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Authors' reply: Cadeyrn J. Gaskin, Stephen J. Elsom and Brenda Happell [Tailoring seclusion policies to the patient group]
Reducing seclusion in psychiatric facilities often involves the coordination of a range of interventions to meet the needs of such organisations and their staff. 1 In their response to our review, Scott & Dean have helpfully highlighted the need to tailor interventions to suit specific facilities through reminding readers of the differing determinants of emotional distress and aggression that are present for children and adults. These differences influence the reasons why children and adults are secluded. In combining the literature on seclusion reduction initiatives at child, adolescent and adult psychiatric facilities, we do not contend that seclusion practices across these facilities, or the reasons for seclusion, are the same. We did, however, find no meaningful differences in the employment of seclusion reduction interventions between child, adolescent and adult facilities. Many of the interventions we found (e.g. monitoring seclusion episodes, staff education, changing the therapeutic environment) were used equally as often in child psychiatric units as they were in adult facilities.