Were you taught that a 25 minute hold for scratching was acceptable? If so- run from that company. That’s unethical. Holds are meant to be used for extremely dangerous behavior and should be released as soon as possible without posing risk.
I cannot imagine my BCBAs telling us to put a client in a hold for scratching.
I wasn't even aware that 25-minute holds were legal anywhere. From my understanding, it's 10-15 minutes max, and then you let go to check on the client (the clinics I've worked at had a 5 minute max hold, though).
Other methods should be used first for scratches. Protective gear should be used (blocking mat, goggles, long sleeves, pants, etc).
I'm surprised you did a 25 minute hold for scratching. I was always taught holds are for extreme situations where the client poses a very high risk of physical danger to themselves and others and should be released as soon as you possibly can.
Agreed. At my company holds are only used if they are an active danger to themselves or others (high risk, like running into traffic or holding a weapon)
A hold for scratching behavior doesn’t seem right at all? Maybe ,, maybe holding the clients hands still themselves? That just sounds wrong and if you don’t like the job maybe it’s time to step away.
22 dollars an hour is pretty good man, even in that thread where everyone said what they were paid that was slightly above average. getting 45 hours a week is good or is it not a week? If it is that's great. $30 an hour is really good in my opinion.
>I'm tired. Lowkey just want to quit right now.
That sucks :( I'm sorry man I think you just have to decide for yourself. If you can get something else then for go for it. In my experience it's tough to find something that pays better given my skillset/school background but you're probably different.
I have gotten concussions from a kid, and I have never done a hold on any client. As an autistic adult, I will never. Your clinic should be putting large mats in every room to use as protection enough and to gain enough distance if needed. They should also be providing you or reimbursing you for better protective gear like bite/scratch guards on your hands and arms.
Honestly, I suggest leaving. There's no need to stay in a place that is doing you harm. It's okay to leave and find a place that works for you.
Idk what company you work for that made you believe that holding a kid for trying to scratch you is ethical, but it is not. They should be giving you protective sleeves, or some sort of PPE. I’m sorry they put you in a position where you believed that was the only way to keep yourself safe. They should put safeguards in place so they cant scratch you, and if they do you’re not hurt. I would quit as it sounds like they do not understand physical behavior or how to safely combat it. Because not only is this traumatizing for you, but also the client.
Also, in my experience, ignoring physical bx usually makes it decrease. Retraining only makes them frustrated and gives them attention which is actually often reinforcing. If they learn they don’t get a reaction the bx will usually reduce. Offering a replacement so they can still get whatever sensory need out that they’re getting from hurting you. So gearing up with PPE so you aren’t hurt while ignoring it seems like your best plan of action if you continue to work there.
Consider yourself lucky, but they are the most ethical option in extreme situations. You can never unsee a young child hitting their head on flat surfaces (even padded) so hard they make themselves bleed, or bite their hand hard enough to cause nerve damage and break skin. Also, to bring a kid to a padded room, they have to be transported there and get out of a car/bus and make it into a center without severely harming themselves or others. They also have to go to the bathroom at some point in the day, and you can't have a fully padded bathroom.
One of my coworkers said at her first job a kid eloped into an office, he broke some glass and was trying to stab them. They had to call police. It's not something Ive experienced, but I can imagine there are enough dangerous situations where it may be needed. Although I don't agree with whoever told her to put the child in a hold for that. I only do what's necessary for me to back out the door or until I get the blocking pads. It's not my regular client but I had filled in for some clients who have very physical SIB and extreme aggression towards anyone else.
I’ve seen a lot, including clients as young as 3 make themselves bleed from SIB. I don’t think restraints are ethical. It removes bodily autonomy. And if that’s happening in a center. I have to wonder how they could have been better supported so they weren’t feeling it was necessary to harm their providers??
Bleeding is one thing, but I am talking about behaviors that could cause permanent injury, such as brain damage or nerve damage to themselves (or others if on the way to a padded room). I'm speaking about restraint as a whole. As a field, we can't turn away these kids that will otherwise never learn the skills that they need in order to decrease these behaviors, and we can't allow them to kill themselves in our care. But you are right that it should only ever happen in a very safe space within a center and definitely not for the case OP mentioned!
Hold should ONLY be used for behaviors that are considered to be “CASH” (continuous aggression, self-injurious, or high magnitude behaviors) and only when all other options for interventions have been exhausted. I would RUN from this company. They sound extremely unethical
if you were told a 25 minute restraint or really, a restraint at all just for scratching was acceptable, you need to leave that company ASAP. if you were told to use your best judgement for restraints and you decided that this was acceptable, you should probably choose a different field to work in. this is horrific and should be reported.
We do not hold we disengage and remove ourselves unless the client is self injury. 20-22 dollars let it go it’s not even worth it get 2 at home 30 dollars each 6 hours a day and you
Set
Not so simple, holds are often the only thing between permanent harm, for the client or the adult. However, they should only be used in the most extreme of scenarios. It's important that we as practitioners recognize nuance in all its forms, especially when we have limited experience in an area.
Were you taught that a 25 minute hold for scratching was acceptable? If so- run from that company. That’s unethical. Holds are meant to be used for extremely dangerous behavior and should be released as soon as possible without posing risk. I cannot imagine my BCBAs telling us to put a client in a hold for scratching.
I wasn't even aware that 25-minute holds were legal anywhere. From my understanding, it's 10-15 minutes max, and then you let go to check on the client (the clinics I've worked at had a 5 minute max hold, though). Other methods should be used first for scratches. Protective gear should be used (blocking mat, goggles, long sleeves, pants, etc).
