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Management of Challenging Behaviour

Management of Challenging Behaviour. Mike Holligan Nurse Manager Scottish Neurobehavioural Rehabilitation Service Robert Fergusson Unit. FACTS AND FIGURES. Opened in January 1992 National Unit Treatment of head injured adults with associated challenging behaviour

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Management of Challenging Behaviour

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  1. Management of Challenging Behaviour Mike Holligan Nurse Manager Scottish Neurobehavioural Rehabilitation Service Robert Fergusson Unit

  2. FACTS AND FIGURES • Opened in January 1992 • National Unit • Treatment of head injured adults with associated challenging behaviour • Multi disciplinary approach (51.60WTE Nurses, 3 psychologists, 1.5 SALT, 2.5 OT, Physio, Art Therapy, Associate Specialist, Dietitian, Neuropsychiatry, Socialwork)

  3. FACTS AND FIGURES • 19 BEDDED UNIT (12&7) • TREATMENT APPROACH NON AVERSIVE • IABA LaVIGNA & WILLIS • TREATMENT PHILOSOPHY • RAID DAVIES APT

  4. AIMS OF THE ROBERT FERGUSSON UNIT • TO PROVIDE A NATIONAL SERVICE FOR THE MULTI-DISCIPLINARY ASSESSMENT AND REHABILITATION OF PATIENTS WITH BEHAVIOURAL AND PSYCHIATRIC COMPLICATIONS OF ACQUIRED BRAIN INJURY • TO PROVIDE THERAPEUTIC PROGRAMMES WHICH PROMOTE MOBILITY, OPTIMUM PHYSICAL FUNCTIONING, INCREASE COGNITIVE AND SOCIAL SKILLS AND REDUCE PHYSICAL AND MENTAL DISABILITY. • TO PROVIDE OPPORTUNITIES FOR SOCIAL AND RECREATIONAL ACTIVITIES. • TO PROVIDE SUPPORT AND ADVICE TO RELATIVES, CARERS AND RELEVANT PROFESSIONALS.. • TO PROVIDE A HIGH QUALITY AND STANDARD OF TREATMENT, CARE AND THERAPY.

  5. HOW MANY TREATED • 304 referrals (up to December 2002) • 114 patients admitted since January 1992 • Five patients have been re-admitted.

  6. Define the Challenging Behaviour • Closely observe the behaviour • Define parameters • Agree what is challenging behaviour

  7. Positive Programming Strategies • Teaching New Behaviour • Communication Strategies • Teaching more appropriate alternative behaviours • Assuming a meaning

  8. THE RAID PHILOSOPHY

  9. Two philosophies are fatally flawed Punishment: whereby you spot the things the person does wrong, and ask yourself “What can I do so s/he doesn’t do that again?” Extinction: whereby you work out what the person “gets out of” their behaviour, and resolve that s/he won’t get it any more. E.g: not giving attention for ‘attention-seeking’ behaviour

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