@article{ref1,
title="Behavioral management leads to reduction in aggression in a child and adolescent psychiatric inpatient unit",
journal="Journal of the American Academy of Child and Adolescent Psychiatry",
year="2007",
author="Dean, Angela J. and Duke, Suzanne G. and George, M. and Scott, J.",
volume="46",
number="6",
pages="711-720",
abstract="OBJECTIVE: Aggression is common in children and adolescents admitted to psychiatric inpatient units. Few interventions for reducing aggressive behaviors have been identified. This study aimed to evaluate the impact of a milieu-based behavioral management program on the frequency of aggressive behaviors in a child and adolescent mental health inpatient unit. METHOD: The behavioral management program incorporated individualized patient management plans, early detection and prevention, staff training, reinforcement of appropriate behaviors, and intervention using the least restrictive option. Outcomes were assessed for 6 months before and after program introduction, and included episodes of aggressive behavior, injuries, use of physical restraint, seclusion, p.r.n. sedation, use of security services, and staffing factors. RESULTS: Implementation of behavioral management led to a significant reduction in the episodes of aggressive behavior (p < .05) and other unwanted outcomes including injuries (p < .05), use of physical restraint (p < .001), and duration of seclusion (p < .001). These outcomes were achieved without reducing the number of admissions, changing the types of patients admitted, increasing staff costs, or increasing the use of p.r.n. medications. CONCLUSIONS: Aggressive behaviors in child and adolescent psychiatric inpatient units can be reduced by implementing a broad-based behavioral management program. These findings highlight the importance of organizational approaches to behavior and risk management.<p /> <p>Language: en</p>",
language="en",
issn="0890-8567",
doi="10.1097/chi.0b013e3180465a1a",
url="http://dx.doi.org/10.1097/chi.0b013e3180465a1a"
}