Abstract
Psychiatric inpatient facilities may treat patients with a history of or current aggressive tendencies. Restraint and seclusion (R/S) techniques have been a controversial choice for patient and staff safety. Literature on aggression and restraints in psychiatric facilities suggested a need for further training on de-escalation and violence prevention to support safer environments for patients and staff. A 5-hour de-escalation and violence prevention training program based on dance/movement therapy (DMT) techniques was developed and taught to Drexel University students in the Psychiatric Mental Health Nurse Practitioner Master’s program (N = 73). The training program, De-escalation with DMT, focused on teaching observational skill building, empathy building, and self-efficacy in order to support violence prevention and de-escalation. This article looks at the effectiveness of the training program in each of the three skill areas, as well as, participants’ views on the overall effectiveness of the program as it relates to de-escalation, violence prevention, and the use of R/S. Findings suggest an increase in observational skills, empathy levels, and self-efficacy, and positive views regarding the overall training program as reported by participants. Results from this program evaluation suggest that De-escalation with DMT could be useful in increasing skills that would support safe and effective de-escalations.
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References
American Psychiatric Nurses Association. (2007). Seclusion and restraint standards of practice. The American Psychiatric Nurses Association Board of Directors. http://www.apna.org/files/public/APNA_SR_Standards-Final.pdf
Bandura, A. (1994). Self-efficacy. In V. S. Ramachaudran (Ed.), Encyclopedia of human behavior (Vol. 4, pp. 71–81). New York, NY: Academic [Reprinted in H. Friedman (Ed.), Encyclopedia of mental health. San Diego, CA: Academic, 1998].
Bell, C. (2000). Assessment and management of the violent patient. Journal of the National Medical Association, 92(5), 247–253.
Berrios, C., & Jacobowitz, W. (1998). Therapeutic holding: Outcomes of a pilot study. Journal of Psychosocial Nursing, 36(8), 14–18.
Berrol, C. (2006). Neuroscience meets dance/movement therapy: Mirror neurons, the therapeutic process and empathy. The Arts in Psychotherapy, 33, 302–315.
Bonner, G., Lowe, T., Rawcliffe, D., & Wellman, N. (2002). Trauma for all: A pilot study of the subjective experience of physical restraint for mental health inpatients and the staff in the UK. Journal of Psychiatric and Mental Health Nursing, 9, 465–473.
Burnes Bolton, L., & Goodenough, A. (2003). A magnet nursing service approach to nursing’s role in quality improvement. Nursing Administration Quarterly, 27(4), 344–354.
Calabro, K., & Williams, S. (2002). Evaluation of training designed to prevent and manage patient violence. Issues in Mental Health Nursing, 23, 3–15.
Crisis Prevention Institute. (2009). https://www.crisisprevention.com/CPI/media/Media/Resources/research/14-CPI-INT-003_empirical.pdf
Dulicai, D. (1973). Movement therapy on a closed ward. Journal of the Bronx State Hospital, 1(4), 150–154.
Evans, D., Wood, J., & Lambert, L. (2003). Patient injury and physical restraint devices: A systematic review. Journal of Advanced Nursing, 41(3), 274–282.
Iacoboni, M. (2009). Imitation, empathy, and mirror neurons. Annual Review of Psychology, 60, 653–670. doi:10.1146/annurev.psych.60.110707.163604.
Johnson, M. (1998). Being restrained: A study of power and powerlessness. Issues in Mental Health Nursing, 19, 191–206.
Joint Commission on Accreditation of Healthcare Organizations, JCAHO. (2010). http://www.premierinc.com/quality-safety/tools-services/safety/topics/patient_safety/index_3.jsp
Jonikas, J., Cook, J., Rosen, C., Laris, A., & Kim, J. (2004). A program to reduce use of physical restraint in psychiatric inpatient facilities. Psychiatric Services, 55, 818–820.
Kaltiala-Heino, R., Tuohimaki, C., Korkeila, J., & Lehtinen, V. (2003). Reasons for using seclusion and restraint in psychiatric inpatient care. International Journal of Law and Psychiatry, 26, 139–149.
Kestenberg-Amighi, J., Loman, S., Lewis, P., & Sossin, K. (1999). The meaning of movement: Developmental and clinical perspectives of the Kestenberg movement profile. New York, NY: Brunner-Routledge.
Lee, S., Gray, R., Gournay, K., Wright, S., Parr, M., & Sayer, J. (2003). Views of nursing staff on the use of physical restraint. Journal of Psychiatric and Mental Health Nursing, 10, 425–430.
Lev-Wiesel, R. (2008). Child sexual abuse: A critical review of intervention and treatment modalities. Children and Youth Services Review, 30, 665–673.
Lewis, M., Taylor, K., & Parks, J. (2009). Crisis prevention management: A program to reduce the use of seclusion and restraint in an inpatient mental health setting. Issues in Mental Health Nursing, 30, 159–164.
Luiselli, J., Kane, A., Treml, T., & Young, N. (2000). Behavioral intervention to reduce physical restraint of adolescents with developmental disabilities. Behavioral Interventions, 15, 317–330.
Lundy, H., & McGuffin, P. (2005). Using dance/movement therapy to augment the effectiveness of therapeutic holding with children. Journal of Child and Adolescent Psychiatric Nursing, 18(3), 135–144.
Martin, A., Krieg, H., Esposito, F., Stubbe, D., & Cardona, L. (2008). Reduction of restraint and seclusion through collaborative problem solving: A five-year prospective inpatient study. Psychiatric Services, 59, 1406–1412.
Mohr, W., Mahon, M., & Noone, M. (1998). A restraint on restraints: The need to reconsider the use of restrictive interventions. Archives of Psychiatric Nursing, 12(2), 95–106.
Ryan, C., & Bowers, L. (2006). An analysis of nurses’ post-incident manual restraint reports. Journal of Psychiatric and Mental Health Nursing, 13, 527–532.
Saldaña, J. (2013). The coding manual for qualitative researchers. Thousand Oaks, CA: Sage.
Sandel, S. (1993). The process of empathic reflection in dance therapy. In S. Sandel, S. Chaiklin, & A. Lohn (Eds.), Foundations of dance/movement therapy: The life and work of Marian Chace (pp. 98–111). Columbia, MD: The Marian Chace Memorial Fund of the American Dance Therapy Association.
Sullivan, A., Bezmen, J., Barron, C., Rivera, J., Curley-Casey, L., & Marino, D. (2005). Reducing restraints: Alternatives to restraints on an inpatient psychiatric service—Utilizing safe and effective methods to evaluate and treat the violent patient. Psychiatric Quarterly, 76(1), 51–65.
Van Doeselaar, M., Sleegers, P., & Hutschemaekers, G. (2008). Professionals’ attitudes toward reducing restraint: The case of seclusion in The Netherlands. Psychiatric Quarterly, 79, 97–109.
Whitman, G., Davidson, L., Rudy, E., & Sereika, S. (2001). Practice patterns related to mechanical restraint use across a multi-institutional health care system. Outcomes Management for Nursing Practice, 5(3), 102–109.
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The author wishes to thank Dr. Sherry Goodill for her support in all stages of this work.
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Biondo, J. De-escalation with Dance/Movement Therapy: A Program Evaluation. Am J Dance Ther 39, 209–225 (2017). https://doi.org/10.1007/s10465-017-9261-5
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DOI: https://doi.org/10.1007/s10465-017-9261-5