Challenging behaviour strategies aren’t necessarily complicated but they are powerful. It’s important then that we use them ethically. This video outlines some of the more basic points about ethics and philosophies of working with people who challenge us.
Is ‘Expressed emotion’ really a thing in mental health care?
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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.
Sometimes the harm, or risk of harm, affects others and so we really must intervene. Service-users don’t have the right to hurt others, no matter how much they might learn from the experience.
If, for example you heard of an assault you must take reasonable steps to try to prevent it. If necessary and appropriate call the police or other outside agencies as needed. If an offence has occurred then always report it to the police. That’s part of learning from experience too.
Never fall into the trap of being too ‘understanding’ in these situations. Compassion is important but naivety is not. Shielding a person from consequence teaches them the wrong lesson – it teaches them that there are no consequences and that tends to encourage both more frequent and more serious challenging behaviour. Do you really want your service-users to believe that it’s OK to hit you or your clients? If you don’t then let them face the consequences of their actions while they’re still at the shouting stage.
We know that challenging behaviour, including violent behaviour, escalates if left unchecked. We know that some people are dangerous and that they tend to become increasingly violent so long as they continue to ‘get away with it’. So the obvious solution is to ‘nip violence in the bud’, thus preventing it from escalating.
If you work with people, be they mentally disordered or not, ask yourself this:
Do you ever excuse their hostility because you ‘understand’, because they’re ill, because they have anger ‘issues’ or they’ve been through such a lot of trauma in their early lives etc etc?
If so please understand that the more you excuse the behaviour the worse it will get. People learn through consequence – you did, from an early age. That’s why you’re able to hold down a job. You learned to behave appropriately in society by experiencing negative consequences when you transgressed. That’s why as parents we ‘ground’ our children for example – it teaches them ‘the rules’. We do people no favours by pretending that violence and aggression is acceptable.
When you or others are at risk intervene, do what is necessary to manage those risks but without focussing more than is needed on the behaviour itself and always encourage more appropriate alternatives.