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Use of a holding technique to control the violent behavior of seriously disturbed adolescents.

Therapeutic holding is a treatment technique in which a violent patient is physically contained by people rather than by mechanical or chemical restraints or seclusion. Episodes of therapeutic holding that took place on an inpatient adolescent psychiatric unit over an 18-month period were examined retrospectively through chart review and review of written audits of each episode. During that period, 22.8 percent of the patient population experienced at least one episode of therapeutic holding. Patients requiring this intervention were more likely to be younger and, when day at risk were controlled, to be male and to have had longer stays on the unit. The technique enabled patients to regain behavioral control after a mean of 21.2 minutes, a much shorter period of containment than the four to 16 hours reported in studies of seclusion.