Staff Perspectives of Precipitants to Aggressive Behavior of Adolescents in Residential Treatment Facilities
2008; Taylor & Francis; Volume: 25; Issue: 2 Linguagem: Inglês
10.1080/08865710802309964
ISSN1541-0358
Autores Tópico(s)Workplace Violence and Bullying
Resumosummary Face-to-face, semistructured interviews with 18 staff in a public psychiatric adolescent residential treatment facility were conducted to obtain an inductive approach to their understanding of what leads to aggressive behavior among adolescents. Staff's views of the precipitants of aggressive behavior centered on three themes: understanding of the adolescent, views of interactions within the milieu, and perspective of the service system policies and procedures. Important service system factors included the culture and climate of professional development, the professional practice standards, and the available resources and technologies. A key message was the need for consistent training and awareness of philosophical differences in staff's approaches. KEYWORDS: Residential careseclusion and restraintaggressive behaviorstaff trainingseclusion and restraint reduction We are grateful for the support of: Dr. Brian Hepburn, Director, Dr. Al Zachik, Director of Child and Adolescent Services of the Maryland Mental Hygiene Administration (MHA); Maryland Youth Practice Improvement Committee (Gayle Jordan-Randolph, MD (MHA); Mark A. Riddle, MD, Shannon R. Barnett, MD (Johns Hopkins University); David Pruitt, MD, Eileen Hansen, LCSW, Ruth Anne McCormick, RN, C., DNSc, Robert K. White, MA, LCPC (University of Maryland); Claudette Bernstein, MD (John L. Gildner Regional Institute for Children and Adolescents); Holly Sikoryak, MD (Regional Institute for Children and Adolescents, Southern Maryland); David Horn, MD (Regional Institute for Children and Adolescents, Baltimore); Kimberly Bright, MD, Jerry Kowaleski, PhD (Spring Grove Hospital); Judith Hott, MSN, RN,C. (Finan Center); Amanda Selin and Matthew Mychailyszyn. This work was made possible through the financial support of the Maryland Mental Hygiene Administration. Notes Medicaid Program; Use of restraint and seclusion in psychiatric residential treatment facilities providing inpatient psychiatric services to individuals under age 21, 42 C. F. R. § 441 and 483 (2001) Medicare and Medicaid Programs; Hospital conditions of participation: patient's rights; interim final rule, 42 C. F. R. § 482 (1999) Medicare and Medicaid Programs; Hospital conditions of participation; patients' rights; final rule, 42 C. F. R. § 482 (2006). Nvivo [Computer software]. (2002). Doncaster Victoria, AU: QSR International Pty., Ltd.
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