The Engagement Model for reducing seclusion and restraint: 13 years later.

In 2001, an inpatient psychiatric unit sought to greatly reduce, or even eliminate, the use of seclusion and restraint by initiating the Engagement Model. Despite many changes in management and staff, the model has remained largely intact and effective during the past 13 years. The current article reflects on key clinical interventions and leadership approaches that have helped sustain the culture change undertaken to better serve patients on this unit.