Format

Send to

Choose Destination
J Am Acad Child Adolesc Psychiatry. 2007 Jun;46(6):711-720. doi: 10.1097/chi.0b013e3180465a1a.

Behavioral management leads to reduction in aggression in a child and adolescent psychiatric inpatient unit.

Author information

1
Dr. Dean is with Kids in Mind Research, Mater Child & Youth Mental Health Service, South Brisbane; Dr. Scott, Ms. Duke, and Ms. George are with the Mater Child & Youth Mental Health Service Inpatient Unit, South Brisbane; Drs. Dean and Scott are also affiliated with Department of Psychiatry, University of Queensland, Australia.
2
Dr. Dean is with Kids in Mind Research, Mater Child & Youth Mental Health Service, South Brisbane; Dr. Scott, Ms. Duke, and Ms. George are with the Mater Child & Youth Mental Health Service Inpatient Unit, South Brisbane; Drs. Dean and Scott are also affiliated with Department of Psychiatry, University of Queensland, Australia. Electronic address: james_g_scott@health.qld.gov.au.

Abstract

OBJECTIVE:

Aggression is common in children and adolescents admitted to psychiatric inpatient units. Few interventions for reducing aggressive behaviors have been identified. This study aimed to evaluate the impact of a milieu-based behavioral management program on the frequency of aggressive behaviors in a child and adolescent mental health inpatient unit.

METHOD:

The behavioral management program incorporated individualized patient management plans, early detection and prevention, staff training, reinforcement of appropriate behaviors, and intervention using the least restrictive option. Outcomes were assessed for 6 months before and after program introduction, and included episodes of aggressive behavior, injuries, use of physical restraint, seclusion, p.r.n. sedation, use of security services, and staffing factors.

RESULTS:

Implementation of behavioral management led to a significant reduction in the episodes of aggressive behavior (p < .05) and other unwanted outcomes including injuries (p < .05), use of physical restraint (p < .001), and duration of seclusion (p < .001). These outcomes were achieved without reducing the number of admissions, changing the types of patients admitted, increasing staff costs, or increasing the use of p.r.n. medications.

CONCLUSIONS:

Aggressive behaviors in child and adolescent psychiatric inpatient units can be reduced by implementing a broad-based behavioral management program. These findings highlight the importance of organizational approaches to behavior and risk management.

PMID:
17513983
DOI:
10.1097/chi.0b013e3180465a1a
[Indexed for MEDLINE]

Supplemental Content

Full text links

Icon for Elsevier Science
Loading ...
Support Center