Letters to the Editor

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Teaching Family Approach Works

T. Lindsay Joines
Program Compliance/Crisis Management Officer
Eliada Homes, Inc.
Ashville, NC

Your article on the Maryville Academy [March] … appears to present a limited and somewhat narrow view of the applicability and usefulness of teaching family programs and technology. It is also significant to note that most of the critical statements you quoted were from clinical individuals who did not hold a positive view of this model. It is an oversimplification to lay the demise of Maryville at the feet of the teaching family model.

I am associated with an agency that uses teaching family technology and incorporates significant use of clinical insights and therapy. This model has been quite successful in working with more difficult populations. In fact, we serve some of the most difficult clients in our state system.

Spin on Restraints Insults Workers

Joseph K. Mullen
JKM Training
Carlisle, PA 

In their eagerness for reform, advocates for reduction in the use of restraint and seclusion have created a misleading spin on reality. The spin is being used as part of the effort to change the culture in youth service that they believe currently supports using restraint and seclusion.

The spin labels any use of restraint as a “therapeutic failure.” This label comes from the president’s New Freedom Commission on Mental Health (2000) recommendations, which indicated that high frequency of restraint was “evidence of therapeutic failure” in programs. Note that the commission did not label restraint and seclusion intervention as “therapeutic failure.” It said that our “therapeutic failures” lead to higher rates of restraint and seclusion intervention.

While the misuse of restraint and seclusion must be reformed, the advocates need to know that their spin is insulting the thousands of teachers and youth service workers who struggle every day to assist misbehaving youth as they learn to regulate their behavior. These individuals deserve recognition, not insult.

If a culture exists that tolerates misuse, semantic trickery is not the answer. Clear performance expectations, competent staff and professional oversight are.

Restraint and seclusion are emergency response interventions, not “therapeutic failures.” We need to be clear on when and how they can or cannot be used.