Applying restrictive measures in the care of adolescents with mild intellectual disabilities

Attitudes of support staff and policy implications

V.E.T. Dörenberg, A. de Veer, A.L. Francke, P.J.C.M. Embregts, M. van Nieuwenhuijzen, B.J.M. Frederiks

Research output: Contribution to journalArticleScientificpeer-review

Abstract

Research suggests that restrictive measures are widely used on adolescents with mild intellectual disabilities. In the Netherlands, restrictive measures are defined as all measures that limit the freedom of a person. In most countries, legislation and policies that seek to reduce the use of restrictive measures focus on seclusion and mechanical and physical restraints. The study aimed to investigate the extent to which restrictive practices are used in the care of adolescents with mild intellectual disabilities while also exploring the attitudes of support staff toward these interventions. A survey study was done among a nationally representative Dutch research sample consisting of support staff. A structured questionnaire was completed by 195 staff members (response of 68.7%) working in settings providing care for people with intellectual disabilities. The measures generally used by staff members who work with adolescents with mild intellectual disabilities involved restricting the freedom of movement and so‐called social restrictions (such as limiting the use of mobile phones). Nearly all respondents considered restrictive measures to be justified in the case of danger, physical aggression, or sexually abusive behavior (87.8–96.8%). Frequently mentioned reasons for using restrictive measures were averting or avoiding danger (90.4 and 83.0%, respectively) and calming the adolescent (63.8%). Although seclusion and mechanical and physical restraints were generally considered most intrusive, staff members were aware that social restrictions could also be instrusive. The fact that current policies do not address these measures makes support staff question the lawfulness of their actions. As well as staff training to reduce the use of restrictive measures, rules, and legislation are also needed to clarify the options and limits to using such measures in the professional care of adolescents with mild intellectual disabilities.
Original languageEnglish
Pages (from-to)26-35
JournalJournal of Policy and Practice in Intellectual Disabilities
Volume15
Issue number1
DOIs
Publication statusPublished - 2018

Fingerprint

disability
adolescent
staff
Legislation
legislation
Disabled Persons
freedom of movement
Netherlands
aggression
Surveys and Questionnaires
human being
questionnaire

Keywords

  • AGGRESSIVE-BEHAVIOR
  • CHALLENGING BEHAVIOR
  • CHILDREN
  • EXPERIENCES
  • IMPLEMENTATION
  • PEOPLE
  • PHYSICAL INTERVENTIONS
  • RESPONSES
  • RESTRAINT
  • SECLUSION
  • adolescents
  • mild intellectual disabilities
  • policy implications
  • restrictive measures
  • staff perceptions

Cite this

@article{91cc4f6a74e4436bbc7b911f02562a84,
title = "Applying restrictive measures in the care of adolescents with mild intellectual disabilities: Attitudes of support staff and policy implications",
abstract = "Research suggests that restrictive measures are widely used on adolescents with mild intellectual disabilities. In the Netherlands, restrictive measures are defined as all measures that limit the freedom of a person. In most countries, legislation and policies that seek to reduce the use of restrictive measures focus on seclusion and mechanical and physical restraints. The study aimed to investigate the extent to which restrictive practices are used in the care of adolescents with mild intellectual disabilities while also exploring the attitudes of support staff toward these interventions. A survey study was done among a nationally representative Dutch research sample consisting of support staff. A structured questionnaire was completed by 195 staff members (response of 68.7{\%}) working in settings providing care for people with intellectual disabilities. The measures generally used by staff members who work with adolescents with mild intellectual disabilities involved restricting the freedom of movement and so‐called social restrictions (such as limiting the use of mobile phones). Nearly all respondents considered restrictive measures to be justified in the case of danger, physical aggression, or sexually abusive behavior (87.8–96.8{\%}). Frequently mentioned reasons for using restrictive measures were averting or avoiding danger (90.4 and 83.0{\%}, respectively) and calming the adolescent (63.8{\%}). Although seclusion and mechanical and physical restraints were generally considered most intrusive, staff members were aware that social restrictions could also be instrusive. The fact that current policies do not address these measures makes support staff question the lawfulness of their actions. As well as staff training to reduce the use of restrictive measures, rules, and legislation are also needed to clarify the options and limits to using such measures in the professional care of adolescents with mild intellectual disabilities.",
keywords = "AGGRESSIVE-BEHAVIOR, CHALLENGING BEHAVIOR, CHILDREN, EXPERIENCES, IMPLEMENTATION, PEOPLE, PHYSICAL INTERVENTIONS, RESPONSES, RESTRAINT, SECLUSION, adolescents, mild intellectual disabilities, policy implications, restrictive measures, staff perceptions",
author = "V.E.T. D{\"o}renberg and {de Veer}, A. and A.L. Francke and P.J.C.M. Embregts and {van Nieuwenhuijzen}, M. and B.J.M. Frederiks",
year = "2018",
doi = "10.1111/jppi.12223",
language = "English",
volume = "15",
pages = "26--35",
journal = "Journal of Policy and Practice in Intellectual Disabilities",
issn = "1741-1122",
publisher = "Wiley-Blackwell",
number = "1",

}

Applying restrictive measures in the care of adolescents with mild intellectual disabilities : Attitudes of support staff and policy implications. / Dörenberg, V.E.T.; de Veer, A.; Francke, A.L.; Embregts, P.J.C.M.; van Nieuwenhuijzen, M.; Frederiks, B.J.M.

