This series of blog posts first appeared a few years ago on a now defunct blog called ‘Care Training’. It was inspired by the training maxim of ‘making the unconscious conscious’. It is intended to take what really ought to be the most basic principles of health and social care and put them down on paper. The series isn’t only an exercise in stating the obvious though whatever the title might suggest. It’s actually intended as a philosophical foundation manual for workers and informal carers to help them get their care ‘on track’ and then to keep it that way.
There are many different definitions of challenging behaviour. Some rely upon long lists of activities and behaviours that society sees as unacceptable. Others attempt to define the concept philosophically by referring to the works of ethical or moral authorities, sometimes dating back thousands of years. Throughout this series we shall use a fairly simple definition.
Challenging behaviour is a combination of two criteria:
- Behaviour that we don’t like;
- Behaviour that we think we need to respond to.
According to this definition both criteria must be met before we can say that the behaviour is challenging. For example, someone somewhere has been attacked within the last thirty seconds (a statistical certainty). I am not challenged by that because I am not in a position to respond to it. Therefore the behaviour is merely something I disapprove of but it is not actually challenging to me because there is nothing for me to do about it.
It’s important to get the sense of this definition clearly in mind before we go any further with this topic. Much of what people think of as challenging behaviour is not really challenging at all. We don’t have to respond in every case. Arguably, if we do respond and try to prevent people from doing things that they have a perfect right to do then the truly challenging behaviour is our own – not that of the service-user. Disagreeing with the care staff is not necessarily a challenging behaviour – it’s just a choice.
One of the most common problems among health and social care workers is the assumption that they have to ‘deal with’ behaviours that they do not personally agree with. This isn’t always true and by adopting a more flexible approach to the choices of service-users we can avoid many of the conflicts that make this work so difficult in practice.
Another important theme is the right of the worker (and others) to be free from abuse, assault or harassment. The law in UK, in particular the Health & Safety at Work Act (1974), is very clear on the responsibility we all have to keep ourselves safe and the need for proper assessment of risk. This is intended to ensure the safety of the service-user but also that of the worker and the person’s other carers or relatives. We’ll also consider ways to strike a realistic and reasonable balance between the needs of all concerned and the rights of all people to be safe and free from abuse.
Different types of challenging behaviour require different types of approaches. This is one of the most fundamental principles of challenging behaviour work and yet it is overlooked with alarming regularity. Just as with other challenges we come across in life, behavioural regimes and strategies are most effective when we take the trouble to understand the problem before we begin work on the solution.
In the broadest sense behaviours can be divided into two basic categories:
- Behaviours that harm the individual;
- Behaviours that harm other people.
Of course some behaviours will fall into both these categories so it’s not quite so simple as all that but this way of thinking does, at least provide us with a starting place. In the next post we’ll begin to look at these categories in turn.