Improving the Management of Acute Aggression in State Residential and Inpatient Psychiatric Facilities for Youths

Shannon R. Barnett, Susan DosReis, Mark A. Riddle

Research output: Contribution to journalArticlepeer-review

24 Scopus citations


The Maryland Youth Practice Improvement Committee for Mental Health, which includes academicians, clinicians, and policymakers, was convened by the Maryland State Mental Hygiene Administration to advise on approaches to improve mental health care for youths in state inpatient and residential facilities. This report describes the development of a guide to improve the management of acute aggression. The process included the identification of key stakeholders, a literature review on managing acute aggression and promoting staff behavioral change, and many debates among the Committee members. An external peer review critiqued the Guide for content validity and feasibility in routine practice. The therapeutic process, a model to direct clinical decision-making used in other medical fields, forms the theoretical framework. Three levels of aggression and corresponding treatment options were established. The Committee hopes that acute aggressive episodes requiring restrictive interventions can be reduced with the combination of careful planning, adequate resources, and sufficient training. When selecting an intervention, the safety of all individuals involved is of primary importance and a patient's past stated preferences should also be considered. This report concludes with a brief discussion of future plans for the implementation and evaluation of this protocol in clinical practice.

Original languageEnglish (US)
Pages (from-to)897-905
Number of pages9
JournalJournal of the American Academy of Child and Adolescent Psychiatry
Issue number8
StatePublished - Aug 2002


  • Aggression management protocol
  • Child and adolescent psychiatry
  • Psychopharmacology
  • Restraint
  • Seclusion

ASJC Scopus subject areas

  • Developmental and Educational Psychology
  • Psychiatry and Mental health


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