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Restriction on restraints in the care for people with intellectual disabilities in the Netherlands: lessons learned from Australia, UK, and United States
- Authors:
- ROMIJN Anita, FREDERIKS Brenda J.M.
- Journal article citation:
- Journal of Policy and Practice in Intellectual Disabilities, 9(2), June 2012, pp.127-133.
- Publisher:
- Wiley
The use of restraints in the care of people with intellectual disabilities in the Netherlands is regulated by the Psychiatric Hospitals Act. Physical or mechanical interventions may be used to avert aggression and danger to a client or his surroundings. The issue of restrictive practices has attracted considerable attention following a television documentary which revealed excessive use of mechanical restraints on an 18-year old youth. The aim of this article was to provide insight into legislation, protocols, and practices in other countries so as to make recommendations for policy on reducing the use of restraints in the Netherlands. Journal articles and policy reports on national policies and practices for the years 2000-11 were analysed for 3 countries: the United Kingdom, United States, and Australia. The findings showed that, although the use of restraints in the care for people with intellectual disabilities is internationally regulated by the criterion of ultimum remedium, policy is clearly not always in line with practice. Common elements in best practices designed to reduce the use of restraints include: strong leadership in care facilities based on national policy; trained staff; a strict monitoring system; and changes in attitudes on the use of restraints, with restraints being identified as treatment failure.
Staff ability to carry out behavioural strategies for individuals with intellectual disabilities and challenging behaviours
- Authors:
- KLAVER Marian, et al
- Journal article citation:
- Advances in Mental Health and Intellectual Disabilities, 10(4), 2016, pp.248-257.
- Publisher:
- Emerald
Purpose: The purpose of this paper is to give an overview of studies that focused on variables likely to affect staff ability to carry out behavioural strategies for challenging behaviours in individuals with intellectual disabilities. Design/methodology/approach: Literature review: studies that were published in a peer reviewed journal, between 1999 and 2016, were selected for this review. Findings: In total, 29 articles were selected. Several factors likely affect staff ability to appropriately carry out behavioural interventions were identified: staff assumptions, distressing emotions elicited by challenging behaviours, reciprocal reinforcement systems, service characteristics and cultural systems. Originality/value: These findings raise the question what staff need in order to be able to change their naturally occurring behaviours in response to challenging behaviours and to carry out behavioural interventions. Future research may identify barriers and facilitators underlying the provision of effective interventions, taking into account the possible role of staff beliefs, their emotions, service characteristics and cultural systems. (Publisher abstract)