Containment and holding environments: Understanding and reducing physical restraint in residential child care

Abstract

There have long been concerns about physical restraint in residential child care and much of the surrounding discussion is negative. Yet in a recent in-depth Scottish study exploring the views of those most directly affected by physical restraint—children, young people and staff—a more complex and nuanced picture emerges. Much of what the 78 study participants said about their experiences can be understood through the theoretical lenses of containment and holding environments. Such an understanding can potentially reduce, and where possible eliminate, the need for physical restraint and can increase the likelihood that when restraints do occur, they are experienced as acts of caring. For this to be possible, both direct practice (between staff and young people), and indirect practice (the ways that staff are supported to work with young people) must be containing. This paper starts by discussing the complex context in which physical restraints in residential child care in Scotland occur and then reviews concepts of therapeutic containment and holding environments. The findings of the study are then theorized in relation to containment and holding environments, across identified themes of control, touch, relationships and organisational holding. Implications for practice are offered in conclusion.