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Workforce development and challenging behaviour: training staff to treat, to manage or to cope?
- Author:
- CAMPBELL Martin
- Journal article citation:
- Journal of Intellectual Disabilities, 14(3), September 2010, pp.185-196.
- Publisher:
- Sage
- Place of publication:
- London
The workforce development strategies and workforce development frameworks in the United Kingdom are in a period of transition. They are designed to produce a competent, confident workforce delivering high-quality, person-centred care services. Staff working directly with adults’ challenging behaviours in learning disability services not only need to excel at what they do, but also need to want to do the job. However, a theory-practice gap exists between what is known about effective, evidence-based approaches and whether and how these are used in person-centred community services. Many frontline staff working with people with the most serious challenging behaviours do not have the skills to implement programmes to change behaviour. This discussion article reviews workforce development in the context of clinical and service guidelines and asks whether the legitimate purview of frontline staff is treating challenging behaviour, managing it or simply coping with it on a daily basis, whilst maintaining the best quality of life possible for service users.
Positive approaches to challenging behaviour: understanding the origins of challenging behaviour; workbook 1; supporting the "certificates in working with people who have learning disabilities"
- Authors:
- HARRIS John, HEWETT Dave, HOGG James
- Publisher:
- British Institute of Learning Disabilities
- Publication year:
- 2001
- Pagination:
- 66p.
- Place of publication:
- Kidderminster
- Edition:
- 2nd
Part one of a set of six interactive workbooks aimed at new and more experiences staff, managers who supervise staff, and training managers in services for people with learning difficulties. This book provides essential information about the origins of challenging behaviour.
Positive approaches to challenging behaviour: promoting non-challenging behaviour and responding to people who are emotionally aroused; workbook 2; supporting the "certificates in working with people who have learning disabilities"
- Authors:
- HARRIS John, HEWETT Dave, HOGG James
- Publisher:
- British Institute of Learning Disabilities
- Publication year:
- 2001
- Pagination:
- 64p.
- Place of publication:
- Kidderminster
- Edition:
- 2nd
Part two of a set of six interactive workbooks aimed at new and more experiences staff, managers who supervise staff, and training managers in services for people with learning difficulties. This book focuses on promoting non challenging behaviour and managing the behaviour of people with learning difficulties who are emotionally aroused.
The functional assessment of challenging behaviour: a comparison of information-based, experimental and descriptive methods
- Authors:
- TOOGOOD Sandy, TIMLIN Kevin
- Journal article citation:
- Journal of Applied Research in Intellectual Disabilities, 9(3), 1996, pp.206-222.
- Publisher:
- Wiley
The function of challenging behaviours displayed by 20 people with severe intellectual disabilities was assessed using information-based, experimental and descriptive methods. The results suggest that information-based, descriptive and experimental approaches to assessment vary with regards to (1) the probability of ascribing functions across a range of challenging behaviours; (2) the types and characteristics of behaviours to which functions are more likely to be ascribed; (3) the types of functions which are likely to identified; and (4) the probability with which they identify multiple functions. The results also suggest that the level of agreement between different approaches was disappointingly poor. Attention is also drawn to the importance of staff training to enhance the performance of informant-based methods and the further development of non-experimental approaches to functional assessment.
A quantitative evaluation of a regional Positive Behavioural Support workforce development approach
- Authors:
- MCKENZIE Karen, et al
- Journal article citation:
- Journal of Applied Research in Intellectual Disabilities, 34(6), 2021, pp.1641-1654.
- Publisher:
- Wiley
Background: Research suggests that providing staff with input in relation to Positive Behavioural Support (PBS) can have beneficial outcomes. Much of this research, however, fails to take account of systemic issues and does not include a control group. Method: We used a non-randomised, controlled group design to evaluate accredited PBS programmes, delivered as part of a systemic, regional and workforce development approach. We compared outcomes of those attending the programmes (n = 240) with a control group (n = 54), pre- and post-intervention and at 3-months follow-up. Results: The programme and its wider impact were rated positively. Significant intervention effects were found for staff practice and retention, but not for staff knowledge and attributions, or behaviours that challenge and quality of life of those being supported. Conclusions: The results are discussed in the context of the study limitations and restrictions resulting from the Covid-19 pandemic. (Edited publisher abstract)
Challenging behaviour around challenging behaviour
- Authors:
- JAMES Deborah Michelle, FISHER Sue, VINCENT Sharon
- Journal article citation:
- Journal of Applied Research in Intellectual Disabilities, 34(4), 2021, pp.1166-1179.
