@article{ref1,
title="Patterns of change in restrictive measures in residential care: trauma-informed staff training benefits children and youth who need it the most",
journal="Child abuse and neglect",
year="2023",
author="Matte-Landry, Alexandra and Collin-Vézina, Delphine",
volume="147",
number="",
pages="e106576-e106576",
abstract="BACKGROUND: Implementation of trauma-informed staff training is promising to reduce restrictive measures (restraints, seclusions, and time-outs) used to address problem behaviors in youth in residential care. Previous mixed results may be explained in part by the heterogeneity in the use of restrictive measures among youth. <br><br>OBJECTIVE: The objective was twofold: (1) to examine whether heterogeneity in the initial number of restrictive measures experienced by youth, before implementing trauma-informed staff training, moderates the effect of the training and (2) to explore whether children and youth's characteristics are associated with the number of restrictive measures. PARTICIPANTS AND SETTING: A trauma-informed staff training was implemented in 44 residential care units in Quebec, Canada. <br><br>METHODS: This study used administrative data. The sample (n = 297 youth) was divided into three subgroups based on the number of restrictive measures experienced in the six-month period prior to the training: 1) absence or low (52 % of the sample); 2) moderate (23 %); 3) high (25 %). <br><br>RESULTS: The use of restrictive measures was compared between the subgroups. Main and interaction effects were all significant. None of the slopes for groups 1 and 2 were significant. In contrast, significant decreases from T1 were observed at T2 (-0.18 (0.02), p < .000) and T3 (-0.22 (0.02), p < .000) in group 3. Several children and youth's characteristics distinguished groups. <br><br>CONCLUSIONS: Implementation was more beneficial to youth who experienced a high number of restrictive measures. Training opportunities can lead to positive changes in measures used to address problem behaviors in youth.<p /> <p>Language: en</p>",
language="en",
issn="0145-2134",
doi="10.1016/j.chiabu.2023.106576",
url="http://dx.doi.org/10.1016/j.chiabu.2023.106576"
}