title: Practice parameter for the prevention and management of aggressive behavior in child and adolescent psychiatric institutions, with special reference to seclusion and restraint.
abstract: This parameter reviews the current state of the prevention and management of child and adolescent aggressive behavior in psychiatric institutions, with particular reference to the indications and use of seclusion and restraint. It also presents guidelines that have been developed in response to professional, regulatory, and public concern about the use of restrictive interventions with aggressive patients with regard to personal safety and patient rights. The literature on the use of seclusion, physical restraint, mechanical restraint, and chemical restraint is reviewed, and procedures for carrying out each of these interventions are described. Clinical and regulatory agency perspectives on these interventions are presented. Effectiveness, indications, contraindications, complications, and adverse effects of seclusion and restraint procedures are addressed. Interventions are presented to provide more opportunities to promote patient independence and satisfaction with treatment while diminishing the necessity of using restrictive procedures.
authors.forename: Kim J
authors.initials: KJ
authors.lastname: Masters
authors.forename: Christopher
authors.initials: C
authors.lastname: Bellonci
authors.forename: William
authors.initials: W
authors.lastname: Bernet
authors.forename: Valerie
authors.initials: V
authors.lastname: Arnold
authors.forename: Joseph
authors.initials: J
authors.lastname: Beitchman
authors.forename: R Scott
authors.initials: RS
authors.lastname: Benson
authors.forename: Oscar
authors.initials: O
authors.lastname: Bukstein
authors.forename: Joan
authors.initials: J
authors.lastname: Kinlan
authors.forename: Jon
authors.initials: J
authors.lastname: McClellan
authors.forename: David
authors.initials: D
authors.lastname: Rue
authors.forename: Jon A
authors.initials: JA
authors.lastname: Shaw
authors.forename: Saundra
authors.initials: S
authors.lastname: Stock
mesh_terms: D000293:Adolescent; D000374:Aggression / Q000187:drug effects / Q000523:psychology*; D002648:Child; D002653:Child Behavior Disorders / Q000188:drug therapy* / Q000517:prevention & control* / Q000523:psychology; D003419:Crisis Intervention; D006778:Hospitals, Psychiatric / Q000331:legislation & jurisprudence; D006801:Humans; D011619:Psychotropic Drugs / Q000627:therapeutic use; D012149:Restraint, Physical / Q000331:legislation & jurisprudence / Q000523:psychology; D012934:Social Isolation / Q000523:psychology; D014481:United States
chemical_list: D011619:Psychotropic Drugs