Organizational Interventions: The Evidence

Abstract

This chapter reviews the extensive evidence on organizational interventions to reduce restraint and other restrictive behavior management practices. Organizational interventions can be effective at safely reducing restraint and other restrictive behavior management practices on a large scale. Such interventions may involve hundreds of clients and staff over an extensive time period, in some cases lasting several years. The chapter reviews an extensive literature on this topic, which includes narrative literature reviews, empirical case studies, and systematic literature reviews. The literature covers a wide range of populations and settings. There is a large quantity of evidence of varied quality that organizations can be quite successful in reducing and eliminating restraints and maintaining or improving client and staff safety. The evidence is summarized systematically in tables. Case studies from different types of organizations including community organizations for individuals with intellectual disabilities (ID), autism, and in psychiatric institutions are used to illustrate the general principles described in the previous chapter.