Several treatment alternatives exist for intervention in assaultive behaviour. Medication, physical restraints and seclusion rooms may be used separately or in combination, according to protocols in given treatment settings. The 1982 Supreme Court decision in Youngberg V. Romeo held that professional decision to seclude or restrain a patient is presumptively valid and that liability for secluding or restraining a patient may be imposed only when the professional's decision is a substantial departure from accepted professional judgement, practice or standard.
The purpose of restraining:
Containment of injurious actions.
To reduce difficult interpersonal relationship.
To decrease sensory input to reduce sensory overload.
Uncontrolled and unsafe behaviour of the patient.
One staff member should act as a team leader and direct the actions of everyone according to established and practiced routines. The leader will tell the patient what is occurring and why, keeping verbalizations concise and matter of fact in tone. Other members of the team will be assigned to hold the limbs to hold and transport the patient to the seclusion room or to apply restraints. Restrictive therapies must have clear guidelines and Physician's guidelines.
Termination of Restraining:
Restraining must depend on objective criteria rather than arbitrary feeling states of the nursing staff.