How does Behaviour Smart support the 6 core strategies for Reducing Seclusion and Restraint?

By Dean Cotton, Managing Director, Behaviour Smart Ltd

Here at Behaviour Smart we are passionate about reducing restraint and seclusion, and the evidence speaks for itself with most of our users seeing huge reductions in behaviour incidents, including those involving restraint, with some users experiencing a 95% reduction in serious incidents after just 12 months of implementing our incident recording/behaviour management system. The main reason for these outstanding results is because Behaviour Smart is based on sound psychological research. The Six Core Strategies form the foundations of Behaviour Smart which were developed in the United States by the National Association of State Mental Health Program Directors Medical Directors Council (NASMHPD). The approach is also used in the United Kingdom, Canada, Australia, and Finland.

What are the Six Core Strategies for Reducing Seclusion and Restraint Use?

• Strategy 1. Leadership towards organisational change. ... 

• Strategy 2. Full inclusion of lived experience. ... 

• Strategy 3. Using data to inform practice. ... 

• Strategy 4. Workforce development. ... 

• Strategy 5. Use of specific seclusion and restraint reduction tools. ... 

• Strategy 6. Debriefing techniques.

How does Behaviour Smart support the Six Core Strategies for Reducing Seclusion and Restraint Use?

1. Leadership toward Organizational Change

This first strategy is considered core to reducing the use of seclusion and restraint. Leadership strategies to be implemented include defining and articulating a vision, values and philosophy that expects restraint and seclusion reduction, developing and implementing a targeted action plan and holding people accountable to that plan. The language and ethos of Behaviour Smart steers leadership teams to consider their approach towards good behaviour management and allows leadership teams to monitor incidents and improve workforce development issues.

This is a mandatory core intervention.

2. Use of Data To Inform Practice

This core strategy suggests that successfully reducing the use of Seclusion and restraint requires the collection and use of data to identify the services Seclusion and Restraint use baseline. Behaviour Smart doesn’t just gather data, it ensures that staff and services respond to the data effectively and alter the approach on an individual and service level. The data gathered by Behaviour Smart is presented very clearly on your analytics page and supports users to accurately monitor the data and the changes over time. Following the completion of an incident report Behaviour Smart will use the data inputted to create a very accurate and affective behaviour plan. This also helps ensure that data collected informs practice.

3. Workforce Development

The purpose of this strategy is to create an environment that is less likely to be coercive or trigger conflicts and in this sense is a core primary prevention intervention. This strategy is implemented through intensive and ongoing staff training and education. When a user records an incident using Behaviour Smart they are forced into considering their response to the behaviour which was displayed and consider alternative responses they could try next time. Behaviour Smart offers supportive suggestions in line with an individualised, trauma informed and person centred approach which are designed to teach emotional self-management. This strategy also includes consistent communication, mentoring, supervision and follow-up to assure that staff are provided the required knowledge, skills and abilities. Behaviour Smart has been described by several use as daily continuous professional development.  

4. Use of specific seclusion and restraint reduction tools.

This strategy relies heavily on the concept of individualised support. Behaviour Policies should be focused on how services generally manage behaviour and support individuals in the service setting, but very rarely does one size fit all. Some individuals need a personalised approach and specific interventions. The plans developed by Behaviour Smart are based on the strategies that have been tried, what works and what doesn’t work. Every individual’s plan is specific to them and includes the use of de-escalation techniques, environmental changes and other responces designed to teach people emotional self-management skills. It's important to note that reducing restraint and improving behaviour use requires a comprehensive and individualized approach that considers the unique circumstances of each person. These strategies should be implemented together and supported by organizational policies, guidelines, and a commitment to person-centred care.

5. Involvement of families and peers  

This strategy involves the full and formal inclusion of families, peers and external advocates in various roles and at all levels in the organization to assist in the reduction of seclusion and restraint. Behaviour Smart easily allows information to be shared with all parties. External consultants, parents and the individuals themselves can be given access to the person-centred plans that the system develops so that their voices can be heard and ideas implemented.  

6. Debriefing Techniques

This core strategy recognises the usefulness of a thorough analysis of every incident. It values the fact that reducing behaviour incidents occurs through knowledge gained from a rigorous analysis of the events and the use of this knowledge to inform change to avoid repeats in the future. A secondary goal of this intervention is to attempt to mitigate the adverse and potentially traumatising effects of the incident event for all involved. The post incident learning section of Behaviour Smart was designed through research and is based on three simple questions. What triggered the behaviour? How did the trigger make you feel? What can you do the next time you feel that way? This approach resulted in a 64.5% reduction in behaviour incidents when implemented over a 3-month period (full research paper available on request).

Behaviour Smart is not just an incident recording tool. our development team are continually exploring ways to help services improve behaviour and the carefully designed questions the system asks are designed by our legal team and expert whiteness who work in this field daily.

If you would like to try Behaviour Smart in you service or you would like a demonstration please get in touch. We also offer free training for individuals or staff teams.