ABSTRACT

In situations where the immediate safety of children or others is at risk, residential workers are authorized to use specific measures intended as last resort, namely restraint and seclusion (R&S). This study sought to identify and detail the reasons invoked by residential workers when justifying their decision to restrain or seclude a child. Researchers reviewed and coded 628 anonymized official R&S reports written by residential workers from two different residential treatment centers over the 14 months between September 2015 and May 2017. Researchers used qualitative thematic analysis to analyze official reports. Researchers found nine reasons invoked by residential workers that they regrouped into four themes as follows: workers justified their use of R&S based on their own perceptions of 1) the danger associated with children’s affects and behaviors; 2) their obligation to yield to external constraints; 3) the benefits associated with R&S for children, and 4) the demands imposed by their professional culture. Researchers found that the reasons invoked in official reports by residential workers to justify their decisions are not always consistent with R&S as being methods of last resort. Specifically, residential workers appear to be missing the training and organizational resources needed to use alternative forms of intervention.

摘要

在儿童或其他人的直接安全受到威胁的情况下，住宅工作人员被授权使用旨在作为最后手段的特定措施，即约束和隔离 (R&S)。本研究旨在确定并详细说明住宅工作人员在证明他们决定约束或隔离儿童的理由时所援引的原因。研究人员在 2015 年 9 月至 2017 年 5 月的 14 个月内审查并编码了由来自两个不同住院治疗中心的住院工作人员撰写的 628 份匿名官方 R&S 报告。研究人员使用定性主题分析来分析官方报告。研究人员发现了住宅工人提出的九个理由，他们将其重新组合为以下四个主题：工人证明他们使用 R& S 基于他们自己对 1) 与儿童的情感和行为相关的危险的看法；2）他们有义务屈服于外部约束；3) 与 R&S 相关的儿童利益，以及 4) 他们的专业文化所提出的要求。研究人员发现，住宅工人在官方报告中援引的理由来证明他们的决定并不总是与 R&S 作为最后手段的方法一致。具体而言，住宅工作人员似乎缺少使用替代干预形式所需的培训和组织资源。研究人员发现，住宅工人在官方报告中援引的理由来证明他们的决定并不总是与 R&S 作为最后手段的方法一致。具体而言，住宅工作人员似乎缺少使用替代干预形式所需的培训和组织资源。研究人员发现，住宅工人在官方报告中援引的理由来证明他们的决定并不总是与 R&S 作为最后手段的方法一致。具体而言，住宅工作人员似乎缺少使用替代干预形式所需的培训和组织资源。