sedate a patient. Holding the patient's arms down on to chair arms from behind so that another person can force-feed the person, often a child, during ABA. Manual techniques A number of private national and regional companies teach physical (non-mechanical) restraint techniques for companies and agencies that care for or have custody of people who might become aggressive. The strategies vary widely, with many based on police or martial art pain compliance techniques, with others using only pain-free techniques. Most also emphasize verbal de-escalation and defusing skills before using any physical skills. A non-inclusive list: Crisis Consultant Group (CCG) Non-Violent Physical technique. The Mandt System. Non Abusive Psychological and Physical Intervention (NAPPI). Non-Violent Crisis Intervention (NVCI) techniques. Professional Crisis Management (PCM). Professional Assault Crisis Training (ProACT). Therapeutic Crisis Intervention (TCI). Adverse effects Throughout the last decade or so, there has been an increasing amount of evidence and literature supporting the idea of a restraint free environment due to their contradictory and dangerous effects. This is due to the adverse outcomes associated with restraint use, which include: falls and injuries, incontinence, circulation impairment, agitation, social isolation, and even death. In a 2017 The Guardian article:As of 2021 research is still on-going as to how much restraint an cause and/or exacerbate PTSD for the person being restrained. In a systematic review in 2020:Research is also ongoing into the adverse mental health effects on the health workers doing the restraint. Applicable laws United States Current United States law requires that most involuntary medical restraints may only be used when ordered by a physician. Such a physician's order, which is subject to renewal upon expiration if necessary, is valid only for a maximum of 24 hours. Japan Japanese law states that psychiatric hospitals may use restraints on patients only if there is a danger that the patients will harm themselves or others. The law also states that a designated psychiatrist must approve the use of restraints and examine the patient at least every 12 hours to determine whether the situation has changed and the patient should be removed from restraints. However, in practice, Japanese psychiatric hospitals use restraints fairly often and for long periods. Despite being required to certify every 12 hours whether a patient still needs restraints, Japanese psychiatric hospitals keep patients in restraints for a much longer time than hospitals in other countries. According to a survey conducted on 689 patients in