How To Restrain A 17-Year-Old Client

How To Restrain a 17-Year-Old Client
Two staffers will approach the child in crisis having established that he poses a threat either to himself or to somebody else. Between them, they will have indicated to one another which staffer will be the lead on the restraint. On either side of the child, each will grab for a wrist with their outside hand, holding the arms at forty-five degree angle across their bodies. They will put their inside arms up along the hip, the ribs, and finally, behind the child’s shoulders. Their inside feet will be positioned slightly behind the child’s back feet, and from there, the child will be lowered down, first onto his butt, then his back, and finally his head. The staffers will then roll the child onto his stomach, one having released a grip on an arm so that the child ends up face down, arms along ribs and hips, legs together. One staffer will then lay across the child, pinning the closer arm with a knee and the farther arm with a combination of elbow, wrist, and hand (depending on the staffer’s and the child’s size). The second will slide down, pinning the child’s legs at the below the knee. From here, the staffer pinning arms will either begin an immediate conversation with the child or wait until a conversation is possible. The staffer will speak in the clearest possible terms, explaining what will happen next, including an allowance of a sufficient amount of time for a calm demeanor to be achieved, as well as a period of post-restraint stillness undertaken by the client. After those steps, an interview can occur, reconstructing what lead to the restraint and what can be done to avoid the next restraint. The client can then be returned to the group and the restraint appropriately documented through the use of agency specific paperwork.

How To Actually Restrain a 17-Year-Old Client
One staffer will be in the basement, monitoring a client’s laundry completion, while a second staffer remains in the commons area with a child whose anger has been slowly building all day, specifically because the nearby staffer, who is new to the facility and unknown to the child, has been enforcing the rules as they have been explained to him. The child, having decided that this enforcement has been too stringent, will instigate a conflict in an attempt to tease out where exactly the line exists with the new staffer. This will result in his instigating a physical confrontation in an attempt to figure out if the staffer is willing to engage in restraint protocol.

The new staffer will then wrap the client up in a manner that might be described as an awkward bearhug. He will also shout for assistance from his staffer downstairs while attempting to drown out the now furious child who is alternately swearing, threatening, and demanding to be let go of. This will be a standing wrestling match that will eventually end on the floor, with the child rolled over and in a vaguely approximate but not entirely appropriate position in which his hips never really square on the floor. As one attempt to break free, the child will have bitten into the arm of the new staffer, but only long enough to have the arm shoved deeper into his open mouth, forcing him to pull away. After an hour, the seething, wheezing child will eventually calm down. The new staffer will do as good a job as an new employee is capable of at doing the talking down that each client is meant to receive, but will be relieved by workers from a nearby facility who arrived to see what the unexpected commotion was. After all, this is occurring at the quieter and calmer facility. It will be repeatedly noted how rare restraints are here and how honored the new staffer ought to be to have participated in one. The appropriate post-restraint steps will be followed and, the next day, the child will joke around about having been restrained. The staffer will debrief his bosses about the restraint and asked if he is okay, which he will shrug about. He will be assured that this was a good and necessary restraint.

He will reflect upon that later with bemusement. In the meantime, his bosses will tell him to get back to work, as this restraint occurred on his third of four-and-a-half straight days in the facility.

(Image borrowed from Tact2.)