Behavioral assessment and analysis of mechanical restraint utilization on a psychiatric,child and adolescent inpatient setting

A behavioral assessment and analysis of mechanical restraint utilization on a child and adolescent psychiatric inpatient unit was performed to identify contextual variables associated with implementation. The most frequent antecedent conditions correlated with restraint were when staff initiated physical contact towards a patient and when a patient refused to go to, or remain in, the “quiet room” when instructed. These interactions were seen as staff-initiated encounters that elicited aggressive responses from patients and increased the likelihood of restraint because the physical intervention and “quiet room” procedures were implemented in the absence of a comprehensive treatment formulation, and without reference to behavior-specific guidelines. Recommendations to reduce the use of mechanical restraint with child and adolescent inpatients by isolating functionally controlling variables are presented. © 1998 John Wiley & Sons, Ltd.