A new look at seclusion: Stress, coping and the perception of threat

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Abstract
In this paper we wish to develop a new perspective on the issue of seclusion. Much of the debate on seclusion has become polarized between its supporters and antagonists with a variety of rationales put forward for the employment of the technique. We seek to move this debate forward by emphasizing the social psychology of the seclusion episode and focusing in particular on the experience of threat and anxiety by staff prior to the initiation of seclusion. Anticipation of possible violence and harm generates high levels of anxiety in staff, especially as the predictability of violence is often low. We propose a new model of the seclusion decision-making process based on Lazarus and Folkman's (1984) cognitive theory of stress. This model enables us to examine the role of the nurse's appraisal of threat and of his (or her) coping resources as key factors in the decision to seclude a patient.