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WHAT WORKS IN EDUCATION The George Lucas Educational Foundation

The use of theraputic holds and other restraint techniques

The use of theraputic holds and other restraint techniques

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Hello all, I am a self contained early childhood teacher, We have had an increasing number of incidents of teachers and IAs for mod-severe disabilities are under fire from parents and the public for cruel and criminal techniques. My questions are: Are you finding this true in your area? With the ever increasing caseloads for students even those with behaviors, are all pertinent staff trained? What techniques do you use in your district? Thanks, Diane

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LPS's picture
LPS
Cross Categorical/self-contained - Teacher

I have been trained in several interventions; MANDT, SIT and CIT. I liked the MANDT presentation the best as they focussed on de-escalation strategies and assisted transports as well as therapeutic holds and releasing. Most all the strategies are basically the same. A focus on assessing the situation, and environmental factors are important. Prevention is always the best. All staff in self-contained classrooms are required to be trained. I do a lot of additional training as well with my staff. We are a team and need to all be on the same page. Students know that I will not allow them to hurt themselves, others or damage property. I have had students be out of control, and I do not hesitate to call parents. I have not needed to call the police, however, I would not hesitate. Safety, is always the primary concern. I have had to clear the room in order to keep myself and others safe. The parent and principal dealt with the student. This was a one time event that never happened again after the student realized that I was serious about calling parents and that I would not hesitate to call the police. (Once in 4 years at this school). I document everything and stay in communication with my exceptional education superiors. The principal is not always my best advocate.

Eric Anderson's picture
Eric Anderson
Special Ed Teacher for students with emotional and behavioral disorders

I work in a high school for students with emotional/behavioral issues and all staff except clinicians are trained in Therapeutic Crisis Intervention (TCI). New York State is attempting to reduce and eliminate the use of holds. I think because the use of holds is highly regulated we do not encounter a lot of opposition from parents and public.

The big issue to remember when working with a population with severe disabilities is to remember that you as a teacher or behavior support specialist need to be at your baseline emotional state before attempting to de-escalate a student or initiate a hold. If one goes into a situation with a chip on his or her shoulder it becomes too easy to let one's emotions take control. If that happens the chance of injury to the student or yourself is too high to be acceptable.

It looks as if holds are going to be prohibited at some point in the future. I think that will deprive professionals in certain setting of a valuable tool. On the other hand some of the stories I've read make my skin crawl. If an agency or district cannot provide adequate, ongoing training of staff, it has no business using holds or seclusion rooms.

Shannon's picture

Hello Diane,

I have had to use restraint in my classroom, and it is always as a last resort or as part of a ECMP/BIP. This is necessary sometimes to keep myself and staff safe. I do not allow anyone in my classroom to restrain a student unless they hold CPI (crisis prevention intervention) card which shows that they have been properly trained and certified to employ these holds. Our district supplies the training twice a year usually. I have a student whose maladaptive behaviors were so bad that the only way he became under control was to use CPI. After months of using the holds he became more compliant knowing that when he became dysregulated and non-compliant that he would be held until he calmed down. If we use this type of treatment on a child the parent is always brought in to discuss the techniques with them so they realize that the child is not being injured and the holds are safe.

I hope this helps,
Shannon

MK's picture
MK
school social worker

Several years ago while working in a private therapeutic day school for children with (only) autism spectrum disorders, we were all trained in CPI and our certification updated yearly with more training. We needed to use it only when there was a danger to ourselves, others and the student him/herself. Having said that, naturally all was done to avoid the stressful or aggravating circumstance that triggered the violent behavior. I agree with Shannon, who's reply is above mine.

Jeanette De Jesus's picture

Does anyone who has been trained in CPI or TCI have any information regarding this type of training in NYC? I have a special needs child who has a crisis paraprofessional who is very dedicated and capable, however, she is seeking to acquire some additional professional development in CPI or TCI in order to safely and productively work with Na'ila when she becomes out of control and presents a danger to herself or others. Thank you.

MANDIE KILGORE's picture
MANDIE KILGORE
Parent of one high school student and a 6th grade student

children with emotional disturbances will be haunted for years after your methods. I , as a parent know how much counseling and sleepless nights, not to mention the nightmares my son and the rest of our family endures do to his previous schools unwillingness to follow his IEP and call me to drive the one mile I live from the school to intervene but instead 'restrained' my disabled 12 year old 60# child with three adults on to of him for four hours and 14 restraint occasions. whats that? Torture and child abuse!!!!!

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