Common elements to reduce seclusion in child and adolescent residential care settings: A synthesis of literature and semi-structured interviews

In the past decades, awareness of the harmful effects of seclusion has led to a strong desire to reduce its use in child and adolescent residential care settings. As a response, various seclusion reduction interventions have been developed and implemented in practice. These interventions consist of both methods as well as more practice-based and ad hoc actions. Identification of common elements within this wide variety of seclusion reduction interventions would be beneficial for the further understanding and implementation of these interventions, training of staff, and research aimed at the reduction of seclusion. Therefore, the objective of this study was to identify the common elements of both methods and practice-based actions to reduce seclusion in child and adolescent residential care settings. A literature review and semi-structured interviews with experienced professionals involved in child and adolescent residential care were used to determine the common elements of seclusion reduction interventions. In total, 21 studies and 11 interviews were assessed. This led to the identification of two domains with six common elements each. Further investigation of how these common elements influence the reduction of seclusion could potentially build strong universal methods and training modules for the reduction of seclusion in a broad range of child and adolescent residential care settings.