Communication Skills (Advanced)
Week 5
Context
Communication is the main way we interact and express our needs, likes and dislikes. If communication is a problem then it can be very frustrating for the person involved and may result in challenging behaviour. If this behaviour leads to a desired outcome, it may be repeated again and again.A person’s behaviour can be defined as “challenging” if it puts them or those around them, (such as their carer), at risk or leads to poorer quality of life. It can also impact on their ability to join in everyday activities. Challenging behaviour can include aggression, self-harm, destructiveness and disruptiveness.
Content
Behaviour
A widely accepted definition of challenging behaviour is: "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 use of, or result in the person being denied access to, ordinary community facilities" (Emerson, 1995).
A five point definition of challenging behaviour (Clements and Zarkowska, 2000), is behaviour that is:
- Inappropriate in its severity, or for the age or stage of the persons development
- Dangerous to the person or others
- Constitutes additional disability, interefers with learning new skills, or excludes from learning
- Causes significant stress to those living and working with the person
- Impairs the quality of a persons or other persons life to an unreasonable level or degree
- Is contrary to socially acceptable norms
When in Carols story does her behaviour speak louder than her words?
When does Carols behaviour become challenging?
What is happening at these points in Carols story, before, during and afterwards?
How might you measure Carols behaviour?
What does Carols behaviour tell us about her emotional state?
Guidelines from the British Psychological Society (2004) emphasise that challenging behaviours are socially defined, that is, they are defined to be challenging by virtue of another person’s perspective of, or reaction to, those behaviours. The recent paper ‘Challenging Behaviour: a unified approach’ (2007) produced by the Royal College of Psychiatrists, British Psychological Society and Royal College of Speech and Language Therapists, places strong emphasis on the need for the label ‘challenging behaviour’ to be reclaimed as a way of viewing behaviours within their interpersonal context, rather than as a diagnostic label applied to the person.
Causes of challenging behaviours in a mental health context
Physical | Cognitive | Psychological/ Emotional | Environmental/ Social |
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Functional Analysis
References and Further Reading
British Psychological Society (2004) Challenging Behaviours: Psychological Interventionsfor Severely Challenging Behaviours Shown by People with Learning Disabilities. British Psychological Society.
Clements J. and Zarkowska E. (2000) Behavioural Concerns and Autistic Spectrum Disorders. Explanations and Strategies. London: Jessica Kingsley.
Emerson, E. (1995) Challenging Behaviour. Analysis and Intervention in People with Learning Difficulties. Cambridge: Cambridge University Press.
NHS Protect (2013) Meeting needs and reducing distress Guidance on the prevention and management of clinically related challenging behaviour in NHS settings Download Meeting needs and reducing distress Guidance on the prevention and management of clinically related challenging behaviour in NHS settings. London: NHS
O'Collins, F. (2009) The concept of human behaviour [WWW] http://www.ucadia.com/uca/u18/180600.htm Links to an external site.
Royal College of Psychiatrists, British Psychological Society and Royal College of Speech and Language Therapists (2007) Challenging behaviour: a unified approach: Clinical and service guidelines for supporting people with learning disabilities who are at risk of receiving abusive or restrictive practices. London: Royal College of Psychiatrists
Xeniditis, K. Russell, A. and Murphy, D. (2001) Management of people with challenging behaviour. Advances in Psychiatric Treatment 7: 109-116