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An overview of promoting positive behaviour in various settings such as acute psychiatric settings, residential units for people with learning disabilities, services for elderly and confused individuals, and some child care settings. It covers best practices, identifying patterns of behaviour, understanding the impact of the environment, physiological aspects of behaviour, behavioural support plans, and relevant legislation and guidance.
Typology: Exercises
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Unit 12 – Promote positive behaviour
The table below shows all the topics you will cover. Learning outcomes What you must know 1.Be able to promote positive behaviour Understand the contexts where the promotion of positive behaviour is required ✓ Acute psychiatric settings ✓ Residential units for people with learning disabilities ✓ Services for people who are elderly an confused ✓ Some child care settings ✓ Foster care Positive behavioural support – ‘a framework to understand the context and meaning of behaviour in order to inform the development of supportive environments and skills that can enhance a person’s quality of life’. (Positive and Proactive Care, reducing the need for restrictive interventions, Department for Health, 2014) Best practice ✓ Use person-centred, values-based approaches ✓ Assessment – must understand probable reasons why a person presents behaviours of concern. Knowing the individual’s personal and medical history – health issues that contribute to behaviour, personal likes and dislikes, possible triggers. Assessments must have input from the individual, their carers, relatives or advocates. Identifying patterns of behaviour ✓ Identifying precursor behaviours – tense muscles, pacing, sweating, facial expressions, increased breathing rate
significant risk of harm to the individual or others around them Evaluation of best practice ✓ Peer review ✓ Formal observation of practice ✓ Supervision ✓ Self-reflection on your practice 2.Understand situations in which staff are required to use reactive and restrictive interventions Situations ✓ Preventing someone from harming themselves ✓ Holding a person to receive a medical treatment in a planned situation ✓ Holding someone to receive medical treatment in an emergency situation ✓ Self-defence ✓ Escaping from violence ✓ Protecting vulnerable people from violence Recognising stages of behaviour ✓ The green ‘Proactive’ phase – where the person is feeling mostly calm and relaxed and is able to engage positively with you in a meaningful way – no action required ✓ The amber ‘Active’ phase – where the person may be starting to feel anxious or distressed and there is a chance that he/she may need to challenge you in some way – self-management can reduce this or secondary strategies may need to be implemented ✓ The red ‘Reactive’ phase – where challenging behaviour actually occurs and there is a need to do something quickly to achieve safe and rapid control over the situation to prevent unnecessary distress and injury –
tertiary strategies to be applied in the least restrictive way possible. Certain strategies can only be applied in hospitals and with individuals detained under the Mental Health Act ✓ The final blue ‘Post Reactive’ phase
positive behaviour ✓ Section 3 Criminal Law Act 1967, Common Law ✓ Health and Safety at Work Act 1974 ✓ Human Rights Act 1998 ✓ Police and Criminal Evidence Act 1984 Guidance ✓ Positive and Proactive Care – reducing the need for restrictive interventions (2014) ✓ A positive and proactive workforce (2014) Key terms ABC chart The aim of ABC charts is to identify between the behaviour and its antecedent and consequent events, to aid understanding of the function that a particular behaviour serves for an individual. A stands for Antecedent, B for Behaviour and C for Consequence Acute psychiatric settings Advocates of individuals An acute psychiatric setting is where people are admitted when they are in crisis and who may need safety, monitoring and assessment as well as therapy and medication management Advocates of individuals Advocates represent the views, needs and interests of individuals who are unable to represent themselves. This involves advocates working closely with individuals and on some occasions with others who know the individual well. Advocates may represent individuals bother verbally and in writing. Occasions when this may occur may include at a young person’s review meeting or when there is a change in the health needs of an individual who have dementia
Amber ‘Active’ phase The Amber ‘Active’ phase is where the person may be starting to feel anxious or distressed and there is a chance that he/she may challenge you in some way. In this phase the person is expressing that they are anxious; wanting something they are unable to ask for; not liking something; feeling bored, etc. These are early warning signs and provide the opportunity to intervene before the behaviour escalates to challenging behaviour Assessment An assessment of behaviour is usually called a functional assessment or functional analysis and aims to identify possible causes of an individual’s behaviour and determine the best ways to promote their positive behaviour Autonomy Autonomy is allowing individuals to make decisions and choices about their own life Behaviour support plans Behaviour support plans are developed after an individual has had an assessment. They:
De-escalate De-escalation refers to reducing the intensity of a conflict or potential challenging situation Diabetes (^) A disease in which the body’s ability to produce or respond to the hormone insulin is impaired, resulting in abnormal metabolism of carbohydrates and elevated levels of glucose in the blood. There are two main types of diabetes; in Type 1 diabetes, the body lacks the cells which produce insulin in the pancreas; in Type 2 diabetes (which is common, and often develops later in life) the cells of the body fail to respond to insulin normally and the pancreas does not produce enough insulin Diversity The concept of diversity means positively recognising and understanding that each individual is unique and different. For example, this may be in relation to an individual’s abilities, sexual orientation or religious beliefs Epilepsy A neurological disorder marked by sudden recurrent episodes of sensory disturbance, e.g. loss of consciousness, or convulsions, associated with abnormal electrical activity in the brain Green ‘Proactive’ phase The Green ‘Proactive’ phase is where the person is feeling mostly calm and relaxed and is able to engage positively with you in a meaningful way Interpersonal skills Interpersonal skills are the life skills we use every day to communicate and interact with other people, both individually and in groups Legislation Refers to the process of making or enacting laws. Laws are debated and passed by Parliament and are upheld by the judicial
system. There are a number of laws that promote positive health including;
of communication such as signs or picture cards to indicate they have finished an activity or to ask for a drink Positive relationship Positive relationships are meaningful ways of interacting with others that result in positive emotions such as happiness, enjoyment and peacefulness as well as a sense of wellbeing. Positive relationships are constructive and beneficial for all those involved Precursor behaviours Precursor behaviours can sometimes precede a specific challenging behaviour e.g. tense muscles, pacing, sweating, facial expressions, increased breathing rate. Identifying precursor behaviours can assist in developing effective strategies to promote positive behaviour Primary preventative strategies These consist of changing aspects of a person’s living, working and recreational environments so that the possibility of challenging behaviour is reduced – reducing noise levels for some individuals may reduce levels of anxiety and distress Reactive interventions Reactive interventions are brought into play once unforeseen behaviour that challenges occurs;