Administration of Challenging Behavior

Presentation Transcript

Administration of Challenging Behavior Mike Holligan Nurse Manager Scottish Neurobehavioural Rehabilitation Service Robert Fergusson Unit

FACTS AND FIGURES Opened in January 1992 National Unit Treatment of head harmed grown-ups with related testing conduct Multi disciplinary approach (51.60WTE Nurses, 3 clinicians, 1.5 SALT, 2.5 OT, Physio, Art Therapy, Associate Specialist, Dietitian, Neuropsychiatry, Social work)

FACTS AND FIGURES 19 BEDDED UNIT (12&7) TREATMENT APPROACH NON AVERSIVE IABA LaVIGNA & WILLIS TREATMENT PHILOSOPHY RA ID DAVIES APT

AIMS OF THE ROBERT FERGUSSON UNIT TO PROVIDE A NATIONAL SERVICE FOR THE MULTI-DISCIPLINARY ASSESSMENT AND REHABILITATION OF PATIENTS WITH Behavioral AND PSYCHIATRIC COMPLICATIONS OF ACQUIRED BRAIN INJURY TO PROVIDE THERAPEUTIC Programs 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.

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

Define the Challenging Behavior Closely watch the conduct Define parameters Agree what is testing conduct

Positive Programming Strategies Teaching New Behavior Communication Strategies Teaching more fitting option practices Assuming an importance

THE RA ID PHILOSOPHY

Two methods of insight are lethally defective Punishment: whereby you detect the things the individual does wrong, and ask yourself "What would I be able to do as such s/he doesn't do that once more?" Extinction: whereby you work out what the individual "escapes" their conduct, and resolve that s/he won't get it any more. E.g: not giving consideration for 'consideration looking for' conduct