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Posted: Apr 6, 2007 08:58

RESTRAINTS OR NO RESTRAINTS

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That is the Question

By Timothy Smith

For many years I have listened to the debate regarding the use of restraints by transport agents. There are those who incorporate handcuffs or other mechanical restraints into their S.O.P. (standard operating procedure) and always use them. There are also those who profess a strict "hands off" policy and never use restraints. I have come to learn that this is quite a sensitive subject that many would like to side step if possible. Given the sensitive nature of our industry and the scrutiny of operating under an ever widening magnifying glass of criticism, that mindset is unrealistic and can lead to unforeseen problems for everyone. Consider the facts and draw your own conclusion.


  1. Some adolescents are very cooperative and willfully comply with the transport agents. Are restraints warranted in this situation?
    No! An adolescent should be given every opportunity to not only cooperate but contribute in a positive way regarding their initial intervention process. When given respect and a voice to be heard many adolescents will feel less threatened and be more willing to comply. This is ideally what a seasoned transport agent will always strive to institute. Does it always work? No… then what?


  2. "High-risk" adolescents (teens with risk factors including current drug use, a propensity for aggressive behavior, and those with certain disorders such as ODD) are more likely to escalate into crisis. The question posed here is: "What if my child refuses to go?"
    This is to be expected. A qualified agent is thoroughly trained to go into each initial intervention with the expectation that the child will not go willingly. A good agent understands that the child is going to be angry, overwhelmed, and/or scared. The agent also understands that the child may be under the influence of drugs and/or alcohol. With this in mind the agent will take every possible aspect into consideration when making the initial assessment of the child's overall behavior. If the child refuses to cooperate, the agent(s) will give the adolescent every opportunity to rescind and comply. After all avenues of verbal de-escalation have been exhausted the agents will, if necessary, tactfully take the adolescent into their custody and continue with the intervention. I am always leery of intervention/transport companies that advertise a strict "no restraints… ever" policy. Inevitably, in our profession, there will be times when verbal de-escalation fails and an individual escalates into "extreme crisis". When one escalates to this level you must remember he/she is incapable of rationalizing. In this dangerous mindset the individual has a significant potential to act out with physical aggression. Also, when intervening with someone under the influence of or detoxing from drugs or alcohol you must never forget you are dealing with a "chemically influenced" personality. In this situation the individual can escalate into "extreme crisis" without warning or provocation.

    A professional intervention/transport company's field agents should be trained and proficient in ALL "crisis resolution" techniques. An inexperienced or unqualified
    agent can actually exacerbate the crisis by being unprepared and/or incapable of instituting safe intervention. In these scenarios an unqualified agent basically has two choices: "Wing-it" or "Let the child go".


Both situations have the propensity to produce dangerous results. The agent who is willing to "wing-it" must improvise as he/she will likely have little if any training in physical restraint and detainment techniques (as there is no reason for this type of training in a company that professes a total "hands-off" policy). Also, an inexperienced agent will likely overcompensate if physically engaged by the individual in crisis. Therein resides the potential for harm… to both the aggressor and the agent. When physically threatened, it is human nature for the body to react with the "fight or flight" syndrome. Essentially, this syndrome is the brain's chemical response to fear, anxiety, stress, and/or anger. The brain releases bursts of adrenaline throughout the blood stream which, in turn, fuels the body's muscles with extreme energy. If an agent is not experienced in working under this type of duress he/she could over exert themselves and, unintentionally, physically harm the adolescent or themselves.

The agent who decides to disengage and allow the adolescent to leave has failed as well. The child has just been given information that he/she is being sent away to an intervention program. If not taken into custody at this critical juncture the adolescent may likely run or worse, attempt to harm those responsible for making this decision. Once information is given to the child you must be prepared to and capable of seeing the initial intervention through to completion.

An agent should never negotiate with the child. It sets precedence for future noncompliance and lack of accountability. As an adolescent should always be held accountable for their actions, so must the agent(s) working with the child. An agent going back on his/her word or making false promises will only slow down and harm the positive intervention process for the adolescent and his/her family (not to mention causing the adolescent to distrust those who will be working with him/her at the program). If necessary, it is better to withhold information for a time than to lie to the child. During the transport a good agent will do everything in his/her power not to embarrass the adolescent in private or public. He/she will also mentally prepare the child for their intervention placement. Although transport agents need to operate with a "tough love" attitude they need to operate with the mindset that compassion must always take precedence.

A qualified transport agent will be certified and proficient in non-combative crisis intervention utilizing verbal de-escalation techniques. The agent should be certified by an industry recognized crisis intervention and de-escalation certification i.e. (Non-violent Crisis Prevention Intervention (CPI), Therapeutic Aggression Control Techniques (TACT 2), or Advanced Conflict Resolution & Restraint Reduction Mandt). The basics of these courses teach recognition and levels of conflict and crisis, verbal de-escalation techniques, and DDT (detention and detainment techniques). DDT utilizes the body's own mechanics to safely secure an individual without the use of foreign restraints (hand cuffs, shackles, zip-ties, etc…)

For example, at Guardian Angel it is standard operating procedure for our agents to employ DDT only when an adolescent is a physical threat to himself/herself or the public as a whole. If the adolescent has escalated too far and his/her "on scene" threat assessment indicates a high potential for PHYSICAL harm then our S.O.P. warrants temporary use of mechanical restraints employed by agents trained to use them correctly. Restrains should never be used as a punishment and should only be utilized until the adolescent de-escalates. Verbal threats or passive reactions never warrant the utilization of mechanical restraint measures.

In closing, the most ultimate goal for agents should be to treat each and every adolescent in your custody as though he/she was your very own child.

About The Author: Timothy Smith is the Co-owner of Guardian Angel Youth Services, which has transported at-risk youth for over a decade. 866-240-5142, www.guardianangel.cc.





~Comments~

April 15, 2007

I have no idea what the women's comment meant but, I do know that Timothy Smith is absolutely correct. I should have used Guardian Angel when I needed help with my daughter. The company that we used did not restrain her and she ran away. Our daughter was missing for over three weeks because they failed to do their job. Some of these teens need to be restrained.

If you think otherwise then you have no business in the transportation of high risk teenagers.


Thank you.

Jim Nightshade
Arizona



April 09, 2007

Hi I live in Florida where the cops are "macho-man" and always use restrictive measures immediately. Thus, they are not trained in CPI, TACT 2 or DDT. What would the purpose of that be, when you can just assume they are on drugs, may have a concealed weapon or will run immediately because that is what adolescents see regularly and view on "COPS" TV shows. Excessive violent "man-handling" is never accepable unless someone has already injured anyone (self or others) but techniques that prevent serious injury in the least restrictive manner should be used with teens and compromised adults with known disorders such as Alzheimer patients. I think many are plain frightened and agree with the adrenalin rushing and producing fight or flight in a natural response. More investigation needs to be done into alternative methods (not stun guns!) that are safer for de-escalation of our youth in schools, care facilities, transportation and camp situations in the wilderness therapies.

Joanna Tugliesa
Florida



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