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Objective: During their professional activities, healthcare workers often encounter emotionally charged and tense situations involving both patients and their families. These dynamics can sometimes escalate into episodes of physical and verbal violence, jeopardizing the overall well-being of the healthcare environment and the safety of the staff, patients, and their families. To effectively address such situations, it becomes necessary in some cases to implement restraint measures. Among these measures, physical restraint (PR) is a highly debated topic within the realm of mental health and continues to pose an ethical dilemma in the clinical practice of healthcare professionals. Interventions involving the use of physical restraint can, in some instances, lead to a range of ethical, legal, and clinical/health-related implications for patients, professionals, and institutions. On the other hand, considering the holistic health of the patients under care, healthcare interventions should always prioritize the respect for the individual's dignity and freedom. In this regard, restrictive measures may not always align with these principles. In the context of psychiatric patient care, managing instances of anger and aggression may involve exploring alternative intervention strategies centered around crisis de-escalation, maintaining a therapeutic approach without necessarily resorting to restrictive practices. The objective of this study is to highlight the evidence, based on effectiveness trials, regarding the use of "de-escalation" techniques in managing psychiatric patients, in order to promote their utilization in clinical practice and make them a routine therapeutic approach in cases where they are needed. Method: A literature search was conducted between December 10, 2022, and January 20, 2023, utilizing various search strategies across databases such as PubMed, Cochrane Library, and Cinahl. The most relevant articles were selected and included in this systematic review. Results: The selected studies, while dealing with the topic in different settings (psychiatric hospital wards, specialized primary schools, medical and nursing university students), demonstrated the effectiveness of different "de-escalation" strategies in reducing the incidence and severity of aggression episodes and the frequency of the use of restrictive measures for psychiatric patients. Conclusions: The hypothesis of this review was confirmed by all selected studies, but there is a need for future research that directly investigates the effectiveness of each individual alternative technique in relation to specific subject groups. Another area of interest for future investigations could be a cost analysis of the alternative strategies to restraints for both hospital and non-hospital settings. [ABSTRACT FROM AUTHOR]