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Collaboration lowers incidence of physical restraint for youth in care

June 20, 2017

(0) Comments.  |   Tags: article,   collaboration,   Elliott Smith,   evaluation,   Michael Nunno,   RCCP,   research,   residential care,   youth,  
Michael Nunno and Elliott Smith

Michael Nunno and Elliott Smith

By Sheri Hall for the BCTR

Two BCTR researchers have been working with a Connecticut child welfare agency to implement and evaluate a program that promotes evidence-based approaches in supporting troubled youth. The Cornell researchers and two agency administrators published the results of their collaborative effort in March in the journal Child Welfare under the title “Benefits of embedding research into practice: An agency-university collaboration”.

Since 2009, Michael Nunno and Elliott Smith, members of the research team for the Residential Child Care Project (RCCP), have consulted with Waterford County School in Connecticut, which provides residential and day care to youth with mental health problems, behavioral issues, addiction and emotional problems.

A team of agency executives, clinicians, supervisors and staff members worked with RCCP staff and consultants to learn about and implement the Children and Residential Experiences: Creating Conditions for Change (CARE) program model.  The CARE model is a research-informed framework created at the BCTR by Martha Holden and her RCCP colleagues that focuses on improving interpersonal relationships between caregivers and youth.  Nunno and Smith were part of the effort to examine if CARE was making a difference in the day-to-day life of the children and staff. 

After the school implemented the program, agency administration reported a substantial decrease in physical restraints among the school’s residential population.  Physical restraints are safety interventions that hold a youth in order to contain physical behavior that is likely to result in injury to the youth or others.  They are, however, not without risks to both the child and the staff since they can have harmful or even fatal consequences. 

“The wonderful thing about the Waterford Country School from an evaluator’s perspective is that it has a thirty-year history of collecting and publishing administrative data on measures that matter to practitioners,” Nunno said.  Our job was to portray the data in relevant and meaningful ways so that it could inform practice, soften professional resistance to change, and add to the growing evidence that relationship-based, trauma-informed practice models can create safe and therapeutic physical spaces.”

“By examining the data, we documented a 48 percent decrease in restraint events within Waterford’s residential and shelter settings,” he said. “We were able to verify the staff perceptions and narratives that the Waterford agency was becoming a safer, calmer place.” 

Yet not all Waterford programs saw this decline.  “The day-school data showed an increase in restraints in the corresponding time frame,” Nunno said.  “Although we were all surprised at this finding, our analysis triggered the agency leadership to examine the children’s social and emotional regulation needs.  They involved day-school teachers and children’s families who designed unified approaches to meet those needs.  Within months of implementing these strategies we saw a significant decrease in the use of restraints.”

The partnership between RCCP and the school demonstrates RCCP’s success at monitoring and detecting problems, guiding solutions, improving practice, supporting learning organizations, and contributing more broadly to evidence-based practice. 

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