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Physical Hold vs Restraint or Seclusion

What is the difference between seclusion/restraint and physical holding of children/youth?

Any examples are for illustrative purposes only.

The Comprehensive Manual for Behavioral Health Care (CAMBHC) has standards which address the use of physical holding of children and youth as well standards that address seclusion/restraint. 

For adults, physical holding is a restraint, thus there are no separate standards related to physical holding for adults. For children and youth, physical holding is separate from restraint. Both sets of standards and Elements of Performance(EP) would not be applied at the same time.  For organizations that use physical holding of adults, only seclusion/restraint standards apply. For organizations that use physically holding of children and youth, only physical holding standards apply.  For organizations that use seclusion/restraint, outside of physical holding, for children and youth, the seclusion/restraint standards apply. 

The following definitions are published in the glossary of the Comprehensive Accreditation Manual- Behavior Health Care:
  •  Physical holding of children and youth: A method of restraint in which a child’s or youth’s freedom of movement or normal access to his or her body is restricted by means of staff physically holding the child or youth for safety reasons.
  • Restraint: Any method of restricting an individual’s freedom of movement, including seclusion, physical activity, or normal access to his or her body that (1) is not a usual and customary part of a medical diagnostic or treatment procedure to which the individual or his or her legal representative has consented, (2) is not indicated to treat the individual’s medical condition or symptoms, or (3) does not promote the individual's independent functioning.
  • Seclusion: Involuntary confinement of an individual in a room alone, for any period of time, from which the individual is physically prevented from leaving. Seclusion does not include involuntary confinement for legally mandated but nonclinical purposes, such as the confinement of a person who is facing criminal charges or who is serving a criminal sentence.
Last updated on March 04, 2021
Manual: Behavioral Health
Chapter: Care Treatment and Services CTS

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