Patterns of change in restrictive measures in residential care: Trauma-informed staff training benefits children and youth who need it the Most.
Residential care
Restraint
Seclusion
Time-out
Trauma-informed
Youth
Journal
Child abuse & neglect
ISSN: 1873-7757
Titre abrégé: Child Abuse Negl
Pays: England
ID NLM: 7801702
Informations de publication
Date de publication:
02 Dec 2023
02 Dec 2023
Historique:
received:
03
04
2023
revised:
08
09
2023
accepted:
20
11
2023
medline:
4
12
2023
pubmed:
4
12
2023
entrez:
3
12
2023
Statut:
aheadofprint
Résumé
Implementation of trauma-informed staff training is promising to reduce restrictive measures (restraints, seclusions, and time-outs) used to address problem behaviors in youth in residential care. Previous mixed results may be explained in part by the heterogeneity in the use of restrictive measures among youth. The objective was twofold: (1) to examine whether heterogeneity in the initial number of restrictive measures experienced by youth, before implementing trauma-informed staff training, moderates the effect of the training and (2) to explore whether children and youth's characteristics are associated with the number of restrictive measures. A trauma-informed staff training was implemented in 44 residential care units in Quebec, Canada. This study used administrative data. The sample (n = 297 youth) was divided into three subgroups based on the number of restrictive measures experienced in the six-month period prior to the training: 1) absence or low (52 % of the sample); 2) moderate (23 %); 3) high (25 %). The use of restrictive measures was compared between the subgroups. Main and interaction effects were all significant. None of the slopes for groups 1 and 2 were significant. In contrast, significant decreases from T1 were observed at T2 (-0.18 (0.02), p < .000) and T3 (-0.22 (0.02), p < .000) in group 3. Several children and youth's characteristics distinguished groups. Implementation was more beneficial to youth who experienced a high number of restrictive measures. Training opportunities can lead to positive changes in measures used to address problem behaviors in youth.
Sections du résumé
BACKGROUND
BACKGROUND
Implementation of trauma-informed staff training is promising to reduce restrictive measures (restraints, seclusions, and time-outs) used to address problem behaviors in youth in residential care. Previous mixed results may be explained in part by the heterogeneity in the use of restrictive measures among youth.
OBJECTIVE
OBJECTIVE
The objective was twofold: (1) to examine whether heterogeneity in the initial number of restrictive measures experienced by youth, before implementing trauma-informed staff training, moderates the effect of the training and (2) to explore whether children and youth's characteristics are associated with the number of restrictive measures.
PARTICIPANTS AND SETTING
METHODS
A trauma-informed staff training was implemented in 44 residential care units in Quebec, Canada.
METHODS
METHODS
This study used administrative data. The sample (n = 297 youth) was divided into three subgroups based on the number of restrictive measures experienced in the six-month period prior to the training: 1) absence or low (52 % of the sample); 2) moderate (23 %); 3) high (25 %).
RESULTS
RESULTS
The use of restrictive measures was compared between the subgroups. Main and interaction effects were all significant. None of the slopes for groups 1 and 2 were significant. In contrast, significant decreases from T1 were observed at T2 (-0.18 (0.02), p < .000) and T3 (-0.22 (0.02), p < .000) in group 3. Several children and youth's characteristics distinguished groups.
CONCLUSIONS
CONCLUSIONS
Implementation was more beneficial to youth who experienced a high number of restrictive measures. Training opportunities can lead to positive changes in measures used to address problem behaviors in youth.
Identifiants
pubmed: 38043458
pii: S0145-2134(23)00564-1
doi: 10.1016/j.chiabu.2023.106576
pii:
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
106576Informations de copyright
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