Table 11 Training and education in the included studies

Code Training instructor Trainees Training Method Key training topics
A Behavior consultant Supervisors & Staff L · Components of QAMs· BSP compliance via Behavioral Skills Training· Staff compliance rate ≥ 80%
B Cognitive Behavioral Therapist Staff P & F · Application of Functional Behavioral Assessment· Proactive strategies (e.g., environmental adjustments, teaching alternative skills)· Reinforcement· Documentation of BSP
C - Staff - · Theory & application of the therapeutic program
D Conflict leads (Selected nursing staff) Staff - · Training in safety, release, & Restraint strategies· Provision of refresher training - Frequency: Annual - Content: Consistent with initial training - Retraining: Required for competency gaps
E - Staff L & P · Philosophical perspectives· Non-physical crisis de-escalation strategies
L, D & P · Extraordinary blocking techniques - Protective techniques using pillows or beanbags for user & staff safety
G - Staff - · Training on support program content· Training on target behavior data collection· Provision of refresher training
H - Staff · Theory: Competency-based retesting & retraining· Practical application - Exclusionary time-out procedures & protocols - Identification & documentation of target behaviors
I Designated training staff Staff P & Reh · Setting events, proactive/teaching/reinforcement strategies, & QoL· Definitions, characteristics, principles, processes, evaluation, & ethics
K Program-certified trainer Family (Parents, Siblings) - · Proactive & reactive strategies for challenging behaviors
L Parent education specialist Parents or legal guardians L, D & P · Components of Positive Behavior Support (PBS)· Legal regulations on restraint use· Restraint techniques - Crisis response (e.g., bites, hair pulling)
M Certified institutional staff Staff D · Concepts in restraint reduction
N - Staff L, P & Reh · Factors associated with aggression· Escalation cycle: Mild disruption to severe aggression· Theoretical background & practical application
Q - Staff - · Support methodologies
Note. Training Methods: L = Lecture; P = Practice; F = Feedback; D = Demonstration; R = Discussion; Reh = Rehearsal; RP = Role-play. None: F, J, O, P, R = No training-related content identified in these studies.