CASE-STUDY - WHEN RESTRAINTS ARE THE LEAST RESTRICTIVE ALTERNATIVE FOR MANAGING AGGRESSION

This article discusses the controversial use of restraints with a pers istently violent adolescent on a child and adolescent psychiatry unit. The authors present an individualized program that used a series of a mbulatory restraints an a long-term basis and prophytactically to cont ain the aggression of a psychotic girl. Clozapine was used concomitant ly to control her psychosis. The prophylactic use of mechanical restra ints allowed this teenager to be integrated into the milieu and to rec eive multiple treatments that the standard protocol precluded. This ca se underscores the difficulties in managing aggression when youths do not respond to standard protocols and do not conform to our assumption s about the least restrictive alternative. It is concluded that prophy lactic mechanical restraint provided the least restrictive alternative to personal freedom for this teenager and had therapeutic benefit.