In: Journal of Policy and Practice in Intellectual Disabilities, Vol. 15, No. 1, 2018, p. 26-35.

Research output: Contribution to journalArticleScientificpeer-review

TY - JOUR

T1 - Applying restrictive measures in the care of adolescents with mild intellectual disabilities

T2 - Attitudes of support staff and policy implications

AU - Dörenberg, V.E.T.

AU - de Veer, A.

AU - Francke, A.L.

AU - Embregts, P.J.C.M.

AU - van Nieuwenhuijzen, M.

AU - Frederiks, B.J.M.

PY - 2018

Y1 - 2018

N2 - Research suggests that restrictive measures are widely used on adolescents with mild intellectual disabilities. In the Netherlands, restrictive measures are defined as all measures that limit the freedom of a person. In most countries, legislation and policies that seek to reduce the use of restrictive measures focus on seclusion and mechanical and physical restraints. The study aimed to investigate the extent to which restrictive practices are used in the care of adolescents with mild intellectual disabilities while also exploring the attitudes of support staff toward these interventions. A survey study was done among a nationally representative Dutch research sample consisting of support staff. A structured questionnaire was completed by 195 staff members (response of 68.7%) working in settings providing care for people with intellectual disabilities. The measures generally used by staff members who work with adolescents with mild intellectual disabilities involved restricting the freedom of movement and so‐called social restrictions (such as limiting the use of mobile phones). Nearly all respondents considered restrictive measures to be justified in the case of danger, physical aggression, or sexually abusive behavior (87.8–96.8%). Frequently mentioned reasons for using restrictive measures were averting or avoiding danger (90.4 and 83.0%, respectively) and calming the adolescent (63.8%). Although seclusion and mechanical and physical restraints were generally considered most intrusive, staff members were aware that social restrictions could also be instrusive. The fact that current policies do not address these measures makes support staff question the lawfulness of their actions. As well as staff training to reduce the use of restrictive measures, rules, and legislation are also needed to clarify the options and limits to using such measures in the professional care of adolescents with mild intellectual disabilities.

AB - Research suggests that restrictive measures are widely used on adolescents with mild intellectual disabilities. In the Netherlands, restrictive measures are defined as all measures that limit the freedom of a person. In most countries, legislation and policies that seek to reduce the use of restrictive measures focus on seclusion and mechanical and physical restraints. The study aimed to investigate the extent to which restrictive practices are used in the care of adolescents with mild intellectual disabilities while also exploring the attitudes of support staff toward these interventions. A survey study was done among a nationally representative Dutch research sample consisting of support staff. A structured questionnaire was completed by 195 staff members (response of 68.7%) working in settings providing care for people with intellectual disabilities. The measures generally used by staff members who work with adolescents with mild intellectual disabilities involved restricting the freedom of movement and so‐called social restrictions (such as limiting the use of mobile phones). Nearly all respondents considered restrictive measures to be justified in the case of danger, physical aggression, or sexually abusive behavior (87.8–96.8%). Frequently mentioned reasons for using restrictive measures were averting or avoiding danger (90.4 and 83.0%, respectively) and calming the adolescent (63.8%). Although seclusion and mechanical and physical restraints were generally considered most intrusive, staff members were aware that social restrictions could also be instrusive. The fact that current policies do not address these measures makes support staff question the lawfulness of their actions. As well as staff training to reduce the use of restrictive measures, rules, and legislation are also needed to clarify the options and limits to using such measures in the professional care of adolescents with mild intellectual disabilities.

KW - AGGRESSIVE-BEHAVIOR

KW - CHALLENGING BEHAVIOR

KW - CHILDREN

KW - EXPERIENCES

KW - IMPLEMENTATION

KW - PEOPLE

KW - PHYSICAL INTERVENTIONS

KW - RESPONSES

KW - RESTRAINT

KW - SECLUSION

KW - adolescents

KW - mild intellectual disabilities

KW - policy implications

KW - restrictive measures

KW - staff perceptions

U2 - 10.1111/jppi.12223

DO - 10.1111/jppi.12223

M3 - Article

VL - 15

SP - 26

EP - 35

JO - Journal of Policy and Practice in Intellectual Disabilities

JF - Journal of Policy and Practice in Intellectual Disabilities

SN - 1741-1122

IS - 1

ER -