ABSTRACT

Trauma-informed care (TIC) is receiving growing interest and support as a promising approach to reducing the use of restrictive measures (restraints, seclusions and time-outs) in children and youth living in residential care. In this study, we aimed to compare the use of restrictive measures prior to and following the implementation of a TIC staff training initiative in 44 residential units for children and youth and to explore differences between units and type of measures used. Patterns of change in monthly use of restrictive measures 6 months before and 12 months after the training were compared using growth curve models. Restraints, seclusions and time-outs decreased by 41.82%, 19.91%, and 48.15%, respectively, over a year following the training. Despite these important declines, trajectories of restrictive measures did not change significantly from pre- to post-training when holding the TIC training against stringent criteria. Nonetheless, some units’ characteristics were associated with successful changes. Results are promising, but not conclusive about the ability of this TIC training to produce changes in trajectories of restrictive measures, at least in the first year of implementation. This study highlights the need for rigorous statistical models in further studies to ensure accurate empirical evaluation of TIC staff training programs.

摘要

创伤知情护理 (TIC) 作为一种有希望的方法来减少对居住在寄宿护理中的儿童和青少年的限制性措施（约束、隔离和暂停）的使用，正受到越来越多的关注和支持。在这项研究中，我们旨在比较 TIC 员工培训计划在 44 个儿童和青少年住宅单元实施之前和之后限制性措施的使用情况，并探讨单元之间的差异和所使用措施的类型。使用增长曲线模型比较了训练前 6 个月和训练后 12 个月每月使用限制性措施的变化模式。在培训后的一年中，约束、隔离和超时分别减少了 41.82%、19.91% 和 48.15%。尽管有这些重要的下降，当按照严格的标准进行 TIC 培训时，限制措施的轨迹从培训前到培训后没有显着变化。尽管如此，一些单位的特征与成功的变化有关。至少在实施的第一年，该 TIC 培训能否改变限制性措施的轨迹，结果令人鼓舞，但尚无定论。这项研究强调了在进一步研究中需要严格的统计模型，以确保对 TIC 员工培训计划进行准确的经验评估。但至少在实施的第一年，该 TIC 培训能否改变限制性措施的轨迹，尚无定论。这项研究强调了在进一步研究中需要严格的统计模型，以确保对 TIC 员工培训计划进行准确的经验评估。但至少在实施的第一年，该 TIC 培训能否改变限制性措施的轨迹，尚无定论。这项研究强调了在进一步研究中需要严格的统计模型，以确保对 TIC 员工培训计划进行准确的经验评估。