The agency’s behavior support and management policies and practices promote positive behavior and protect the safety of service recipients and staff.
Effective behavior support and management practices center around preemptive interventions, such as identifying problem behaviors and working with the individual and their support systems to create practical solutions in order to minimize the need for restrictive interventions to the greatest extent possible. A culture that promotes respect, healing, and positive behavior, and provides service recipients with the support they need to manage their own behaviors, can help prevent crisis situations and the need for restrictive interventions. Involving the individual and appropriate family members or support systems early on in identifying triggers and previous successes in coping with escalating behaviors creates a collaborative approach to behavior support and management and helps provide personnel and the individual with early insight into aggressive, harassing, or self-injurious behaviors. Training prevents injuries and deaths in crisis situations, including those that warrant the use of restrictive interventions as a last resort. Agencies that maintain a process for reviewing incidents when they do occur have the opportunity to make changes in their practices to support the safest environment possible and further reduce the use of restrictive interventions.
Agencies serving youth involved with the juvenile justice system may be legally authorized to use restrictive interventions to prevent escapes, or protect property in order to maintain safety, security, and order. However, they should still only employ restrictive interventions when absolutely necessary, as referenced throughout these standards.
Additionally, some agencies serving youth involved with the juvenile justice system and accredited under COA's Juvenile Justice Residential Services (PA-JJR) standards may lock youth in their rooms for routine purposes (e.g., during sleep periods), as opposed to doing so in response to an incident. Although this practice does restrict a person's freedom of movement, it differs from the types of restrictive behavior management interventions addressed in this section insofar as it is utilized on a routine, ongoing, basis, rather than in response to a specific incident. Accordingly, this practice is addressed in PA-JJR 15, and the standards in this section do not apply to that practice.
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Note: Restrictive interventions are those that involuntarily restrict, limit, or curtail a person’s freedom of movement and include manual restraint, mechanical restraint, and seclusion. Federal guidelines consider any restriction of an individual’s movement a restrictive intervention. Related definitions can be found in COA’s glossary.
Timeout or isolation are colloquial terms that may or may not include restrictive interventions. For the purpose of these standards, any instance where an individual is placed in a room separate from others and they cannot voluntarily leave (whether the door is locked or personnel is preventing the individual from leaving) will be referred to as seclusion and considered a restrictive intervention.
Note: Agencies that permit foster homes to employ manual restraints will complete all the standards in this section, as applicable, as well as PA-CFS 25.
Note: Agencies that work with populations with developmental delays and utilize protective clothing, such as protective helmets, will address those interventions in PA-PRG 5.02 and PA-PRG 6.03.
Note: Behavior Support and Management (BSM) will be NA when the policy referenced in PA-ASE 2 prohibits restrictive interventions.
Note: Please see PA-BSM Reference List for the research that informed the development of these standards.