Opinion

The Ugly Reality of Restraints

As a one-time youth worker who worked with youth in an adjudicated residential setting in southern Michigan, I am dismayed by the arrogance that Martha Holden, director and co-developer of Therapeutic Crisis Intervention (TCI), demonstrates in her response to accidental deaths caused by restraints. (“Restraints that Kill,” May.)

Having been fully trained in TCI while employed with Starr Commonwealth schools, it is my opinion that TCI isn’t all it professes to be. What Holden fails to mention or acknowledge is that no matter how properly executed a restraint is performed, the sheer energy of a youth who is in crisis mode and being restrained often calls for staff to make on-the-spot readjustments, reposition themselves, add additional staff in mid-restraint, or repeat the restraint.

When going through the TCI trainings, participants are exposed to a sanitized, unrealistic, mollified version of restraint that seldom, if ever, exemplifies a real restraint situation. It simply walks one through the steps of a given restraint, devoid of the physical and emotional exhaustion experienced by both parties when executing the real thing.

Although it is sad when injury or death occurs, youths who are making threatening statements and are out of control can and do pose a great danger to their peers and staff, and they must be dealt with swiftly in order to rectify the situation. If Ms. Holden is so “angered that organizations aren’t learning anything,” perhaps she should come down from her ivory tower and make the TCI trainings more reflective of the realities faced by front-line youth workers who are performing restraints in adjudicated settings.

Scott Y. Moyer

Kalamazoo, Mich.

(The writer now works at another nonprofit.)

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