Seclusion and restraint practices have a long history dating back to early 18th century vagrancy laws. Since that time, due to regulatory efforts and programs such as collaborative problem-solving, there has been an overall reduction in the use of seclusion and restraint. However, more recently, reports of abuse that include deaths of patients in residential treatment facilities have brought to light the lack of psychiatric involvement in seclusion and restraint. This presentation will provide the learner with a framework for understanding seclusion and restraint practices, including the use of "chemical restraint" in its various definitions, and seclusion and restraint in public schools. Leadership and advocacy alternatives for psychiatrists will also be explored, along with an understanding of psychiatric intervention to prevent seclusion and restraint episodes.

Learning Objectives

• Describe the history of seclusion and restraint practices and psychiatric involvement
• Identify the psychiatrist's role in seclusion and restraint practice in inpatient and residential settings
• Apply opportunities for psychiatric intervention in the teaching, prevention, and management of seclusion and restraint
• Examine the concept of chemical restraint and its relationship to PRN medication

Target Audience

Psychiatrists, Residents/Fellows

Estimated Time to Complete

Estimated Duration: 75 minutes
Begin Date: April 25, 2019
End Date: April 25, 2025
Review Date: April 11, 2022

How to Earn Credit

Participants who wish to earn AMA PRA Category 1 Credit ™ or a certificate of participation may do so by completing all sections of the course including the evaluation. A multiple choice quiz is provided based on the content. A passing score of 70% must be achieved. Retakes are available for the test. After evaluating the program, course participants will be provided with an opportunity to claim hours of participation and print an official CME certificate (physicians) or certificate of participation (non-physicians) showing the completion date and hours earned. 

Continuing Education Credit

The American Psychiatric Association (APA) is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians. 

The APA designates this enduring CME activity for a maximum of 1.25 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Faculty and Planner Disclosures

Program Presenter and Reviewer (2022)

• Kim J. Masters, M.D., DFAPA, Assistant Professor, College of Health Professions, The Medical University of South Carolina. Reports no financial relationships with commercial interests.

Program Planners

• Tristan Gorrindo, M.D., Former Director of Education, American Psychiatric Association. Reports no financial relationships with commercial interests.

Accessibility for Participants with Disabilities

The American Psychiatric Association is committed to ensuring accessibility of its website to people with disabilities. If you have trouble accessing any of APA’s online resources, please contact us at 202-559-3900 for assistance.

Technical Requirements

This internet-based CME activity is best experienced using any of the following:

• The latest and 2nd latest public versions of Google Chrome, Mozilla Firefox, or Safari
• Internet Explorer 11+

This Web site requires that JavaScript and session cookies be enabled. Certain activities may require additional software to view multimedia, presentation, or printable versions of the content. These activities will be marked as such and will provide links to the required software. That software may be: Adobe Flash, Adobe Acrobat Reader, Microsoft PowerPoint, and Windows Media Player.

Optimal System Configuration:

• Browser: Google Chrome (latest and 2nd latest version), Safari (latest and 2nd latest version), Internet Explorer 11.0+, Firefox (latest and 2nd latest version), or Microsoft Edge (latest and 2nd latest version)
• Operating System: Windows versions 8.1+, Mac OS X 10.5 (Leopard) +, Android (latest and 2nd latest version), or iOS/iPad OS (latest and 2nd latest version)
• Internet Connection: 1 Mbps or higher

Minimum Requirements:

• Windows PC: Windows 8.1 or higher; 1 GB (for 32-bit)/2 GB (for 64-bit) or higher RAM; Microsoft DirectX 9 graphics device with WDDM driver; audio playback with speakers for programs with video content
• Macintosh: Mac OS X 10.5 or higher with latest updates installed; Intel, PowerPC G5, or PowerPC G4 (867MHz or faster) processor; 512 MB or higher RAM; audio playback with speakers for programs with video content

For assistance: Contact educme@psych.org for questions about this activity | Contact learningcenter@psych.org for technical assistance