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The Six Core Strategies service review tool

The Six Core Strategies© are evidence-informed approaches effective in reducing seclusion and restraint events. This whole-of-system approach was originally developed in the US by the National Association of State Mental Health Program Directors Medical Directors Council (NASMHPD). It is also used in the UK, Canada, Australia, and Finland.

The New Zealand adaption, formerly known as the Six Core Strategies® checklist (2013), was developed by Te Pou to support services implement the strategies within the New Zealand context. This adaption was refreshed in 2020 to ensure the strategies remain current and useful for services. Feedback from the sector identified potential ways to strengthen the use of the Six Core Strategies© to meet current and future needs. Read the sector feedback summary here.

The refreshed Six Core Strategies© service review tool (2020) was published following sector feedback and commitment to seclusion reduction and eventual elimination. This service review tool aims to support leaders and managers in implementing the Six Core Strategies© in mental health services. The tool is designed to help services to regularly review their progress in shifting towards least restrictive practice through identifying key priorities and supporting ongoing quality improvement and systems change. The Six Core Strategies© service review tool can be accessed here.

An overview of the six strategic areas is outlined below.

The six strategies

  • Strategy 1. Leadership towards organisational change

    Leadership must be aligned and committed to supporting, applying, and resourcing seclusion and restraint reduction initiatives. The inclusion of Māori leadership is important in supporting partnership, participation, and responsibilities under Te Tiriti o Waitangi. This section of the service review tool can be accessed here.

  • Strategy 2. Full inclusion of lived experience

    Full and formal inclusion of people with personal experience in recovery in a variety of roles in the service to assist in the reduction of seclusion and restraint. It is important to have robust cultural and lived experience perspectives influencing your work. This section of the service review tool can be accessed here.

  • Strategy 3. Using data to inform practice

    The use and analysis of data enables quality improvement activities to improve the outcomes and experiences of people, whānau and workers. This section of the service review tool can be accessed here.

  • Strategy 4. Workforce development

    Staff training and education contributes to a least restrictive practice environment. Workforce development helps to equip workers with the right skills, knowledge, values, and attitudes to respond effectively to the needs of people and whānau experiencing distress. This section of the service review tool can be accessed here.

  • Strategy 5. Use of seclusion and restraint reduction tools

    The use of best practice tools and assessments that are integrated into each person’s treatment stay and planning e.g. assessment tools, seclusion and restraint history, safety plans, advance directives, sensory modulation, and welcoming practices. This section of the service review tool can be accessed here.

  • Strategy 6. Debriefing techniques

    Debriefing for people, whānau and staff members can assist in supporting people who have been involved in any adverse event and reduce the traumatic impact of such events. It can also provide important information to assist both individuals and teams in planning for how they may prevent or respond to future concerns. This section of the service review tool can be accessed here.

Webinar series

Te Pou hosted a series of webinars to support the recent launch of the Six Core Strategies Service Review Tool. Each session focused on a specific area of the Six Core Strategies and featured guest speakers who are strong supporters of least restrictive practice and the eventual elimination of seclusion.

Recording of "Introducing the Six Core Strategies Service Review Tool"

Recording of "Leadership towards organisational change"

Recording of "Full inclusion of lived experience"

Recording of "Using data to inform practice"

Recording of "Workforce development"

Recording of "Use of seclusion and restraint reduction tools"

Recording of "Debriefing techniques"

You can find an evaluation of the webinar series here.


Related Initiatives



Te Pou has a wide range of evidence-based resources and tools to help the mental health, addiction and disability workforces.

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Our work

Te Pou works alongside mental health and addiction services, and disability organisations to understand their priorities and workforce challenges.

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