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Seclusion and Restraint Practices in Residential Treatment Facilities for Children and Youth


concerning this article should be addressed to Jonathan Brown, Mathematica Policy Research, 600 Maryland Ave. SW, Suite 550, Washington, DC 20024. Electronic mail may be sent to


Policymakers, advocates, and families remain concerned about the use of seclusion and restraint in residential treatment facilities for children and youth. This study used data from 2 national surveys to examine the extent to which residential treatment facilities consistently implement certain practices following incidents of seclusion or restraint. The study found that 76% of facilities reported having secluded or restrained youth in the previous year; 34% of these facilities reported that, following such incidents, they always debrief the youth, family, and staff; notify the attending physician; and record the incident in the treatment plan. Accredited facilities and those that conduct a trauma assessment upon admission were more than twice as likely as others to consistently implement these practices. States and providers should continue to monitor seclusion and restraint practices and identify opportunities for quality improvement.

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