Title page for ETD etd-01282004-145119

Type of Document Dissertation
Author Smalls, Yemonja
Author's Email Address Yemonja@YemonjaSmalls.com
URN etd-01282004-145119
Title Utility of the Implementation of Programmatic Systems to Reduce and Eliminate Restraint Use for the Treatment of Problem Behaviors with Individuals with Mental Retardation
Degree Doctor of Philosophy (Ph.D.)
Department Psychology
Advisory Committee
Advisor Name Title
Johnny L. Matson Committee Chair
Amy L. Copeland Committee Member
Dorothea C. Lerman Committee Member
W. Drew Gouvier Committee Member
Thomas J. Durant Dean's Representative
  • unplanned emergency restraint
  • polypharmacy
  • chemical restraint
  • baskethold
  • restraint reduction program
  • restraint education program
  • planned programmatic restraint
  • mechanical restraint
  • physical restraint
Date of Defense 2003-11-04
Availability unrestricted
Persons with mental retardation continue to remain one of society’s most vulnerable groups as the number of individuals served increases and non-proportional resources are allotted to take of their needs. With results of national investigations indicating widespread indiscriminate abuse of restraints and overmedication to manage dangerous behaviors, federal mandates have been initiated to ensure ethical, safe and clinically sound use of these techniques. This study addressed the implementation of systemic changes that included a restraint education program and policy changes, careful monitoring and review of restraint and behavioral programming by oversight review bodies, and intense training of preventative and de-escalation techniques to all staff. A statistically and clinically significant reduction in restraints was evidences upon programmatic implementation during this 18-month study. Psychotropic medication use also decreased significantly as did polypharmacy use for persons with mental retardation. Results supported research noting that reduction of behavioral restraint does not result in an automatic increase in alternative highly restrictive management techniques. Further research is warranted to isolate specific elements of effective systemic change which weigh more heavily in the improvement of behavioral management for persons with mental retardation.
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