Innovations: child & adolescent psychiatry: use of collaborative problem solving to reduce seclusion and restraint in child and adolescent inpatient units.

The authors describe "collaborative problem solving," a cognitive-behavioral approach for working with aggressive children and adolescents. The model conceptualizes aggressive behavior as the byproduct of lagging cognitive skills in the domains of flexibility, frustration tolerance, and problem solving. The goal is to train staff to assess specific cognitive skills that may be contributing to challenging behavior and to teach children new skills through collaborative problem solving. The authors present results from an inpatient unit that dramatically reduced rates of seclusion and restraint.