A Clinician’s Request for Change
Our letter to the SEPP in support of the proposed new regulations on seclusion and restraint in Massachusetts
I am writing in my role as a clinical psychologist to support the Department for its proposed new regulations on seclusion and restraint in Massachusetts schools, and the desire they reflect to further positive change for youth in this important area of education and practice.
I am among the staff of Think:Kids, a program in the Department of Psychiatry at Massachusetts General Hospital, whose mission is to change the way adults think about and respond to children whose social-emotional presentations are marked by behavioral difficulties. Over a decade ago, I trained on child and adolescent inpatient units at Cambridge Health Alliance, during the time in which they adopted our model of care, Collaborative Problem Solving, in an attempt to respond to a DMH mandate to reduce the use of restraint and seclusion. I was privileged to have witnessed their great success in these efforts, efforts which won an award from the American Psychiatric Association, in fact, for their contributions to improved patient care. I have also worked, both prior to this and subsequently, in facilities that have used these practices more routinely and unquestioningly, as well as in facilities that have invested a great number of resources to implement changes to move their staff away from such practices. I have seen the unnecessary traumatizing of youth in the former settings, and the possibilities for transcending these practices and providing more humane and effective care in the latter. Additionally, I have had the opportunity to serve as an expert witness in more than one case in which a youth in a DMH group home setting has been charged with assault and battery for their actions in resisting a restraint, a most regrettable case of adding insult to injury for troubled youth. Finally, my current work involves supporting both families and institutions in their effort to learn our model and leave such outmoded and dangerous practices behind. Often this work involves hearing distressing stories about the experiences of youth who have been subject to these practices. In short, I have cared about these issues for a long time.
While many of the abovementioned settings I have referred to are not schools, the fact that they have educational components, I do assume, means that you may yet have some degree of oversight regarding their practices. In any event, the issues that pertain are nevertheless the same. The bottom line, moreover, is that there exist practices, implementable in a variety of settings that treat and serve youth, and most certainly including schools, that represent empirically supported alternatives to approaches that either rely on restraint and seclusion as part of their approach to behavior management, or, perhaps more to the point, to approaches that inadvertently induce the kind of behavioral dysregulation which can then seemingly justify or require the need for restraint and seclusion.
I hope that this current effort to amend the regulations around these practices is but one further step toward the banning of such practices in the not-too-distant future.
This is a follow up to Massachusetts DOE wants to hear YOUR thoughts on seclusion and restraint in schools. – See more at: http://thinkkids.org/massachusetts-doe-wants-to-hear-your-thoughts-on-seclusion-and-restraint-in-schools