In 1997, Pennsylvania introduced a program to reduce the use of restraints and seclusion in state behavioral health hospitals. Restraint or seclusion may only be used when less restrictive interventions have been determined to be ineffective to protect the patient or others from harm. Between January 1, 2012, and August 31, 2013, coercive interventions (i.e., restraints and seclusion) were the most frequently identified interventions used to manage patient-to-patient aggression in behavioral health patient aggression-related event reports submitted through the Pennsylvania Patient Safety Reporting System. Analysts, interested by this finding, explored how patient aggression is managed in two behavioral health hospitals that have incorporated the philosophy and principles of the Pennsylvania Recovery and Resiliency program to inform the management of patient aggression using noncoercive techniques. The Recovery and Resiliency program promotes trauma-informed care and the Sanctuary Model to address patient issues and build a restraint-free environment.