Innovative Practices in Preventing Seclusion, Restraint, and other Forms of Aversive Interventions in Mental Health Settings

NCTIC Virtual Learning Network Invitation 

Innovative Practices in Preventing Seclusion, Restraint, and other Forms of Aversive Interventions in Mental Health Settings

SAMHSA’s National Center for Trauma-Informed Care and Alternatives to Seclusion and Restraint (NCTIC) is pleased to announce the opportunity to participate in the upcoming Virtual Learning Network (VLN): Innovative Practices in Preventing Seclusion, Restraint, and other Forms of Aversive Interventions in Mental Health Settings.  

VLN members are also eligible for on-site training/technical assistance. 

This learning network is offered to mental health organizations seeking to prevent the harmful practices of restraint and seclusion and reduction in violence, through implementation of trauma-informed approaches. The VLN will consist of 5-6 organizations working together over 8-months. Each organization is encouraged to include up to four key staff members who will form an active virtual learning community and oversee prevention of seclusion, restraint, and other forms of aversive interventions in their respective organizations. Leadership/decision making authority is critical to the change process – in addition we encourage inclusion of a trauma survivor/person receiving services, family member, direct care staff, and clinical and administrative personnel.

We will use the Plan-Do-Study-Act (PDSA) method  – developed by the Institute for Healthcare Improvement to help measure progress. This will be explained at each phase and will involve some homework assignments. The work will also involve direct consultation with lead trainers and interaction among group members to create a shared learning experience. Course work and materials will help participants create and sustain change.

This “working” classroom event consists of facilitator-led virtual presentations on the Adobe® Connect™ platform, and interactive “work” sessions with the facilitators and group members, development of an action plan, and final brief presentation on outcomes/impact. Sessions will include presentations on topics selected by the group and a “Round-Robin” where each organization will discuss challenges and provide updates. The final session will be a report out of all participant aim, goals, challenges, and progress. 



  1. Participants interact with one another and the instructors via webcam, which creates an interactive and dynamic experience.  
  2. The first webinar will be an introductory session where participants introduce their team and organization, provide an overview of their goal, and meet the NCITC facilitators/coaches. NCTIC will provide a presentation on the PDSA model and an overview of SAMHSA’s principles of trauma-informed approaches. 
  3. The group identifies topics of interest through polling, including identification of challenges/topics in the letter of intent.
  4. Each 90-minute session will include a 30-40 minute presentation by topical experts, followed by an open dialogue with presenters/facilitators/group members. 
  5. One  webinar where participants present their Action Plan for reducing/eliminating seclusion and restraint based on the principles, domains, and consultation work with their coach, and their measurement for change. 
  6. Ongoing TA throughout, which may include on-site training/consultation events and multiple virtual TA events (teleconferences, emails, webinars). 
  7. Inclusion of performance measures (as defined by each organization) in the organization’s Action Plan and shared with the group/facilitators. 
  8. A final webinar where participants share progress, challenges, and innovations.



The VLN will be held from January – August 2018, with the following schedule (first call January 29 from 2:00-3:30 (EDT), all remaining calls will occur the 4th Friday of each month from 2:00-3:30):

  • December 2017 - Solicit and select applicants 
  • January 29, 2018 – Introductory webinar/virtual classroom
  • February – April 2018 – Monthly webinars on the casts on Adobe® Connect™ platform
  • May 2018 – Teams present their Action Plans (VLN Coaches are available to help create plans)
  • January – August 2018 – participants are all eligible for on-site TA and ongoing coaching with one of the facilitators
  • August 2018 – Final webinar where participants report on progress, challenges, innovations and outcomes



Joan Gillece, Ph.D. 

Dr. Gillece has thirty years of experience working in the behavioral health field with seventeen dedicated to trauma and seven in prevention of seclusion and restraint.  Working cross agencies, Dr. Gillece promotes the use of trauma informed care in multiple settings including mental health, substance abuse, adult and juvenile justice and homeless services.

Prior to joining the National Association of State Mental Health Program Directors (NASMHPD) seven years ago, Dr. Gillece served as Director of Special Populations for Maryland’s Mental Hygiene Administration where her responsibilities included all aspects of state mental health planning and delivery of services as well as development of collaboration across agencies serving individuals with psychiatric diagnosis.   As project director for SAMHSA’s National Center for Trauma-Informed Care and  Alternatives to Restraint and Seclusion (NCTIC), Dr. Gillece has championed the cause of full consumer integration and development of Culturally Competent programs.  Utilizing survivors in all aspects of trauma work, Dr. Gillece has coordinated technical assistance, conference presentations, and consultations with experts in the field.  Commitment to strength based support by implementing trauma informed values with the overreaching theme of recovery has been her focus.

Raul Almazar, R.N., M.A.

Mr. Almazar has many years of experience as direct care provider, administrator, organizational and clinical consultant, trainer, and speaker.  Prior to working as full-time consultant in 2009, he served as Deputy Director for the State of Illinois Division of Mental Health where he was charged to facilitate an organizational culture shift in all 10 State -operated facilities towards person-centered, trauma-informed, recovery-promoting, non-coercive treatment settings. He serves as faculty to the National Center for Trauma-Informed Care and Senior Consultant to SAMHSA’s National Center for Trauma-Informed Care  and  Alternatives to Restraint and Seclusion (NCTIC), He provides consultation, training and technical assistance to organizations in the areas of leadership, workforce development, consumer empowerment, organizational planning and changing organizational cultures to effect systems transformation towards development of non-coercive, trauma-informed treatments. He has expertise in working with youth and adult serving, institutional and community based, publicly and privately –funded programs across service systems.