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I found a neat map of the area on google.

http://maps.google.com/maps?ll=40.5 .... 010343&t=k&hl=en

A time-out room is not supposed to be used as an aversive intervention - it is used to remove someone from a reinforcing environment for a SHORT period of time or to give them a chance to be somewhere they can work on calming themself down. It is generally used for more severe behavioral outbursts, such as aggression against others, and this is even further extended to tissue-damaging aggression against others, not just a slap here or there. This sounds like semantics, but it is an important distinction both legally and clinically.

If you have the time-out room door set up so that when you walk away it will automatically swing open, it prevents a staff person from leaving a client in time-out for a lengthy amount of time. After a certain amount of time has passed and the person is still in the time-out room it becomes obvious you are either using the time-out room because you are angry at the person (retribution) or you want them "out of the way" (staff convenience), and neither one of them is therapeutic. If the staff person has to stand at the door to keep it latched from the outside it means they have to remain in the immediate area, which means they won't be tempted to walk away to do something else, possibly lengthening the amount of time the person is in time-out. When time-out is used there are generally a set of "release criteria," such as being calm and/or quiet for 15 seconds before the door is open. If the staff walks away they can't tell when the client is ready to leave the time-out room, and it may only be a minute or two that the client actually needed to calm down. As well, the staff person needs to be right at the door to either hear or see if the client gets into trouble - if they have a seizure, have a heart attack, engage in self-injurious behavior and need to be removed, etc. I don't believe I ever allowed anyone in time-out past 30 minutes tops - and of course that was only if they continued to threaten others or actually tried to harm someone again when the door was opened. And even on my roughest unit with some pretty tough gentlemen I don't believe we used it for more than a handful of times per month ever.

This is different than a seclusion room. Seclusion rooms are used in mental health facilities and are used in lieu of straitjackets or 4-point restraint. They are utilized if someone is severely agitated or aggressive and needs to be apart from others but won't hurt themself if left alone. The door to the room is locked and the person is left in the room with some form of monitoring, although monitoring is a relatively new requirement. I would certainly support a seclusion room if the only alternative was a mechanical restraint (straitjacket or 4- or 5-point restraint) or chemical restraint (almost always antipsychotics these days). It gives the person the option to calm themself down without being restrained or drugged, and I think that is a very good thing.

There are many times when people are so out of control that they may need one of the more restrictive options, such as if they are huge and strong or if they try to hurt themself and won't stop. Everybody in the general public hates straitjackets and drugs until they have a 300-pound person throwing a bed or file cabinet in their general direction. That isn't meant to be a negative comment toward people who are in such a terrible situation that they have lost control; it is meant for those people who seem to be offended that restraint, meds, or seclusion are ever used without realizing the alternative, which is getting your butt badly kicked or possibly losing your life.

Lynne, good to hear these rooms aren't used as much... I'm curious about the door latch though, someone needs to be in front of the door at all times? How does that work?

thank you ~me, for posting that. i was afraid of my post coming across as a little "off", as sometimes, maybe in a small way , i, myself, might seem to be. but i really meant what i said. it was from my heart. i am so relieved it was lucid enough for others to understand and, against all hopes, even relate to. how very kind of you!

bahrusker, that is exactly the beauty of this site and, in my estimation, it's deep importance, especially as these places won't be here forever. unfortunately, in time, all will fall victim to that dratted 2nd law of thermodynamics unless renovation plans are devised, and soon, though the chances of that happening are remote at best. and so we place our hopes and eager anticipation in the very capable hands and eyes of our good motts and co. remember, though, that you will never miss what you do not know. small comfort, i know, but there is truth in that old adage, "hindSIGHT is 20/20." that we are able to share the experience and utilize it as part of our make up is truly a gift indeed.

again, a million thanks to motts for making this all possible for us with his beautiful photographs and the stories behind each one. we are lucky indeed.

now, my dear ladyhawke, i want you to realize that this is a two way street.... we could thank each other back and forth ad infinitum and, of course, that isn't a bad thing at all. at all! your 1st post nourished my soul. your last post nourished my psyche, and at exactly the right time as well! for i, too, was caught in a dangerously grave state of despondency as of late battling growing feelings of helplessness and uselessness, among other demons. and then i read your post. is was as if a single candle was lit brightening up a deep, dark room. that feeling of being good for something, even something very small, something that made a difference somewhere, somehow, to someone, however small, shines like a beacon of hope and my life doesn't seem so desparate any more. i wanted you to know that. i also want you to feel very good about that. this is the best therapy.

and, so you know, everytime i look at the photo of the stairs i still see you holding your mothers hand, and i will always see it that way. even the mere mention of ef will remind me of that. shared memories are a wonderful thing!

my love to all,
~angel~

I shoulda taken a picture of the one that I mentioned in one of the above comments, but, as I said, the gentleman for whom it was initially designed ripped it apart after our first trial. We finally took the padding out because the other gentleman who used to require short time-out periods back then would, em, er, uh, well, use the padded wall to relieve himself, just to irritate us, so we took out the padding and just left it a simple little wooden-walled time-out room.

Of course, a "simple little time-out room" has so many legal specifications you can't believe it, as it rightly should. It has to be a certain number of square feet and you need adequate ventilation and lighting and temperature control and you must be able to see the person at all times in case they try to hurt themself or become ill, and you can't latch it shut - it has to be set up so that if the person outside the room walks away, the door must automatically swing open. That's so they don't place people in there and just walk away and leave them for long periods of time, like used to happen in the bad old days before time-out rooms were better regulated.

I haven't needed a time-out room for a client for probably 15+ years - in that short of a time we have been more effective in our techniques, we start more training and education at a younger age, there are more sophisticated behavioral programs, and there are better medications if there are concomitant psychiatric issues. And that's a very good thing to be able to say. :-)

That's good news for the really tall people out there!

"If ya' gotta go, go now!"

Help! My computer ate this and sent it before I was finished! =8-o

I tried to say, "Isn't that right?" at the end, but the post done went and sent itself before I could do anything! ~Me's orb must be caught up in all this somehows! =8-o

My sweet ~Me, I believe you haven't been wrong yet. is t ;-)

I think those pipes were actually hooked up to empty water directly into the tub, but I have been wrong before (well, three hundred times already today, and that was just before lunch). I worked at a place once with similar old tubs and that is how those worked. These could be totally different, of course.

I'm taking back by previous comment of not seeing a room with rubber walls, there is one in Riverside Psychiatric; photos to come!

there is no such thing as padded rooms..well at least in canada.

IT KINDA LOOKS LIKE ITS ALL HUDDLED TOGETHER.

WOW BEUTIFUL STONE!

WOW! FANTASTIC! IT LOOKS LIKE AN OLD PHOTO OF THE PLACE.