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What is challenging behaviour?


If you google ‘what is challenging behaviour?’ you’ll find a number of different definitions.  But the two that we pay particular attention to at Hft are those accepted by the National Institute for Clinical Excellence (NICE):

“Culturally abnormal behaviour of such an intensity, frequency or duration that the physical safety of the person or others is likely to be placed in serious jeopardy, or behaviour which is likely to seriously limit or deny access to and use of ordinary community facilities’

(Emerson, 2001)

‘Behaviour of such an intensity, frequency or duration as to threaten the quality of life and/or the physical safety of the individual or others and is likely to lead to responses that are restrictive, aversive or result in exclusion’

(Royal College of Psychiatrists, British Psychological Society & Royal College of Speech and Language Therapists, 2007)

Emerson’s definition is the most widely used in the UK. But the second definition is important because it draws particular attention to the likely use of both aversive and restrictive practices – both of which lead to negative outcomes for the person in question.

Why is this important to Hft?

In the past, a lack of access to positive behaviour support training and community services, and an overreliance on the use of restrictive and aversive practices across the sector have in part likely contributed to: –

  • failure of services
  • families being unable to cope
  • people being overmedicated, and eventually
  • people getting stuck in out of area placements

By constantly referring back to these definitions, we can use them as a point of focus – ensuring that our assessments lead to personalised care planning and access to meaningful activities.

We ensure that the approaches used by our staff follow the least restrictive practice, and promote privacy and dignity for people with behaviour that challenges provision of services. We use Positive Behavioural Support (PBS) as a means of identifying and understanding why an individual might exhibit challenging behaviour in order to address the issues that can trigger it.

What can be done to promote effective Positive Behavioural Support?

  • All learning disability support providers should have an organisation-wide approach to Positive Behavioural Support training.
  • Staff recruitment needs to be values-focused, and induction should include mandatory training on value bases when working with people with learning disabilities – including Positive Behavioural Support.

Hft has an internal team of skilled PBS practitioners that are responsible for providing in-house support across the organisation.  As we’re not exclusively reliant upon NHS or state provision in this area, we can respond quickly to challenges and ultimately help prevent placement breakdowns and possible out of area placements.

What difference does this make?

Embracing a Positive Behavioural Support philosophy across the organisation, and ensuring that it remains at the heart of day to day operations, leads to a reduction in the levels of behaviour that challenges, and an increase in people’s quality of life.

This means that people with learning disabilities, their families and local authority commissioners can have confidence in Hft as a provider that is good at supporting people with challenging behaviour in a variety of different settings.