Abstract
Frontline, milieu workers in psychiatric settings are often called upon to intervene by using physical restraint on their patients. Standard child care practice (Redl & Wineman, 1957) requires that such episodes be worked through verbally with the patients in order to ensure that the impact of such interventions is ultimately therapeutic. There has been very little written about how milieu staff experience such crisis situations. The intense feelings that staff experience and their thoughts about what their needs are regarding such situations are the focus of this study. Frontline child care workers and nursing staff from a variety of psychiatric treatment facilities were invited to complete a self-report questionnaire which was aimed at tapping their experience of using physical restraint. The results indicate that staff experience many troublesome feelings of varying intensity which they would like more opportunity to discuss and work through. The findings are discussed within a framework of the notions of transference and counter-transference.
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References
Caraulia, A. (1984). Managing aggressive behavior in human service facilities: Changes and direction in the field.The Crisis Prevention Institute (CPI) National Report, 4 (2).
Drisko, J. W. (1981). Therapeutic use of physical restraint.Child Care Quarterly.10 (4, 318–328.
Gair, D. S. (1984) Guidelines for children and adolescents. In Tardiff, K., (ed.).The psychiatric uses of seclusion and physical restraint. Washington, D.C., American Psychiatric Press, 69–85.
Garrison, T. (1984). Aggressive behaviour, seclusion and physical restraint on an inpatient child population.Journal of American Academy of Child Psychiatry.23 (4, 448–452.
Haldipar, C. V., Dewan, M. & Beal, M. (1982). On fear in the countertransference.American Journal of Psychotherapy.XXXVI (2), 240–247.
Helmer, J. (1978). Constructive and destructive anger in child care work: An exploratory study and conceptual schema.Child Care Quarterly, 7 (4), 302–317.
Kupfersmid, J., & Monkman, R. (eds.). (198).Assaultive youth: Responding to physical assaultiveness in residential, community, and health care settings. New York: Haworth Press. (Also published as a Special Issue ofChild & Youth Services, 1987,10, 1).
Liberman, R. P., & Wong, St. E. (1984). Behaviour analysis and therapy procedures related to seclusion and restraint. In Tardiff, K., (ed.).The psychiatric uses of seclusion and physical restraint. Washington, D.C., American Psychiatric Press, 35–67.
Lion, J. R. (1972).Evaluation and management of the violent patient. Springfield, IL: Charles C. Thomas.
Lion, J. R., & Soloff, P. H. (1984). Implementation of Seclusion and Restraint. In Tardiff, K., (ed.).The psychiatric uses of seclusion and physical restraint. Washington, D.C., American Psychiatric Press, 19–34.
Nelson, J. E. (1978). Child care crisis and the role of the supervisor.Child Care Quarterly, 7 (4), 318–326.
Redl, F., & Wineman, D. (1957).The aggressive child. New York: Free Press.
Rycroft, C. (1972).A critical dictionary of psychoanalysis. England, Penguin Books.
Schowalter, J. E. (1985). Countertransference in work with children: Review of a neglected concept.Journal of the American Academy of Child Psychiatry, 25 (1), 40–45.
Treischman, A. E., Whittaker, J. K., & Brendtro, L. K. (1969).The other 23 hours. New York: Adline De Gryter.
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The author wishes to express appreciation to all the frontline staff who took the time to complete and return the questionnaire and to the supervisory staff of the agencies involved to J. R. Wachsmuth, L. Kostrzewa, E. Pask, and R. Williamson—for their advice and support during this study.
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Hunter, D.S. The use of physical restraint in managing out-of-control behavior in youth: A frontline perspective. Child Youth Care Forum 18, 141–154 (1989). https://doi.org/10.1007/BF01184761
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DOI: https://doi.org/10.1007/BF01184761