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Questions Are Raised on Restraint Training

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    Questions Are Raised on Restraint Training By JENNIFER GOLLAN The Bay Citizen Published: July 7, 2011
    Message 1 of 1 , Jul 8, 2011
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      Questions Are Raised on Restraint Training
      By JENNIFER GOLLAN  The Bay Citizen
      Published: July 7, 2011
      http://www.nytimes.com/2011/07/08/us/08bcrestraint.html?_r=1&pagewanted=all
      Corporal punishment is illegal in California public schools, but physically restraining unruly students is not. As incidents of restraint, seclusion and other emergency interventions have soared in recent years, schools have relied on training programs and physical restraint protocols developed by private companies that in many cases appear to have few qualifications.
      Although restraint training is directed at some of the most difficult and sensitive situations that school personnel encounter, the companies operate with little oversight. Federal law imposes strict rules on the use of restraints and seclusion in federally-financed hospitals and treatment centers, but the laws do not address their use in schools.
      Restraint companies now work with dozens of school districts across California and elsewhere, training teachers and counselors to use controversial restraint maneuvers. Students involved in restraint situations usually have serious behavioral problems or developmental disabilities. More than half the incidents reported statewide in the 2009-10 school year occurred in the Bay Area, most of them in Alameda, Contra Costa and San Francisco Counties.
      “We don’t know why this is happening,” said Fred Balcom, director of the California Department of Education’s special-education division.
      The San Francisco Unified School District contracts with a company called Handle With Care Behavior Management System to train teachers and administrators — who then train their colleagues — on how to restrain students properly.
      Bruce Chapman, the company’s founder and president, is a onetime psychiatric-hospital technician who said he had developed his “take down” restraint during a confrontation with an aggressive patient and refined it as a martial arts devotee who earned a black belt.
      The Oakland Unified School District and the Mount Diablo Unified School District are among those that work with Pro-ACT, a company founded in 1975 by Paul Smith, a psychologist. The program’s methods are largely based on Mr. Smith’s graduate-level psychology work more than 30 years ago, said Kim Warma, Pro-ACT’s co-owner.
      The San Mateo County Office of Education, for its part, works with the Crisis Prevention Institute to teach some staff techniques to handle problem students.
      The company was founded in 1980 by AlGene Caraulia Sr., who has a background in martial arts, and Gene Wyka, who holds a bachelor’s degree in psychology. They initially developed their program for psychiatric institutions, and it has changed little over the last 30 years, according to Randy Boardman, executive director of research and development at the company. It is now used by employees of group homes, prisons, elderly homes and schools.
      Maggie Roberts, an associate managing attorney at Disability Rights California, a nonprofit advocacy organization for the disabled in Sacramento, said that school districts see the restraint training as a bigger need than ever because they have big class sizes and less money and are feeling overwhelmed. “I have certainly seen a number of situations where people clearly don’t know what they are doing, where they weren’t trained well enough,” Ms. Roberts said.
      Incidents of restraint (in which a child’s movement is restricted), seclusion (in which a child is involuntarily confined alone in a room) and other behavioral episodes in California schools more than doubled to 21,076 between the 2005-6 and 2009-10 school years, according to California Department of Education figures.
      Under state law, restraints and seclusion in schools are considered “emergency interventions” that can be employed to control spontaneous behavior that “poses clear and present danger” to the student or others. Educators are not permitted to lock children away in a room or use mechanical restraints.
      School districts are required to have some kind of training program for the use of restraints, and state Department of Education policies specify that only properly trained personnel should use restraint and seclusion.
      But there are no rules governing the training programs or what restraint techniques are recommended.
      “Right now, there isn’t any oversight of whether the districts are using a good company or they are following up on their training,” said Connie Cushing, a special-education consultant for the Mount Diablo Unified School District.
      Several recent incidents illustrate how efforts at restraint can go awry. Last year, at George Hall School in San Mateo, teachers restrained a first grader with an anxiety disorder who had wandered away from campus and returned him to school. He then climbed on top of a cabinet and refused to get down. Teachers called the police, who pepper-sprayed the boy in the face and had him involuntarily committed to the San Mateo Medical Center, court records show. A psychiatrist released the boy to his parents a few hours later.
