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There's no place for physical restraint in residential child care

Monday 14 October 2019

Alex Horne is a Participation Assistant with South Ayrshire Champions Board and is care experienced.

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There’s no place for physical restraint in residential child care in the 21st century – there, I’ve said it, put it out there! I advocate for a total ban on restraining young people, and I would start it right now if I could.

When a young person acts up or shows signs of distress, there are lots of other ways that carers can de-escalate the situation, calm down the young person, and let them feel ‘heard’. Violence is not the answer.

For me it all starts with trust, and that is built through respectful relationships, and through two-way conversations. It’s important residential child care workers get to know the young people in their care, find out what could be bothering them, and what their emotional triggers are, so that they very seldom reach crisis point, and if they do, what will calm them down.

Finding out the hard way

I speak from experience - I spent several years in a residential school, and was restrained every day I was there. If I tried to walk out of class because I didn’t want to be there – I was restrained, if I showed emotion – I was restrained. After every restraint, when I had calmed down, I was then made to apologise for kicking off and explain why I had, before I was left alone. There was little thought given to my emotional wellbeing and how this affected me.

I remember one day in the residential house I was watching football with a member of staff, when another young person came in, grabbed the remote, switched off the TV, and ran away. I gave chase, angry he had disturbed the game. In the chaos that followed I accidently knocked against another member of staff – this led to me being restrained. I still get angry at the injustice of that - I felt I had done nothing wrong, it was the other boy who had instigated it and he got off scot-free. I felt betrayed and angry – this whole incident had been witnessed by the men now pinning me down. I felt that it always seemed to be MY fault.

One night I overhead staff at the start of their shift saying “Who are we going to restrain tonight?” It appeared to me, as a troubled and emotional teenager, that they enjoyed exerting control over us. I tried once to complain, but the complaints procedure meant I had to go to the very people that I had the problem with to get a complaint form, so I didn’t get very far.

I grew up feeling I was always in the wrong, and as I got older I suppressed my emotions and feelings, as I thought you should be punished for feeling emotional and it was definitely not okay to talk about how I felt or what was wrong. It’s taken me a long time to come to terms with this.

Physical restraint doesn’t get to the root of the problem

Why do I think there is now no place for restraint today? Because my time in residential care wasn’t all bad, and I saw first-hand other approaches that could be used. I formed a really close bond with one carer who always used other techniques, techniques that worked for both of us. He would take me outside and leave me alone for a short time to cool off, as he knew that’s what worked – he had taken the time to get to know me. Then we would go for a long drive in the car, where we would talk about why I was upset and allow me to get things off my chest, and talk about other strategies for managing my emotions.

Using restraint on a young person does not get to the root of the problem - it forces the young person to conform and comply, but the worry, the upset, the trauma are still there bubbling under the surface, leading to resentment and further trauma.

The need to be emotionally available

There are better techniques that carers could, and should, employ to deal with young people’s emotions, and carers need to be emotionally available to work alongside a young person showing signs of needing help.

I believe all residential child carers should be trained in relationships, ACEs, and teambuilding, but this must not happen in isolation. In a truly participatory way, young people must be in the room and have their opinions and voice heard, listened to, and acted upon. These are important but difficult conversations that need to take place for practice to improve, and I expect some staff would push back on this approach.

It’s important we find a way to residential child care workers along on this journey, as a ban on physically restraining young people must, and will, happen.

The views expressed in this blog post are those of the author/s and may not represent the views or opinions of CELCIS or our funders.

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Author: Alex Horne

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Posted by Brodie Paterson on
brodieliz1@hotmail.com

Abuse via the misuse of restraint and that of power more generally has been a perennial problem in some residential child care and education provision in Scotland, the UK and Internationally. A failure to learn and apply the lessons derived from multiple inquiries into failures of care have meant that corrupted cultures have repeatedly been allowed to develop and exert their malign influence creating thereby the bad barrels within which abuse is fostered and even normalized. A complete ban on restraint is therefore intuitively attractive and would perhaps serve to acknowledge the wrong done to many vulnerable children. However, as Mencken observed 'For every complex problem there is an answer that is clear, simple, and wrong'. There are children being supported today in residential child care whose self harm places them at such a degree of immediate risk that only physical intervention can provide the physical safety necessary to create a space in which the root causes of their distress can be explored and resolved and hope established. There are children in residential care whose distress may present in the form of serious violence to staff which can only be managed with an adequate degree of safety via recourse to physical restraint. Restraint can by misused but its misuse is not inevitable and robust governance and external inspection can minimize it.

Better training for staff, better reflective supervision and robust debriefs can help staff provide what Skelly describes as the 'good hold' the non physical holding that happens when staff are supported to be attuned, compassionate, empathic to the childs distress, can be present to that distress without rejecting, denying or punishing it and instead calmly accept it whilst searching for the meaning underneath it and addressing the issues involved.

Perhaps instead of focusing on eliminating restraint a focus on increasing the number of 'good holds' might recommend a way forward that allows us both to support those most vulnerable and deliver services in which recourse to restraint becomes less necessary?
Posted by John Radoux on
I am just commenting to say I completely agree with every word of Brodie's comment and argument which is beautifully articulated..
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