inform practice – In order to determine the effectiveness of a restraint reduction plan, it is essential to know the outcomes of a facility’s efforts towards reducing restrictive interventions and seclusion. This can be achieved through the collection and analysis of data on restraint incidents which can then be used to inform practice and make changes at both an individual and organisational level.

3. Workforce learning and development – A key component of reducing restraint is ensuring that all staff are adequately trained in the use of physical intervention and de-escalation strategies based on positive behaviour support. Furthermore, it is important that workers are kept up-to-date with changes in policy and practice. Train-the-trainer course and regular refresher training from Timian enables senior managers and staff to be confident and competent in supporting people in crisis.

4. Family and peer roles within inpatient settings – The involvement of families, staff and peers is vital in aiding people with behaviours that challenge and reducing the use of restraint. They can provide practical and emotional support, as well as act as advocates for the person’s rights. An organisation recognises the importance of these roles and gives individuals the ability to manage situations safely and ethically. 

5. Use of restraint and seclusion interventions – There are a range of positive behaviour support resources and tools that can be used to avoid or defuse situations that may lead to the use of restraints. These include verbal de-escalation techniques, distractions, environmental modifications and physical interventions (such as guided holding). 

6. Debriefing techniques – It is important to debrief following any restraint incidents, in order to learn from what happened and make any necessary changes to practice. This should involve all staff and witnesses who were involved in the incident, as well as the person who was restrained. The debrief should be conducted as soon as possible after the event for immediate analysis and should be facilitated by someone with training in PBS. 

By following these best practice guidelines, staff and providers can ensure that their patients receive the safest and most effective care possible.

Positive behaviour management training from Timian 

If you would like to find out more about the six core strategies for restraint reduction and how they can benefit your organisation, please contact us now on 0800 987 4075 or click here to book a course. 

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