In my last two posts, I discussed the very disturbing Government Accountability Office testimony before the House of Representatives, outlining the use of physical restraint in schools and its potential and actual lethality. (This report may be seen at http://alt.coxnewsweb.com/palmbeachpost/pdf/gaoreport.pdf. ) In the second post, I described the history of physical restraint practices in psychiatric treatment, and recommendations that they be used with children, beginning in the 1960s.Attempts have been made to control these practices, but many sources, including www.patriciaebauer.com/category/restraint/, have detailed ongoing problems, especially with respect to children with handicapping conditions. In this present post I will comment on some ways in which the use of physical restraint is encouraged today by practitioners who claim--- without valid evidence--- that it is therapeutic for agitated children to be restrained by adults.
My first example is drawn from a self-published book of advice for adoptive parents, Help for the hopeless child, by Ronald S. Federici, a Virginia psychologist. Dr. Federici advises parents to restrain a disobedient child face-down on the floor, with one or both parents using their weight to hold the child down. The position used can be seen in an illustration in  Help for the hopeless child , or interested readers can see photographs showing the suggested position at http://www.charlydmiller.com/LIB13/2009FebFedericiPage.html. This face-down position, combined with the pressure exerted by the adults and the position of the child's arms, has a serious potential for impeding the child's breathing. Few parents following this advice will have received any formal training in the use of physical restraint--- indeed, many of them will have no instruction except what they have read in Help for the hopeless child . The danger of restraint by untrained persons is explicitly stated in the GAO testimony. Nevertheless, the book stresses the necessity for restraint, and tells adoptive parents that following a session of restraint the child will be especially ready to "attach" to them; this is a persuasive argument, however questionable its basis may be.
To the best of my knowledge, there have been no deaths or serious injuries in families following the methods of Help for the hopeless child. I mention this publication only to show that currently-available material instructs adults that physical restraint is an effective and useful treatment for children's behavioral problems.
A second example, involving materials more likely to be read by professionals, is found in publications by the Oregon psychologist David Ziegler. In his 2001 article "To hold or not to hold... is that the right question?" (Residential Treatment for Children & Youth , Vol. 18, pp. 33-45), and his 2004 article "Is there therapeutic value to physical restraint?" (Children's Voice , July/August), Dr. Ziegler argued in favor of "therapeutic holding", a period of restraint following a child's agitated or aggressive behavior. To support his views, this author referenced a variety of other authors with similar views, none of whom had presented systematic research evidence in agreement with this perspective. Curiously, in the Residential Treatment    article, Dr. Ziegler cited but did not provide references for a series of papers, all of which were actually arguments in favor of "holding therapy"(which I referred to in a previous post) and irrelevant to the issue of "therapeutic holding".
Again, I have no reason to suspect that Dr. Ziegler personally has used "therapeutic holding" in ways that have done harm. I mention these articles simply to emphasize that encouragement of physical restraint of children is by no means a thing of the past. This is especially the case in that the Children's Voice magazine is published by the Child Welfare League of America, an organization that presumably advocates the techniques it considers best practice. If CWLA believes that "therapeutic holding" is a good idea, teachers and child care professionals are likely to agree.
We should not be surprised that teachers carry out harmful or even lethal restraints, that school administrators turn a blind eye, or that juries decline to indict, when professional psychologists circulate the idea that physical restraint of children is not only acceptable, but an advisable therapeutic approach.