Touch, Physical Restraint and Therapeutic Containment in Residential Child Care

Abstract

Within Glasgow School of Social Work, Laura is a SIRCC-funded lecturer and course director for the MSc in Advanced Residential Child Care. She has eleven years of practice and management experience, both in residential treatment centres in the USA (explicitly therapeutic programmes for young people and families who are experiencing difficulties) and in residential child care in Scotland. Much of her teaching is specific to residential child care, at both undergraduate and postgraduate levels. She also teaches ethics and has an undergraduate degree in philosophy *CorrespondencetoLauraSteckley,GlasgowSchoolofSocialWork,UniversityofStrathclyde, Abstract The relationship between touch and physical restraint in residential child care is not well understood. Theories of therapeutic containment offer insight into the practice of phys- ical restraint, the place of touch in residential child care practice and the impact of wider fears about touching between children and adults. Early experiences of containment necessarily involve touch through feeding, holding and other forms of soothing. Yet, for those who have not had 'good enough' early experiences of containment, their need for containment (including containing touch) may remain high. Physical restraint, a not uncommon practice in residential child care, simultaneously embodies extremes of both touch and containment. This paper, then, uses theories of therapeutic containment to illuminate the relationship between touch and physical restraint. It offers findings of a large-scale, qualitative study that explored the experiences of physical restraint of chil- dren, young people and staff in residential child care in Scotland. It provides evidence that staff experience anxieties related to touching young people, that some young people use physical restraint to meet needs for touch, that touch is used to contain dis- tress and avoid restraint, and that touch-related fears may be limiting its ameliorating use, thus potentially increasing the use of physical restraint.