Therapy Neurodiversity Collective members do not use Restraint and Seclusion in our Practices
Seclusion leads to significant trauma and increases the chance of injury and even death. There is no data to support its use. The use of seclusion must be banned.
Restraint is never therapeutic! “Physical restraint is an outdated crisis management technique used in schools, psychiatric facilities, hospitals, and prisons. Physical restraint is disproportionately used on disabled and marginalized populations. Physical restraint is dangerous and can lead to significant trauma, serious injuries, and even death. There are far better ways to work with people that need compassion and support.”
– Guy Stephens, Founder and Executive Director of Alliance Against Seclusion and Restraint.
While Therapist Neurodiversity Collective accepts that there may be very rare or extreme crisis circumstances where people may need to be quickly restrained to keep themselves or other people safe from harm temporarily until the immediate crisis is over, restraint has become part of an established routine in schools, residential homes, and treatment centers and in medical settings. Members prioritize non-aversive, trauma-informed interventions. Members are not “behavior fixers.”
Restraint and Seclusion
Physical restraint immobilizes or reduces the ability of a person to move their torso, arms, legs, or head freely. The term physical restraint does not include a physical escort. Physical escort means a temporary touching or holding of the hand, wrist, arm, shoulder, or back for the purpose of inducing a student who is acting out to walk to a safe location.
Mechanical restraint is any mechanical apparatus, material, device, or equipment that is attached to or adjacent to a human body that restricts their freedom of movement and normal access to their own body. The person generally cannot easily remove the restraint should they have need or want.
Chemical restraints include drugs that restrict the person’s ability to move or control their behavior which were not prescribed by a physical as a standard treatment for the person’s condition and or that are not administered as prescribed (e.g., a much larger dose is given). The dangers of chemical restraint are documented by the Hartford Courant in 1989. (Jess Butler)
Seclusion is the involuntary confinement of a person alone in a room or area from which the person is physically prevented from leaving. Seclusion does not include a timeout, which is a behavior management technique that is part of an approved program, involves the monitored separation of the student in a non-locked setting, and is implemented for the purpose of calming until the person is calm and ready to re-enter the area from which they were separated.
These are violations of human rights.
Restraint is uncomfortable, and often painful, even excruciating. The loss of functionality that comes with being restrained may lead to muscle atrophy, resulting in decreased mobility and freedom of movement. Restraint use causes emotional and psychological harm and a lost sense of dignity and autonomy. Restraint can result in death (murder).
Restraint or seclusion should never be used as punishment or discipline for non-compliance. Restraint and seclusion are often used for noncompliance, disrespect, bad language, property damage, and minor behaviors, which is unacceptable.
Therapist Neurodiversity Collective does not use physical restraint or seclusion in therapy settings other than in an emergency situation – imminent, serious, physical harm and bodily injury including
• A substantial risk of death;
• Extreme physical pain;
• Protracted and obvious disfigurement; or
• Protracted loss or impairment of the function of a bodily member, organ, or mental faculty.
The use of PRONE RESTRAINT is dangerous and deadly. It’s a HUMAN RIGHTS VIOLATION!
Illustration by Kate Jones
People have died in restraints from many causes, including:
• Asphyxia – that is, suffocating, often while being held face down, with staff
sitting or putting pressure on an individual’s person’s back or abdomen, or when
staff have placed blankets or towels around the face;
• Aspiration – that is, swallowing one’s own secretions, generally while being
restrained face-up; and
• Cardiac events brought on by exertion, medication interactions, and unknown
“Restraints and seclusion must only be used in emergency situations to ensure the physical safety of the child and all others and should never be used for purposes of discipline, retaliation and convenience. …The use of chemical restraints and mechanical restraints should be prohibited.” – Child Welfare League of America.
– The Use of Restraints and Seclusion in Residential Care Facilities for Children
“Overuse and abuse of restraints and seclusion are symptoms of poor-quality care in facilities, poor state oversight, and misdirected public policy. State and federal agencies must take a greater role in assuring the safety and protection of children and adults who experience these interventions.”
National Mental Health Association Position Statement: The Use of Restraining Techniques and Seclusion For Persons with Mental or Emotional Disorders (NMHA Program Policy P-41)
The Federal Substance Abuse and Mental Health Services Administration (SAMHSA) issued a National Call to Action in 2003 concerning restraint and seclusion. “SAMHSA is committed to working with States, communities, consumers, families, providers, and provider organizations to ultimately eliminate the use of restraint and seclusion. Individuals with mental illness should not be confined, restrained, or retraumatized by the persons and resources put in place to help them.”
For Further Reading:
National Ban on School Use of Seclusion and Restraint of Students Introduced in Congress – ProPublica
New Data Shows the Use of Seclusion and Restraint Increased in Illinois Schools During the 2017–18 School Year – ProPublica
How Often Do Schools Use Seclusion and Restraint? The Federal Government Isn’t Properly Tracking the Data, According to a New Report – ProPublica
The Quiet Rooms – ProPublica
How Some Schools Restrain Or Seclude Students: A Look At A Controversial Practice – npr
RESTRAINT AND SECLUSION – A RISK MANAGEMENT GUIDE: Stephan Haimowitz, J.D., Jenifer Urff, J.D., Kevin Ann Huckshorn, R.N., M.S.N, CAP, ICADC
Helpful Organizations and Resources:
Alliance Against Seclusion and Restraint
“Our mission is to educate the public and connect people who are dedicated to changing minds, laws, policies, and practices so that restraint and seclusion are reduced and eliminated from schools across the nation (and beyond).”
Types of Restraint – Alliance Against Seclusion and Restraint