Behavioral management leads to reduction in aggression in a child and adolescent psychiatric inpatient unit

Dean, Angela J., Duke, Suzanne G., George, Michelle and Scott, James (2007) Behavioral management leads to reduction in aggression in a child and adolescent psychiatric inpatient unit. Journal of the American Academy of Child & Adolescent Psychiatry, 46 6: 711-720. doi:10.1097/chi.0b013e3180465a1a


Author Dean, Angela J.
Duke, Suzanne G.
George, Michelle
Scott, James
Title Behavioral management leads to reduction in aggression in a child and adolescent psychiatric inpatient unit
Journal name Journal of the American Academy of Child & Adolescent Psychiatry   Check publisher's open access policy
ISSN 0890-8567
Publication date 2007-06-01
Sub-type Article (original research)
DOI 10.1097/chi.0b013e3180465a1a
Volume 46
Issue 6
Start page 711
End page 720
Total pages 10
Editor M. K. Dulcan
Place of publication Baltimore, U.S.
Publisher Lippincott Williams & Wilkins
Language eng
Subject 321021 Psychiatry
730211 Mental health
C1
1103 Clinical Sciences
Formatted 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.
Keyword Aggression
Behavioral management
Inpatients
Mental health services
Restraint
Seclusion
Q-Index Code C1
Q-Index Status Confirmed Code

Document type: Journal Article
Sub-type: Article (original research)
Collections: Excellence in Research Australia (ERA) - Collection
2008 Higher Education Research Data Collection
School of Medicine Publications
 
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Citation counts: TR Web of Science Citation Count  Cited 37 times in Thomson Reuters Web of Science Article | Citations
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Created: Mon, 17 Mar 2008, 20:23:04 EST by Brenda Mason on behalf of Psychiatry - Royal Brisbane and Women's Hospital