Strict Behavior Management on child/adolescent unit

[Shell5]

Do you have SBM on your unit? If so, do you have controversy? How does yours work? Any suggetions? :argue:

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BEHAVIOR PROTOCOL

Strict Behavioral Management (SBM) may be recommended if the patient is not responding to the general treatment milieu or patient is readmitted to Metroplex within ______days for behavioral difficulties. Care must be taken to insure a patient not be placed on SBM for something that is not in his/her control i.e., parent allowed meds to run out or patient is back for more of a psychosis with little to no acting out. When behavior management is recommended by the treatment team and ordered by the doctor, the following protocol is put in place and can be modified by the doctor's orders.`

SBM NO PRIVILEGES

CAN EARN PRIVILEGES BACK WITH DR. ORDERS ONE PRIV. A DAY AS LONG AS THE PT CONTINUES TO DO WELL AND THERE IS A WRITTEN ORDER.

(PATIENT'S CAN ASK FOR THEIR PRIVILEGES BACK OVER THE WEEKEND. THE NURSE CAN THEN SPEAK WITH THE DOCTOR ABOUT A PRIVILEGE BACK. IF DR. OKAYS THIS THEN THEIR MUST BE AN ORDER WRITTEN.)

NO MOVIES ON MOVIE NIGHT. THIS INCLUDES END OF WEEK MOVIES, AT SCHOOL, MOVIES ON THE UNIT DURING HOLIDAYS. MAY WATCH EDUCATIONAL VIDEOS.

NO SNACKS OR DRINKS FROM CAFETERIA OR ON VISITATION. ROUTINE SNACK ONLY.

MAY RUN LAPS IN THE GYM IN THE EVENING THEN MUST DO ASSIGNED WORK.

NO OUTINGS, UNLESS IT IS A STRUCTURED THERAPEUTIC ACTIVITY TO TEACH COPING AND SOCIALIZATION.

LIMITED ACTIVITY THERAPY DURING THE DAY. ACTIVITY THERAPIST WILL DECIDE WHAT THERAPIES THE PATIENT WILL PARTICIPATE IN.

SBM WITH PRIVILEGES

NO MOVIES ON MOVIE NIGHT. THIS INCLUDES END OF WEEK MOVIES, AT SCHOOL, MOVIES ON THE UNIT DURING HOLIDAYS. MAY WATCH EDUCATIONAL VIDEOS.

MAY GO TO CAFETERIA AS LONG AS THEY HAVE EARNED THAT PRIVILEGE BACK.

NO SNACKS OR DRINKS FROM CAFETERIA OR ON VISITATION. ROUTINE SNACK ONLY.

MAY RUN LAPS IN THE GYM IN THE EVENING THEN CAN PARTICIPATE WITH OTHERS AS LONG AS THEY HAVE EARNED THIS PRIVILEGE BACK. UNLESS STAFF DEEMS OTHERWISE.

NO OUTINGS, UNLESS IT IS A STRUCTURED THERAPEUTIC ACTIVITY TO TEACH COPING AND SOCIALIZATION.

LIMITED ACTIVITY THERAPY DURING THE DAY. ACTIVITY THERAPIST WILL DECIDE WHAT THERAPIES THE PATIENT WILL PARTICIPATE IN.

(Patient will continue to earn all other privileges as outlined in the handbook, except for the above stipulations (`i.e. stickers, points, level 2, passes.)

LEVEL FREEZE

IF YOU WERE ON LEVEL 2 YOUR LEVEL WILL DROP.

NO SNACKS OR DRINKS IN THE CAFETERIA OR AT VISITATION.

MAY RUN LAPS IN THE GYM IN EVENING. THEN MUST WORK ON ASSIGNMENT.

YOU WILL BE GIVEN ADDITIONAL ASSIGNMENT (LEVEL FREEZE)

YOU MAY NOT GO DOWN TO THE CAFETERIA.

SOCIAL ISOLATION

FO R PATIENTS WHO HAVE HAD DIFFICUTLY MAINTAING THEMSELVES AROUND OTHER PATIENTS OR WHO HAVE BEEN KNOWN TO TOUCH OTHERS INAPPROPRIATELY. IT IS MEANT TO BE SHORT TERM IN NATURE. IF A PATIENT IS ON SOCIAL ISOLATION BUT NO OTHER RESTRICTION IE; SBM/LF THEY MAY GO TO CAFETERIA AND WATCH MOVIES (BIG MOVIE OR EDUCATION UNLESS THEIR THERAPIST STATES OTHERWISE) BUT THEY MUST SIT SEPARATE FROM THE GROUP. IF STAFF FEELS A PT HAS BEEN ON SOCIAL ISOLATION TOO LONG, THEY MAY LET THE NURSE OR THERAPIST KNOW.

*****NEED TO FIND OUT IF THEY CAN READ BOOK IF THEY ARE ON LF OR SBM AFTER THEY HAVE COMPLETED THEIR ASSIGNMENTS. WHAT DOES THE TEAM THINK? WE NEED TO BE ON THE SAME PAGE. SOME CONTROVERSY EXISTS HERE.

IN ONE WAY I THINK A BOOK IS OK. ON THE OTHER HAND I DON'T BECAUSE THEN THEY DON'T HAVE TIME TO THINK ABOUT WHAT THEY HAVE DONE.

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