New entrants to the health and social care sector may be forgiven for mistaking ‘challenging behaviour’ for aggression or violence. It’s perhaps easy to lose sight of what is happening amid the noise and activity levels. It is key however that staff do understand the difference, because it makes every difference to the quality of care and support provided and ultimately the quality of life experienced by the supported person.

Preventing and managing challenging behaviourSo what would somebody present with challenging behaviour? Research suggests that staff are sometimes disposed to simplifying the answer to this question. They might say ‘because they are difficult or angry’, ‘because they are manipulative and want control!’, or ‘because they want attention!’. In reality the underlying causes are often far more complex. Examples of which include:

  • Biological (pain or discomfort arising from diagnosed or undiagnosed causes, interactions with medication, epilepsy etc)
  • Social (boredom/under stimulation, the need for social interaction, the desire to express choice or preference and assert an element an element of control over their lives, a lack of understanding in respect of what the community/situational norms are, communication difficulties,)
  • Environmental (physical aspects such as heat, noise and lighting, or the ability or not to gain access to preferred objects or activities as and when desired)
  • Psychological (including grief, loss and bereavement, Change and life and life transitions, A history of trauma and abuse, feelings of loneliness and exclusion, being devalued, labelled, disempowered and/or disqualified)

In this sense what staff are seeing is ‘distress’ being revealed through behaviour’. In essence the supported person is communicating to staff that they need help and support to cope, to manage or to move forward constructively in their lives. So what is the answer?

The answer isn’t to think that the behaviour should be extinguished or suppressed, rather is should be analysed and understood so that the immediate care planning provision should be adapted to meet the individuals current need. This includes the behaviour support plan.

A behaviour support plan should include:  Proactive strategies used to make sure that the person has got what they need and that their needs are met. This includes information about environmental conditions, the teaching skills and coping strategies, information about rewards, routine, structure and boundaries as well as triggers to look out for.

Reactive strategies are designed to keep the person and those around them safe. This may include reminders, response plans; diversion, distraction and de-escalation as well as personal safety guidelines and physical intervention strategies.

SecuriCare offer a range of courses designed to enable support workers, carers and foster families to best respond to any ‘Behaviour’ that may occur. The starting point is a discussion about exactly what it is that staff are trying to understand, before going on to explore positive and proactive support strategies, as well as the ongoing need for monitoring, assessment and adaptation to changing circumstances. All programmes are finalised after a full training needs analysis, and delivered by experienced social care practitioners. Click to see our ‘Preventing & Managing Challenging Behaviour’ Course, which includes ‘Positive Behaviour Management’ techniques designed to minimise the need for any kind of restrictive intervention. You can also take a look at our person centred Behaviour Planning Service.

Contact us for more information and to discuss your needs: E: or T: 01904 492442