CALM asked our community of experts to give us their thoughts on the advocacy of restraint elimination. Do they see it as an ethical action or just a marketing strategy? Read on to find out!
Lorna Walker, Wellbeing Specialist
“I believe in the complete elimination of restraint for the purposes of control, compliance, obedience to an arbitrary set of rules, behavioural management, assertion of a hierarchy, and emotional regulation.”
I believe in the complete elimination of restraint for the purposes of control, compliance, obedience to an arbitrary set of rules, behavioural management, assertion of a hierarchy, and emotional regulation.
The question illustrates the complexity of the issue; sometimes it’s both an ethical action and a marketing strategy, and perhaps sometimes, it’s neither. The most dangerous camp to land in is the one in which it is only safe, or acceptable, to adhere to one view; where there is no space for exploration, curiosity and not-knowing.
Linda Hume, Positive Behaviour Support Specialist
“We need to stop hurting people in the name of helping them” (Lovett 1996)
What does six-year-old Max who is distressed, crying and throwing his books around the classroom care about the new buzz words “we advocate restraint elimination” on your shinning glossy organisation brochure, if what he experiences when he is most distressed is two adults, scooping him up and moving him to the quiet room to sit alone to think about his behaviour and, later to apologise to the class.
We need to be attuned to the message of the behaviour that we are presented with, and I do mean all behaviour, not just the difficult or crisis stuff. People’s behaviour gives us important messages about what people think, how they feel, their aspirations…
Sharon Paley, Registered Nurse with a professional interest in reducing and eliminating restrictive practices.
AUTHOR NOTE: I have worked across various settings, including non-government sector, health, education and social care in the UK and Australia and published papers on the above topic. I have provided expert witness testimony to the court of protection in the UK related to the use of restrictive practices. Views expressed ‘in conversation’ are personal and do not reflect those of my employer past or present.
“I would question the ethics of advocacy for total restraint elimination as an objective, while I wholeheartedly agree we should always work to attain it.”
Restrictive practices are controversial, their use can have negative outcomes for people exposed to them and people employed in human services where they are applied (Butler 2019, Department of Health, Victoria 2013, McCarthy 2018, Peterson 2010). Given the risks associated with restrictive practices the goal must always be the eventual elimination of their use.
Kate Sanger, Parent and Co-Creator of www.mycommpass.com
“…we must eliminate the misuse of restraint, but ensure the safety, dignity and happiness for individuals like our daughter.”
As a parent of a young adult with a severe learning disability, I have lived with my child displaying behaviours described as challenging and also self-injurious behaviour, over the past 28 years.
When you learn your child will be disabled you don’t worry or think about behaviours during the first year. We noticed her behaviours around 2-3 years of age; these weren’t your typical toddler’s tantrums, some could really be distressing for us as a family to witness, and place my child in a dangerous situation.
Dr. Brodie Paterson, CALM Clinical Director
“I [fear] … calls for complete restraint elimination via bans represent an example of Mencken’s infamous observation that ‘for every complex problem there is an answer that is clear, simple, and wrong’.”
A number of years ago some colleagues and I engaged in a debate regarding prone restraint – a perennially controversial aspect of restrictive practices. Those proposing a ban under the auspices of the Millfield charter argued that a ban was urgently needed because ‘prone’ was uniquely dangerous based on their interpretation of the literature.
As an opponent then – and now – of such a ban, my counter-argument had three main points. One, framing the issue of safety during restraint as only about ‘prone’ when there was already evidence suggesting that other restraint procedures had the potential to be equally – if not even more dangerous – was in and of itself dangerous because it had the potential to lead to the replacement of ‘prone’ by something that involved even greater risk.
“The current advocacy of restraint elimination at national and organisational levels must be regarded as overly simplistic, premature and therefore unethical. A product of marketing and political sleight of hand.”
Arguing against restraint elimination is akin to opposing goodness. It certainly invites attack from the illiberal “Liberals” of the Wokeness cult. Slogans contain a self-evident appeal but they may also act to obscure underlying complexities and unforeseen consequences: the horrors which await should the objective actually be achieved. Consider “defunding the Police” for instance. In the absence of adequate foundations the strategic shift towards restraint elimination may increase; risk, illicit restraints, under-reporting, invisibility, staff turnover, and further corruption of many service cultures.