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


Behavior Theories, Organizational Change, Program Evaluation, Punishment, Safety, Trauma, Psychology, Special Education, Behavioral psychology


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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