- Publisher:
- Wiley
Introduction: The United Kingdom's Department for Education's advice on behaviour focuses on the power of staff and the strength of the policy in challenging behaviour, via rules, sanctions and rewards. We designed a video-feedback intervention for staff teams in a special educational setting who were working with children with intellectual disability and challenging behaviour. The intervention aimed to raise reflective capacity on relational mechanisms that offer new response possibilities in everyday practices within trans-disciplinary teams. Method: We conducted research with three teams (between five and seven participants in each). We report findings from two teams who were working with children (aged between 10 and 14) who staff identified as having behaviour that challenged. The intervention consisted of two video-feedback intervention sessions, using clips of good interactions between themselves and the child and a review. These sessions took place over three or four months. Qualitative analysis was conducted to analyse changes to the language and depictions of the children. Changes to the participants’ goals during the intervention were also analysed. Results: The staff's focus on the child's challenging behaviour reduced. Children who were originally depicted as isolated became depicted in relationship with peers and staff. Participants became more curious about the child and his interactions in the school and home environment. The participant's personal goals emerged through their understandings of what it meant to be good. Conclusions: Working with staff teams using video feedback can change the interactions around the child and the relational conceptualisation of the child and family. Further adaptations to the intervention are needed to raise critical reflection on the concepts that circulate around ‘behaviour’ that structure policy and shape everyday practices. (Edited publisher abstract)
The East Lancashire Clinic Model: supporting care homes to understand reactive behaviours (Innovative Practice)
- Authors:
- SMITH Michael, SAYER Kelly
- Journal article citation:
- Dementia: the International Journal of Social Research and Practice, 20(2), 2021, pp.807-813.
- Publisher:
- Sage
The East Lancashire Clinic model is a consultancy-based approach to supporting care home staff to assess and respond to reactive behaviours of people with dementia and reduce the need to refer into secondary mental health services. The clinics are person centred and solution focused, aiming to promote recognition of unmet needs and early interventions implemented by staff. The pilot was able to resolve most cases and reduce referral rates into secondary care services. Through working collaboratively, it empowers staff to improve the care of all their residents, improves relationship with secondary care services and has potential to offer efficiency savings. (Edited publisher abstract)
Early childhood education centre director perceptions of challenging behaviour: promising practices and implications for professional development
- Authors:
- GARRITY Sarah M., et al
- Journal article citation:
- Children and Society, 33(2), 2019, pp.168-184.
- Publisher:
- Wiley
Given their key role in overall programme quality, it is critical to examine how early childhood programme centre directors in the United States perceive challenging behaviour. Participants completed a survey asking which behaviours they perceive to be most problematic, the number of children dismissed or expelled from the programme during the last year, and the most commonly used strategies for addressing challenging behaviours. Results point to several promising practices and highlight the variability in access to evidence‐based practices based on programme type. Areas that warrant more targeted professional development are discussed, and findings are situated within the larger early childhood context. (Edited publisher abstract)
The behaviours that dementia care home staff in South Africa find challenging: an exploratory study
- Authors:
- VAN WYK Adele, MANTHORPE Jill, CLARK Charlotte
- Journal article citation:
- Dementia: the International Journal of Social Research and Practice, 16(7), 2017, p.865–877.
- Publisher:
- Sage
Background: Behavioural and psychological symptoms of dementia are often the reasons for moving to a care home. Care staff, often with limited dementia training, may have to support residents with distressed behaviour on a daily basis. Evidence about the support of residents with distressed or challenging behaviour in the South African context is lacking. This exploratory study aimed to gain an understanding of what care home staff perceived to be distressed behaviour, their coping strategies and how they learned to work with residents with behavioural symptoms of dementia. Methods: An exploratory study was conducted among 17 participants working in four care homes in the Western Cape province of South Africa in 2014. Semi-structured interviews were audio-recorded. Data were analysed thematically. Findings: Findings reflected the literature with regard to examples of behavioural symptoms of people with dementia that staff find challenging to manage. Overall, the majority of staff reported holding positive feelings about working with people with dementia. All preferred interpersonal approaches to manage distressed behaviour above medication although a small minority noted the use of medication in some cases. Dementia training was considered by most participants as an unmet need. Conclusion: This exploratory study identified care home workers’ desires for training about dementia and their preferences for interpersonal as opposed to pharmacological approaches to managing residents’ distressed behaviour. The legacy of race and cultural perspectives in South Africa appears to still influence care practice and provision. Staff commitment, their interest in advancing their practice and their aspirations to offer more person-centred care were evident. Dementia training was identified as potentially helpful to care home staff who manage residents’ distressed behaviour. Training should be developed in South Africa to promote good practice. (Edited publisher abstract)
Workforce development and people whose behaviour challenges: key facts
- Author:
- SKILLS FOR CARE
- Publisher:
- Skills for Care
- Publication year:
- 2012
- Pagination:
- 4p.
- Place of publication:
- Leeds
This brief document outlines the key facts emerging from a review to address a number questions around workforce development for staff working with people whose behaviour challenges and changes. What are current reported practices to support workforce intelligence, planning and development? What works, and what does not work, in current practice? What are the key characteristics of effective practice in workforce intelligence, planning and development? Is there any relevant international evidence? What are the gaps in the evidence base? People whose behaviour challenges was defined as including “people whose behaviour presents a significant challenge to services, whatever the presumed cause of the problem”. The evidence review identified a wide range of research studies both quantitative and qualitative but struggled to find many high quality studies. After searching and evaluation 77 full texts were included in the synthesis. However, the authors did manage to identify a range of evidence about current practice, what works and what are the key characteristics of effective practice, and where the gaps in the evidence base exist. The findings are discussed under the following headings: prevalence and persistence, staff attitudes and attribution, effect of working with people whose behaviour challenges on the social care workforce, organisational factors and challenging behaviour, service models, care practices, and training.