An Exploration On Attitudes and Beliefs of School Staff On Physical Restraint Use
Presently, a limited knowledge base exists around the use of physical restraint techniques among developmentally disabled youth, as well as the attitudes of and effects on staff who work in settings where physical restraint techniques are utilized (Villani, Parsons, Church & Beetar, 2011). Individuals with developmental disabilities often have an increased need for intensive services when demonstrating aggression or self-injurious behaviors (Antonacci, Manuel, & Davis, 2008). Physical restraint is used in many settings to manage and create safety for individuals who display self-injurious or aggressive behaviors. While the therapeutic efficacy has not been demonstrated for the use of physical restraint, they continue to be used to ensure safety and promote de-escalation of behaviors. The current mixed methods exploratory study fills a gap in the knowledge base about attitudes and beliefs concerning the use of restraints among staff at a school for children who have developmental disabilities.
All staff who work at a school for children with developmental disabilities were invited to participate in the anonymous, web-based survey. A mixed-methods questionnaire was designed based on previous research by Fogt et al. (2008) to measure the attitudes and beliefs about the frequency, therapeutic value, and potential benefits and consequences of the use of physical restraints in this setting. Open-ended questions solicited greater detail around the reactions that staff members experience when involved in incidents utilizing physical restraint techniques.
There were a total of 93 respondents, with satisfactory representation of all categories of staff. 92% of staff reported some form of injury from using restraints, most frequently being bitten (78%) and emotional distress (59%). The majority of participants (92.1%) agreed that physical restraint techniques are needed to keep school safe and that physical restraint techniques increases safety in school (95.4%). Most staff were not upset after being involved in a physical restraint technique (76.5%), but others were uncomfortable and were affected by being involved in a physical restraint technique (32.5%). Staff members stated that they experience an increased heart rate (52%), feeling sweaty (28%) feeling anxious, sad, or upset (26%), feeling exhausted (15%), or experiencing anger or frustration (12%) during or after a physical restraint technique has been utilized.
Most staff reported favorable attitudes towards the use of physical restraint techniques in the school. This is consistent with literature findings that physical restraint can be seen as a means to maintain safety (Fogt et al., 2008). Some staff members seemed to experience significant emotional reactions and responses to being involved in a physical restraint technique, which may contribute to professional burnout. This field of research is very limited, and the present study offers new insight into the experiences of staff members during physical restraint techniques. Institutions that utilize physical restraint techniques to ensure safety of staff and clients may need to explore implementing procedures around debriefing and staff support after a restraint has occurred to possibly reduce some of the negative implications that are experienced as a result of restraint use.