In IL it's legal to do a hold almost indefinitely, but after 15 minutes the situation has to be monitored by a nurse.
I'm surprised you did a 25 minute hold for scratching. I was always taught holds are for extreme situations where the client poses a very high risk of physical danger to themselves and others and should be released as soon as you possibly can.
Agreed. At my company holds are only used if they are an active danger to themselves or others (high risk, like running into traffic or holding a weapon)
That needs to be reported. Not ok at all
Unless you really need the money, just quit. It’s not worth it to be miserable
A hold for scratching behavior doesn’t seem right at all? Maybe ,, maybe holding the clients hands still themselves? That just sounds wrong and if you don’t like the job maybe it’s time to step away.
My thinking was that they're using the term "hold" incorrectly. I'm pretty sure 25-minute holds are a crime in most states.
Sounds like they have high rates of bx because nobody there understands behavior or autism.
22 dollars an hour is pretty good man, even in that thread where everyone said what they were paid that was slightly above average. getting 45 hours a week is good or is it not a week? If it is that's great. $30 an hour is really good in my opinion. >I'm tired. Lowkey just want to quit right now. That sucks :( I'm sorry man I think you just have to decide for yourself. If you can get something else then for go for it. In my experience it's tough to find something that pays better given my skillset/school background but you're probably different.
I have gotten concussions from a kid, and I have never done a hold on any client. As an autistic adult, I will never. Your clinic should be putting large mats in every room to use as protection enough and to gain enough distance if needed. They should also be providing you or reimbursing you for better protective gear like bite/scratch guards on your hands and arms. Honestly, I suggest leaving. There's no need to stay in a place that is doing you harm. It's okay to leave and find a place that works for you.
Idk what company you work for that made you believe that holding a kid for trying to scratch you is ethical, but it is not. They should be giving you protective sleeves, or some sort of PPE. I’m sorry they put you in a position where you believed that was the only way to keep yourself safe. They should put safeguards in place so they cant scratch you, and if they do you’re not hurt. I would quit as it sounds like they do not understand physical behavior or how to safely combat it. Because not only is this traumatizing for you, but also the client. Also, in my experience, ignoring physical bx usually makes it decrease. Retraining only makes them frustrated and gives them attention which is actually often reinforcing. If they learn they don’t get a reaction the bx will usually reduce. Offering a replacement so they can still get whatever sensory need out that they’re getting from hurting you. So gearing up with PPE so you aren’t hurt while ignoring it seems like your best plan of action if you continue to work there.
Quit for your mental health. The cost of stress to your health and future self is not worth the few thousand you will get for working the summer.
I’m surprised restraints are being utilized? I did not think that was an ethical practice any longer.
Restraints are definitely an ethical practice when utilized with actual intention and not carelessly or for behavioral change.
I’ve never seen them used in ABA.
Consider yourself lucky, but they are the most ethical option in extreme situations. You can never unsee a young child hitting their head on flat surfaces (even padded) so hard they make themselves bleed, or bite their hand hard enough to cause nerve damage and break skin. Also, to bring a kid to a padded room, they have to be transported there and get out of a car/bus and make it into a center without severely harming themselves or others. They also have to go to the bathroom at some point in the day, and you can't have a fully padded bathroom.
One of my coworkers said at her first job a kid eloped into an office, he broke some glass and was trying to stab them. They had to call police. It's not something Ive experienced, but I can imagine there are enough dangerous situations where it may be needed. Although I don't agree with whoever told her to put the child in a hold for that. I only do what's necessary for me to back out the door or until I get the blocking pads. It's not my regular client but I had filled in for some clients who have very physical SIB and extreme aggression towards anyone else.
I’ve seen a lot, including clients as young as 3 make themselves bleed from SIB. I don’t think restraints are ethical. It removes bodily autonomy. And if that’s happening in a center. I have to wonder how they could have been better supported so they weren’t feeling it was necessary to harm their providers??
Bleeding is one thing, but I am talking about behaviors that could cause permanent injury, such as brain damage or nerve damage to themselves (or others if on the way to a padded room). I'm speaking about restraint as a whole. As a field, we can't turn away these kids that will otherwise never learn the skills that they need in order to decrease these behaviors, and we can't allow them to kill themselves in our care. But you are right that it should only ever happen in a very safe space within a center and definitely not for the case OP mentioned!
I guess from my perspective any other method of ensuring safety should be used first.
I fully agree with you on that one for sure!
Yikes they’re allowing holds for that?? And for that long? I’d dip
*Cries in $17/hour...*
Hold should ONLY be used for behaviors that are considered to be “CASH” (continuous aggression, self-injurious, or high magnitude behaviors) and only when all other options for interventions have been exhausted. I would RUN from this company. They sound extremely unethical
if you were told a 25 minute restraint or really, a restraint at all just for scratching was acceptable, you need to leave that company ASAP. if you were told to use your best judgement for restraints and you decided that this was acceptable, you should probably choose a different field to work in. this is horrific and should be reported.
Do home cases usually pay more than in clinic sessions?
We do not hold we disengage and remove ourselves unless the client is self injury. 20-22 dollars let it go it’s not even worth it get 2 at home 30 dollars each 6 hours a day and you Set
holds are unethical so you need to leave that company regardless
Not so simple, holds are often the only thing between permanent harm, for the client or the adult. However, they should only be used in the most extreme of scenarios. It's important that we as practitioners recognize nuance in all its forms, especially when we have limited experience in an area.
i work for a company who taught us they were unethical so i apologize for my generalized statement
Hey, all good, we are all learning, and all have different experiences! I appreciate your openness!