Study Notes

To change negative behavioural responses to more positive ones, it is essential that an individual is able to identify the specific situations and circumstances that trigger them.

For example, an individual may tear up their clothes when they are hungry as a way of communicating to their staff that they would like some food. This behaviour may have come from their past history whereby they were inadvertently neglected by care staff but learned that when they tear clothes up their care staff give them attention which invariable ends up with asking if they would like a snack.

You would support the individual to identify that this behaviour occurs when they are hungry and a more appropriate behaviour would be to inform staff that they are hungry or even get themselves some food. If the individual has difficulty communicating verbally, it may be necessary to teach them the Makaton sign for food or invent their own sign that their staff will understand.

Other situations or circumstances that may trigger behavioural responses can include:

• Basic needs not being met (tired, hungry, thirsty, cold etc.)
• Boredom
• Feeling a lack of freedom
• Wanting something e.g. toy, sweets, ornament etc.
• Others being too loud
• Others not understanding
• Feeling isolated

Study Notes

The previous post discusses working with an individual to find motivation for changing behaviours. It will also be useful to discuss with them some of the positive outcomes that you envisage from them managing their behaviour in a more positive way.

Some examples of positive outcomes include:

• Having more friends/better relationships
• Intrusive interventions will not have to be used
• Better health and wellbeing
• Better financial situation

For an individual to successfully make adjustments to manage their behaviour, they must have the right motivation. They must have a good reason to make the necessary changes because changing habits is difficult so there must be some sort of incentive in them to put in the requisite effort.

Motivation will vary between individuals and the right motivation for a particular person will depend a lot on the things that are important to them or what makes them ‘tick’. You will need to discuss with the individual what they think will be the right incentive for them to encourage behavioural change.

It is also useful to ensure that the motivation is directly related to the behaviour change (e.g. if an individual washes themselves and their clothes regularly, they are more likely to get a girlfriend). There are times when it may be necessary to have an unrelated incentive (e.g. if an individual washes themselves and their clothes regularly they reward themselves with an extra chocolate bar each week), however for long-term success it is important that the motivation comes directly from the behaviour itself.

Some examples are:

Following a behaviour by an individual, it will be useful to encourage them to consider the impact that their behaviour has had on themselves and others as part of a debrief.

This can help an individual understand the consequences that their behaviour has and can build motivation to manage it better in the future.

Some of the repercussions of the behaviour may be:

• Injury to self or others
• Exclusion from activities in the future
• Friends/family/staff not wanting to associate with them
• Embarrassment
• Damage to or loss of property (own or others)
• Financial costs
• Police intervention/prosecution/litigation
• Upset, anger or sadness to themselves or others
• Being late for an activity or the activity being cancelled
• Tiredness
• Decreased health or hygiene

Part of your role as a health and social care worker will be to support individuals (and others) to recognise their behavioural responses to different situations.

To do this, you will first need to have spent time with an individual and understand the kind of situations that may result in an inappropriate behaviour. This information could be obtained from observations or previous experiences as well as from the individual’s family, other professionals and their care plan.

You can help an individual recognise their behavioural responses before, during and after a situation has occurred.

If a behaviour is regular you can discuss it with them using their preferred communication methods whilst they are at baseline. You may want to discuss the triggers for the behaviour, the behaviour itself, the negative consequences of the behaviour and what they might like to try in future to manage the behaviour and obtain a more favourable outcome.

When a situational trigger occurs, you can help an individual to manage it by offering support and guiding them through the alternative behaviours that you may have previously discussed.

After a behaviour has occurred and the individual has returned to baseline, it will be useful to have a debrief and discuss the repercussions of the behaviour (this could include positive reinforcement if they have managed the situation well).