The following is intended to give an idea of the content, philosophy and background to our three-day MCB ‘Managing Challenging Behaviour’ course for carers of a variety of service users.
The ideals of Studio 3 are to promote the management of challenging behaviour in a gentle and dignified way, by providing a better understanding and insight into challenging behaviour and by use of low arousal approaches and gentle physical skills.
Studio 3 trainers have been running courses in the management of challenging behaviour for many years and our courses are based on applied academic research carried out in residential homes, day centres, respite care and institutional settings. We aim to give carers the skills they need to manage challenging behaviour so that the environment for the clients improves and the carers begin to develop more positive relationships with their clients. We also find that after the course, carers feel more confident in the work place and enjoy their jobs more, hopefully with less stress.
As part of the course package we provide a template policy on the management of violence and aggression. Our trainers will then work with you to develop this basic policy to suit the needs of your service. The policy is written in straightforward language so that it can be easily understood by all staff. This policy clears up the grey areas, especially around physical interventions and restraint. On the course we explain how this policy is meant to give a clear framework for carers and also the service.
The first day of the course goes into legal issues (and how this relates to the policy), understanding the nature of violence expressed by people with learning difficulties, carers’ own reactions and tolerances to challenging behaviour, understanding the causes of challenging behaviour, an introduction to low arousal approaches (including interaction, defusion and distraction strategies), an introduction to debriefing (why it is necessary and how to do it) and finally a section on managing versus changing behaviours.
The second day of the course combines gentle physical skills with the skills learnt on the first day. Studio 3 feel very strongly that physical skills are very much the last resort and no matter how gentle they are, we would prefer not to use them at all. However, being practical, there are times when they will be necessary.
Our academic research has shown us which physical behaviours are most common and the course examines how to manage these. The physical skills presented on the course are gentle, simple and easy to learn and they work very well because they are designed to be part of the overall low arousal approach to help defuse an incident.
The third day of the course allows plenty of time for practising the low arousal approaches and physical skills together. The last element of the course is learning the restraint procedure. This comprises learning to walk a client around in a safe way, allowing them time to calm down. This technique of using movement to defuse a situation has the added benefit of not employing any form of immobilisation which in itself can be highly arousing. We want to emphasise that the philosophy of the course is to use restraint as little as possible and that often, if we know what to do, we can back off and defuse an incident. Any time that we use restraint it is an admission that we have run out of other things to do. However, realistically, there may be occasions when restraint will be needed. This method of restraint allows carers to talk to the client who can then choose to calm down and so be let go, giving the client some choice and control. Most other procedures that we have seen are ‘take down’ procedures giving the client no choice or control, usually ending in a tangle of bodies. Finally, the trainers will role-play a client with each course member. These role-plays will test the various skills learnt on the course and necessitate the use of restraint.
Every 12 to 15 months it is important for staff to undergo a refresher day to renew and update their skills. This is an opportunity to discuss and work through any problems that may arise.
But what if?
This course is designed to help staff cope with the vast majority of challenging behaviour but there will always be incidents that fall outside the remit of the basic course. When there are individuals who are so challenging that additional support is needed, we are happy to make our trainers available to visit your service to work with the client alongside the carers. A major part of this work will include putting together reactive plans to manage these behaviours.