      The parents reached a settlement agreement with the school district and the county. Pamela Bartfield, George Hall’s principal, did not return two telephone calls requesting comment.
      Efforts to limit the use of restraint and seclusion in California schools have been met with resistance from powerful interest groups. Assemblyman Roger Hernández, Democrat of San Gabriel Valley, introduced a bill in February that would ban the use of isolation rooms and impose strict limits on how teachers use restraint. But the bill was tabled after running into stiff opposition from the California Department of Education, the California Teachers Association, the California School Boards Association and the California Alliance of Child and Family Services, which represents more than 130 foster homes and other agencies for troubled youth.
      Federal legislation, prompted in part by fatalities in Texas and other states, has run into similar opposition, including that of Mr. Chapman of Handle With Care.
      In a letter to members of the House of Representatives in February 2010, Mr. Chapman criticized federal legislation sponsored by Representative George Miller, Democrat of California, that called for limits on the use of physical restraint and encouraged restraint training for teachers.
      Mr. Miller’s legislation proposed that states approve only crisis intervention training programs that rely on evidence-based techniques that have been “shown to be effective.” The programs would also have to train teachers in de-escalation practices, first aid and cardiopulmonary resuscitation.
      The bill passed the House but never made it to the Senate floor. Mr. Miller reintroduced the bill in the spring.
      “Tragically, we have seen that restraint and seclusion can get out of hand. Children have died and have been traumatized as a result of being locked away in a closet,” said Mr. Miller, his party’s ranking member of the House Education and the Work Force Committee. “Clearly, training is a very important component of this. I don’t think that it is sufficient.”
      The programs typically run for several days, and teachers then return to their schools to train others.
      Handle With Care, according to its literature, has “created safer human service environments in over 1,000 organizations and schools in all 50 states and internationally” since its founding in 1984. Aside from Mr. Chapman, the company has three full-time employees and roughly 20 “master instructors” who lead seminars.
      Mr. Chapman got his start in restraint training after dropping out of community college. At age 20, he took a job as a psychiatric technician in the in-patient unit at Pennsylvania Hospital in Philadelphia, where he “received a lot of in-service training in the form of practical experience,” Mr. Chapman said during a deposition in a 1999 lawsuit.
      Mr. Chapman said that a chance encounter with an aggressive psychiatric patient in 1974 helped him develop a maneuver that is now central to his training program. The man reached for a brick, and Mr. Chapman restrained him by grabbing his upper arms from behind.
      “The hold just kind of came instinctively at the time,” Mr. Chapman said in a telephone interview. “Any time I had to physically restrain a patient over the next seven years, I used this hold. It offers a tremendous mechanical advantage.”
      Mr. Chapman said he went on to refine his restraint technique through martial arts classes.
      “There is no university-based program or academic program that will help you get someone to the ground safely,” Mr. Chapman said.
      Mr. Chapman is sought out for his training techniques.  But a video that was posted on YouTube showing him firing a pistol while making anti-homosexual slurs raises questions about the school districts’ association with him.
      Mr. Chapman defended the video as “a funny vignette that I did for a production to entertain skydivers. It was a skit not unlike ‘Saturday Night Live.’ It does not reflect my feelings about gays or transgenders.” He added, “That was a satire against homophobes.” The video, which was available at least until August 2009, has since been removed.
      Hilary Adler, Mr. Chapman’s lawyer and vice president of Handle With Care, added in an e-mail that her client and Handle With Care “have been staunch supporters of gay, transsexual and transgender rights.”
      Handle With Care’s literature says its restraint technique is “versatile, effective, painless, safe and easy to apply.”
      But at least one deadly incident raises questions.
      A 14-year-old boy died in 1998 after being restrained by counselors at a Pennsylvania facility for children with emotional and behavioral problems. Staff at the facility, KidsPeace National Center for Kids in Crisis, had been trained to use Handle With Care techniques. The boy’s mother and her lawyers were awarded a $1.2 million settlement in 2006 from KidsPeace. KidsPeace subsequently stopped using Handle With Care’s training program.
      Handle With Care, which was initially named as a defendant but later dropped from the suit, was not implicated. Mr. Chapman said his techniques were not dangerous, and his company was not responsible for what happened.
       
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