Communicating about restrictive practices

Dr Jennifer Frean, Communication and Inclusion Specialist
(The University of Melbourne; Melbourne, Victoria)

Restrictive practices can only ever be used under particular conditions. They must be the least restrictive alternative to keep people safe from serious harm, and all other options have to have been exhausted.

So how do we communicate about restrictive practices?

The person with a disability needs to know in advance what is proposed why and what their options are. Unfortunately, restrictive practices can do more harm than good, and it's possible that the person and the people in their support network have experienced trauma due to a restrictive practice.

So, think carefully about how you manage that when you're engaging with them and how that's going to be managed into the plan.

Our video and Yarning is an excellent example of how you can engage with people in a really authentic way.

Think about where these conversations take place. Who's in the conversation space? And make sure you go slowly and build trust.

Take cues from the person and try different techniques to make sure that they're fully engaged.

Ensure that they have choices and make sure they're included in the decision making.

Remember, restrictive practices must be appropriately authorised, regularly monitored, and are subject to review. And most importantly, they must be discussed with everyone involved.

Closing credits (text presented on screen)

How will you use these ideas to improve engagement in your behaviour support practice?

Sarah Bingley, Core Positive Behaviour Support Practitioner
(Marathon Health; Albury, New South Wales)

If you mention restrictive practices, just out of the blue to a parent or carer, it can be really scary.

Doug Payne, Senior Clinical Consultant, Behaviour Support Practitioner
(SAL Consulting – Darwin, Northern Territory)

They are things that if it happened to you and I would be illegal. Chemical restraint. Physical restraint. Unlawful imprisonment. Taking something from another person without their consent – stealing.

And these are some of the things we need to do in order to keep people safe. And that's our job as a behaviour support practitioner to justify clinically why we need to do these things.

Heather Lambert, Clinical Lead – Positive Behaviour Support
(Marathon Health; Albury, New South Wales)

It is very scary for a lot of people, it can really get people's defences up. And creates this kind of judgemental, ‘Us and them’ kind of attitude.

Nandita Patel, Team Lead – Positive Behaviour Support
(Marathon Health; Albury, New South Wales)

Restrictive practices in behaviour support is very confusing and complex for the participants and their carers.

All in all, it's about the person's quality of life and their safety. But it is there and it's about the reporting.

Heather Lambert

It's terminology that we can't really avoid because it's included in all of the documents, it's included everywhere. And so the best that we can do is use a really compassionate and gentle approach to actually having that conversation and broaching that with the participants.

And really helping them feel that, ‘Yes, there is this term – but it's actually not the term that I would prefer to use either, but we're using it!

This is what I would prefer to use, and here's how I'm going to talk to you about it’.

Doug Payne

It's not a language that people outside behaviour-support land understand, this ‘restrictive practice’ thing.

What most people, and it's just common sense, sometimes you have to put practices in place to keep people safe.

Dr Jennifer Frean, Communication and Inclusion Specialist
(The University of Melbourne; Melbourne, Victoria)

Having a conversation about what we will do to keep the person safe and remembering that engagement is communicating with the person to build their understanding, not talking at them.

Keith McVilly, Professor of Disability and Inclusion
(The University of Melbourne; Melbourne, Victoria)

It might be that we need to take the person out down their driveway and near the road, show them when a car is coming and show them what we'll do to keep them safe, to bring them back from the road.

Doug Payne

If they can't cross the road we say, we need to lock the gate because John you don't know how to cross the road safely.

Closing credits (text presented on screen)

How will you use these ideas to improve engagement in your behaviour support practice?