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Understanding Physical Restraint in Residential Child Care : Juxtaposing Frames of Containment and an Ethic of Care

Steckley, Laura (2013) Understanding Physical Restraint in Residential Child Care : Juxtaposing Frames of Containment and an Ethic of Care. PhD thesis, UNSPECIFIED.

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This PhD is based on 12 pieces of work: 11 published pieces, all of which relate to one large-scale, qualitative study carried out by the applicant and supervised by Professor Andy Kendrick. The study’s aim was to explore, in depth, the views and experiences of children, young people, and staff related to physical restraint in residential child care in order to inform policy and practice. The twelfth piece, the critical appraisal, establishes the coherence of the publications, and contextualises and analyses them. The selected publications reflect a trajectory of development that establishes increasingly complex relationships between features of the social ecology of physical restraint, and theoretical analyses that offer a way of understanding this complexity. Several key themes run through all of the publications, including complexity, ambiguity, relationship, meaning making and therapeutic containment. The last theme, therapeutic containment, is the most theoretically developed and offers an encompassing frame within which to make sense of the others. The critical appraisal examines the publications from a macro perspective. It introduces Goffman’s Frame analysis and explores several frames for understanding the practice of physically restraining children and young people in residential child care. Two new frames are then explored and combined with therapeutic containment, resulting in a three-part combined frame which is offered to better understand and to inform related policy and practice; they are Bion’s micro-level containment, Goffman’s macro-level containment, and Tronto’s political-philosophical ethic of care. The publications are re-viewed through this frame assembly, and the ensuing discussion is organised around three key themes: order versus havoc, anxiety and fear, and policy and practice. It is argued that the use (and misuse) of physical restraint, an extreme form of containment, is predicated on inadequate processes of care and containment at micro and macro-levels.