What Are Restrictive Practices?

Restrictive practices are actions or interventions that limit the rights or freedoms of a person living with a disability.

Restrictive practices are typically used to manage challenging behaviours and should always be a last resort. Under the NDIS, certain restrictive practices are regulated and must be authorised by the respective States or Territory, with monitoring and reporting to the NDIS Commission of Quality and Safeguards. This ensures that the rights and dignity of people living with a disability are protected.

Read our NDIS restrictive practice guide to learn what types of restrictive practices can be used and how they connect to positive behaviour support.

Positive behaviour supports are essential in managing challenging behaviours while minimising the need for restrictive practices. Our behaviour support practitioners focus on reducing or eliminating restrictive practices, empowering individuals to regain their dignity and independence, and improving their overall quality of life.

Types of Regulated Restrictive Practices

Defining restrictive practices provides clear expectations and guidelines on when and how they should be carried out and ensures they are performed ethically.

There are five types of regulated restrictive practices [1]:

1. Chemical restraint – the use of chemical or medical substances to influence a person’s behaviour. This doesn’t include prescribed medications for a diagnosed mental disorder, physical illness or physical condition. The NDIS seeks to ensure that, where medication has been prescribed to influence behaviour, NDIS providers have a positive behaviour support plan in place that may assist in the future reduction or elimination of that medication. Identifying when a medication is a chemical restraint is necessary to protecting the dignity and human rights of a person living with a disability.
2. Environmental restraint – the restriction of a person’s free access to their environment, including activities and items. Examples could include locking a door, room or fridge to restrict a person’s access, preventing access to the person’s phone or cigarettes, or restricting access to hazardous items such as sharps or chemicals to prevent self-harming behaviour.
3. Mechanical restraint – using a device to prevent, restrict or subdue a person’s movement. This doesn’t include the use of devices for non-behavioural or therapeutic purposes. This may include a helmet, splint, or gloves to prevent self-harming behaviour, restrictive clothing, or the use of straps to restrain a body to stop a behaviour of concern. The reason why a device is being used can help identify whether it is a therapeutic or a mechanical restraint. For example, if a splint prevents a person from picking at their skin, it is a mechanical restraint. If a splint facilitates independent eating, it is classified as therapeutic/non-behavioural and is not a mechanical restraint. Any mechanical restrain that is intended to cause harm to another person with a disability is considered abuse.
4. Physical restraint – the use or action of physical force to prevent, restrict, or subdue a person’s movement for the purpose of influencing their behaviour. This does not include hands-on guidance or redirection consistent with what would be considered the exercise of care towards a person to protect them from harm. Physical restraint should only be used for serious behaviours of concern to prevent harm to the person or others when other strategies have failed. Physical restraint carries a high risk of injury, including soft tissue damage. Support staff must be appropriately trained on how to use physical restraint and under what circumstances it may be used.
5. Seclusion – the confinement of a person away from others where voluntary exit is prevented. This does not include when a person enters a room and locks the doors by choice. Examples include placing a person in a room and locking the door that prevents them exiting due to behaviours of concern, or other people leaving a room until the person calms down.

Managing Challenging Behaviours: How and Why Do Practitioners Use Restrictive Practices?

The use of restrictive practices on people with a disability can present serious breaches of human rights. Their use must be performed within a positive behaviour support framework, only as a last resort to protect the person or others from harm, and only after other less restrictive strategies have been tried and are ineffective.

Practitioners must ensure that restrictive practices are necessary to prevent harm and are the least restrictive option. They must also continuously monitor the individual while the restrictive practice is used to ensure their safety and well-being.

The duration of the practice must be as short as possible and thoroughly documented by the practitioner.

High Risk Practice NDIS Regulation

Restrictive practices are regulated under the NDIS Quality and Safeguards Commission and guided by the NDIS (Restrictive Practices and Behaviour Support) Rules 2018. These rules set out the requirements for using, reporting, and monitoring restrictive practices to ensure their safe and ethical use.

The use of restrictive practices must be:

• A last resort after implementing proactive PBS strategies
• The least restrictive option
• Used for the shortest time possible
• Planned to be gradually reduced and eliminated as part of the PBS plan
• Used by trained and supported staff
• Regularly reviewed
• Reported to the NDIS

How Are Restrictive Practices Used in Positive Behaviour Support?

Behaviour support plans are essential for the regulated use of restrictive practices. The behaviour support plan must:

• Be developed by a registered positive behaviour support (PBS) practitioner
• Include behaviour management strategies, including the use of any restrictive practices
• Detail the proactive and preventative measures to reduce the need for restrictive practices
• Include regular review timeframes

Positive behaviour support focuses on the reasons behind challenging behaviours, with the goal of reducing or eliminating them. Skilled practitioners assess the person’s strengths and environments to identify triggers and plan interventions to reduce behaviours of concern. These interventions may include increasing independence and building emotional regulation skills.

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Summary

Restrictive practices may be included in a person’s positive behaviour support plan as a last resort to protect the person or others from harm, with the goal of reducing or eliminating restrictive practices over time.

Restrictive practices limit the rights or freedoms of a person with a disability, and their use is heavily regulated to protect the person’s human rights and dignity. For more information, visit the NDIS Quality and Safeguards Commission website.

References

[1] NDIS, 2024. Behaviour Support and Restrictive Practices. ndiscommission.gov.au/rules-and-standards/behaviour-support-and-restrictive-practices