Theses and Dissertations

Date of Award


Document Type

Dissertation - NSU Access Only

Degree Name

Doctor of Education (EdD)


Abraham S. Fischler School of Education


Susan Kabot

Committee Member

Christine Reeve


This applied dissertation was designed to provide a longitudinal evaluation, using Stufflebeam’s context, input, process, and product (CIPP) model, of an organizational change effort to minimize restraint and seclusion within a behavioral health care facility that serves at-risk and high-risk clients with intellectual, developmental, and psychiatric disabilities. The change effort was developed and implemented at Grafton Integrated Health Network, an agency in the mid-Atlantic region that provides a continuum of care to children and adults in residential, educational, and home settings.

Interviews showed insight into all 4 components of the CIPP model. Data from 2003–2013 revealed a 93% decrease in restraint frequency, coupled with an 81% decrease in staff injury, a 51% decrease in client-induced injury, and a goal-mastery increase of 135%. This shows that trauma-informed, less restrictive treatment methods provided safer treatment for individuals with a variety of disabilities, and it saved the organization over $12 million in lost time expenses, turnover costs, and workers’ compensation policy costs. Implications of the change model are considered and commonalities among trauma-informed care, applied behavior analysis, and positive behavior supports are discussed.

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