In many institutions in the UK, when an adult or child is distressed or agitated, staff may use techniques such as physical restraint and/or being locked in a seclusion room to contain the situation. These ‘restrictive practices’ can be physically harmful and cause psychological trauma. We systematically reviewed interventions to reduce the use of restrictive practices in institutional settings and found the most effective interventions combined techniques from a common pool. Health, education and criminal justice sectors should be encouraged to prioritise evidence backed interventions to prevent harm, reduce associated costs, and improve care