Introduction

When social care workers must respond to behaviour which poses serious, imminent danger, the response can sometimes take the form of physical restraint. Physical restraint has long been the subject of serious concern in social care, as well as other areas, such as law enforcement and psychiatry. This chapter focuses on physical restraint in residential childcare. It is one of the most complex and ethically fraught areas of practice, yet there is almost no dedicated literature that applies itself to the ethical dimensions of this practice in this field. The chapter starts with discussion of the context of practice in residential childcare. A tentative explanation for and critique of the lack of ethically dedicated attention to the subject of physical restraint in residential childcare is then provided, with an argument for the transformative potential of care ethics to develop related thinking and practice. The chapter goes on to draw from a large-scale qualitative study of physical restraint in residential childcare in Scotland. The study was funded by Save the Children, Scotland and included in-depth interviews with 41 care workers and 37 children and young people. Interviews were comprised of four multi-level vignettes and a semi-structured interview schedule and averaged around 100 minutes for workers and 30 minutes for children and young people. Relevant findings are then examined and discussed through the lens of care ethics. While the contextual issues and findings discussed below are located specifically in Scotland, they have relevance to residential childcare (and indeed other forms of care where physical restraint is used) in the United Kingdom and internationally.

Context

In Scotland, residential childcare is comprised of a range of provision that includes secure accommodation, residential schools for children with emotional and behavioural difficulties, children's homes and homes that provide respite to families whose child or children are disabled. The vast majority of children and young people who are placed in residential care have experienced abuse, neglect and/or other trauma (Anglin, 2002; Ward, 2006) and sometimes their related, underlying pain can manifest in behaviours that pose risk of serious harm to themselves and/or others.