Improving Freedom and Choice for People Receiving Social Care Support

Restrictive practices – such as restraint, seclusion, or other forms of control – have historically been used to manage risk and behaviour in care settings. But these practices often do more harm than good, limiting freedom, eroding dignity, and causing lasting trauma.

This guide provides practical insights for anyone supporting people with intellectual disabilities, autism, or mental health needs – including families, carers, and professionals – on how to reduce and eliminate restrictive practices in everyday care.

Understanding Restrictive Practices

Restrictive practices include any intervention that limits a person’s freedom or choice – such as physical restraint, seclusion, chemical control, financial restrictions, or involuntary treatment.

While often introduced with the intention of keeping people safe, these practices can cause significant harm, violating human rights and reducing quality of life. Over time, they can also create cultures of control within services, making it harder for individuals to feel respected or included.

Reducing restrictive practices begins with a shift in thinking – from managing behaviour to understanding it. By recognising behaviour as communication, social care teams can respond with empathy, not restriction.

Shifting Attitudes and Culture

Eliminating restrictive practices requires a deep cultural change. Awareness and training are vital for helping staff challenge old habits and build confidence in using positive, proactive approaches.

Awareness campaigns and reflective practice sessions can help teams identify hidden forms of restriction in daily routines – such as unnecessary rules, limited choices, or lack of privacy. Small changes, like increasing access to outdoor spaces or giving people more control over their daily activities, can have a big impact on wellbeing.

Acknowledging past injustices, both within services and society, also helps rebuild trust. Publicly recognising harm and committing to change reinforces dignity, transparency, and accountability.

Empowering People Through Choice

True empowerment means more than consultation – it means shared decision-making. Services that prioritise autonomy help people lead more fulfilling, self-directed lives.

Practical steps include:

• Person-centred planning that prioritises individual preferences and goals.
• Co-production, involving people with lived experience in designing policies and support plans.
• Trauma-informed care, recognising the long-term impact of past experiences and avoiding re-traumatisation.
• Promoting autonomy can also mean advocating for independent living, ensuring that people have the resources and supports needed to live in their communities with choice and control

Replacing Restriction with Support

 When staff feel confident and supported, reliance on restrictive practices naturally decreases. Training in de-escalation and communication helps workers respond calmly and creatively to distress or crisis.

Practical initiatives might include:

• Creating calming, sensory-friendly environments to reduce stress.
• Using clear communication tools and visual supports.
• Encouraging routine, engagement, and social connection to prevent behaviours of concern.

Embedding trauma-informed and rights-based approaches across teams ensures that everyone – from frontline workers to senior managers – understands that safety and dignity are not opposites, but partners in good care.

Building a System That Supports Freedom

Policy and practice need to align to make long-term change possible. This means advocating for:

• Funding and resources that make independent living achievable.
• Training frameworks that focus on rights, empathy, and relationship-based practice.
• Redress mechanisms to recognise and respond to the harm caused by restrictive interventions.

Community-based, inclusive models of care, where people live and participate alongside others, reduces the need for restrictive settings and fosters a stronger sense of belonging.

Key Takeaways

Reducing restrictive practices is not only about eliminating control – it’s about creating freedom, trust, and opportunity. When people are listened to, supported, and empowered, challenging behaviours often decrease naturally.

Families, carers, and professionals all play a role in promoting autonomy and choice. By replacing control with collaboration and restriction with respect, we can build services that truly value the dignity and humanity of every person.

Reference:

• Steele, D. (2023). Restrictive practices: a pathway to elimination. In Research on services for people with mental health problems, learning disabilities, autism and behaviours of concern, Praxis Care Research Conference, Queen’s University Belfast.