Restrictive practices are generally used in the context of keeping people and/or others safe in relation to a challenging behaviour that a person may be engaging in and, if required, should adhere to the following:
- be used as a last resort in response to risk of harm
- be the least restrictive option that ensures safety of the person and others
- reduce the risk of harm to the person and/or others
- be in proportion to the risk of harm to the person and/or others
- be used for the shortest possible time to ensure the safety of the person and/or others.
Types of regulated restrictive practices
There are five types of regulated restrictive practices that can be used under certain circumstances.
Seclusion
Seclusion is defined as confining a person to a room or area by themselves where they are not able, or they believe that they are not able, to leave.
Seclusion does not include a person who chooses to have quiet time or space on their own in their room, where they are able to come out at any time on their own accord. It also does not include someone choosing to lock their door for privacy, where they are able to unlock the door and exit whenever they choose to.
Chemical restraint
Chemical restraint is the use of medication or chemical substance for the primary purpose of influencing a person’s behaviour or movement. It does not include the use of medication prescribed by a medical practitioner for the treatment of, or to enable treatment, of a diagnosed mental disorder, a physical illness or physical condition.
Physical restraint
Physical restraint is the use or action of physical force to prevent, restrict or subdue movement of a person’s body, or part of their body, for the primary purpose of influencing a person’s behaviour. Some examples of physical restraint may include:
- physically holding any part of a person’s body, to stop a behaviour from occurring, e.g. holding down a person’s hand to stop them from pulling their hair
- using your body to physically guide a person to walk in a certain direction, where they do not want to go.
Physical restraint does not include if a person needs assistance in their daily living activities to complete a task safely and accepts this support. For example, if the person needs physical help with dressing or brushing their teeth.
Mechanical restraint
Mechanical restraint is the use of a device to prevent, restrict, or subdue a person’s movement, or to control a person’s behaviour.
This does not include the use of devices for therapeutic purposes.
Environmental restraint
Environmental restraint involves restricting a person’s free access to all parts of their environment, including items or activities. Examples of environmental restraint include locked doors, cupboard and fridges where the person cannot open them.
Prohibited practices
It is recognised that some forms of restrictive practice pose an unacceptable risk of harm to people. These are termed ‘prohibited practices’ within the Authorisation of Restrictive Practices in Funded Disability Services Policy (the Policy) and must never be used. These include the following physical restraints, which can lead to harm or death:
- the use of prone or supine restraint
- pin downs
- basket holds
- takedown techniques
- any physical restraint that has the purpose or effect of restraining or inhibiting a person’s respiratory or digestive functioning
- any physical restraint that has the effect of pushing the person’s head forward onto their chest
- any physical restraint that has the purpose or effect of compelling a person’s compliance through the infliction of pain, hyperextension of joints, or by applying pressure to the chest or joints.
The following punitive approaches are also prohibited:
- aversive practices
- overcorrection
- denial of key needs
- practices related to degradation or vilification
- practices that limit or deny access to culture
- response cost punishment strategies.
Refer to the restrictive practices resources page for more information.
