Date of Conferral

2022

Degree

Doctor of Psychology (Psy.D.)

School

Psychology

Advisor

Mark A. Arcuri

Abstract

To manage difficult behaviors and ensure the safety of clients and staff, behavioral health organizations have often relied on restrictive interventions such as seclusion and restraint. Although organizational leaders are increasingly seeking alternatives, there is very little literature or organizational practice knowledge addressing this issue. The purpose of this qualitative study was to explore, from an organizational leader’s perspective, sustainable best practices after the leaders of a behavioral health organization in the Southeastern region of the United States adopted a statewide initiative to reduce and eliminate restrictive intervention by transitioning to a no seclusion policy. The Baldrige Excellence Framework was used to ground the case study. The data sources were literature on the study topic, semistructured interviews with the organization’s executive director of residential services and the vice president of performance improvement, the organization’s website, and archival data kept by the organization such as client and staff surveys, client data, and restrictive intervention reports. Findings highlighted three strategies that could address the practice problem: (a) leadership, (b) use of data, and (c) workforce development. Recommendations include development of a protocol to use existing data to inform decisions and create staff development plans over a 1-year period. This study may contribute to positive social change by informing organizational leaders of the best practices for reducing or eliminating the use of restrictive interventions in behavioral health, thus furthering possibilities for trauma-informed care. Organizational leaders may be able to establish a more effective response to problematic behaviors that reduces retraumatization and exposure to violence and aggression.

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