Document Detail


Case study: when restraints are the least restrictive alternative for managing aggression.
MedLine Citation:
PMID:  9585658     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
This article discusses the controversial use of restraints with a persistently violent adolescent on a child and adolescent psychiatry unit. The authors present an individualized program that used a series of ambulatory restraints on a long-term basis and prophylactically to contain the aggression of a psychotic girl. Clozapine was used concomitantly to control her psychosis. The prophylactic use of mechanical restraints allowed this teenager to be integrated into the milieu and to receive multiple treatments that the standard protocol precluded. This case underscores the difficulties in managing aggression when youths do not respond to standard protocols and do not conform to our assumptions about the least restrictive alternative. It is concluded that prophylactic mechanical restraint provided the least restrictive alternative to personal freedom for this teenager and had therapeutic benefit.
Authors:
B Troutman; K Myers; C Borchardt; R Kowalski; J Bubrick
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of the American Academy of Child and Adolescent Psychiatry     Volume:  37     ISSN:  0890-8567     ISO Abbreviation:  J Am Acad Child Adolesc Psychiatry     Publication Date:  1998 May 
Date Detail:
Created Date:  1998-06-11     Completed Date:  1998-06-11     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  8704565     Medline TA:  J Am Acad Child Adolesc Psychiatry     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  554-8     Citation Subset:  IM    
Affiliation:
Division of Child Psychiatry, University of Iowa, Iowa City 52242-1057, USA.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Aggression / psychology*
Antipsychotic Agents / administration & dosage
Clozapine / administration & dosage
Combined Modality Therapy
Female
Humans
Patient Admission*
Patient Isolation / psychology
Psychiatric Department, Hospital
Psychotic Disorders / psychology,  therapy
Restraint, Physical* / psychology
Suicide, Attempted / prevention & control,  psychology
Violence / prevention & control*,  psychology
Chemical
Reg. No./Substance:
0/Antipsychotic Agents; 5786-21-0/Clozapine

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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