I stole this title from one of my readers (thanks John!) because I think it speaks so clearly about restraint and seclusion. I asked you readers yesterday what you thought about seclusion rooms at school and got lots of feedback that told me what I suspected. It’s a gray thing.

Because we need places for children who are not safe at school, we need “quiet rooms”. Some children really do improve having a quiet, safe place to calm down. How the rooms are administered and how the staff is trained is of paramount importance in determining whether the rooms are used abusively or not. And what each individual child needs comes into play as well.

Children who escalate into dangerous behaviors need positive behavioral interventions. What happens, if someone in charge of them doesn’t understand that or work darn hard to make sure things stay positive is the behaviors spiral further out of control. Eventually, even the strongest, most patient, Mother Teresa-like school employee will get triggered by a child’s behavior. (Same with Awesome Moms!) If a booger flung at the principal won’t do it – then being spit on or cussed at might. (read Sue’s comments on my blog from yesterday). So it all boils down to these simple principles:

1. the school personnel have to believe in and strive for POSITIVE behavioral interventions. They have to be able to separate the behavior from the child. Behavior is undesirable, but the child is not bad! Unless this is the overriding philosophy, the interventions are never going to be positive.
2. school personnel have to be trained in looking for antecedents and recognizing when and how to de-escalate a child. It takes both formal training and understanding an individual child to know when to push an issue and when to distract, divert or otherwise positively intervene. They also have to be willing to believe that sometimes you don’t see the antecedent (internal) but need to recognize the escalation at the beginning stages and work to de-escalate.
3. school personnel and parents MUST communicate and truly listen to each other. They must share what’s working and what isn’t. And there must be total and open communication about what steps and processes will be used and under what conditions.
4. and everyone much therapeutically support the child who has been restrained or secluded.

This is the point that I think John touched upon when he said "Restraint is rarely cost free." The most obvious way that restraints “cost us” is if someone (child or restrainer) gets physically hurt in the process. But that’s only a small piece of the cost. When we restrain or seclude our children we are in essence being their self-control because they can not (or in some cases will not…although I believe it is more can not). This puts us in a very powerful and dangerous position. But we are imposing that control by sending them away. For all children, but especially those who've been traumatized, this can be read as rejection. If restraint and seclusion is not coupled with (or followed by) a chance for the child to get back to an emotional equilibrium, it can cost this child more emotional damage.

This is why at hospitals the policy is to have some one on the therapeutic staff (doctor, counselor, etc.) talk things over with a person who’s been isolated. It is not to go over the child’s litany of sins (or it shouldn’t be). Instead it is to enable the child to regain some self-dignity and control over their own thoughts and behaviors. It’s not to beat into a child what he/she did wrong, although the staff may ask them that. But it is to give the child the chance to reflect on how they might try to self-correct, what they can do to repair relationships and how they improve their behaviors and situation so they can start feeling positive toward themselves again. It is to help the child be able to separate the bad behavior from who they are.

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