The Rights and wrongs of challenging behaviour

1
The Rights and wrongs of challenging behaviour

• People with learning disabilities' experiences of
  people who challenge
• Martin Stevens, Social Care Workforce Research
  Unit
• martin.stevens_at_kcl.ac.uk

2
Introduction

• Definitions
• Background
• Approach and methods
• Findings
• The Moral web
• Causal factors
• Moral characterisations
• Consequences
• Challenging behaviour as position taking
• Implications

3
Definitions
Behaviour of such 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 or delay access to and use of
ordinary community facilities (Emerson et al.,
1987, quoted in Lowe and Felce, 1995, p. 118).
Challenging behaviours are best thought of as
being a way in which people respond and try to
gain control over difficult situations. (UK
Department of Health 2001 103)
4
Background

• Third phase of research for a local authority
• Few studies exploring service user perspectives
• Emphasis on increased choice and control for
  people with Intellectual Disability
• Challenging behaviour seen as a barrier to social
  inclusion and exercising choice

5
Approach and methods

• Exploring experiences
• Sample
• mainly witnesses or people who had been affected
  by challenging behavious
• Interviews and group discussions
• Observations
• Limitations

6
Information Sheet
Would you like to talk to Martin? About the
things some people do or say that make other
people feel unsafe

• Changes Picture Bank
• http//www.changepeople.co.uk/

7
Ethical issues

• Consent
• Confidentiality
• Accessible materials
• Time

8
The Moral Web
Emotional Impact
Impact on behaviour
Causal factors
Resolution
Own /others intervention
Staff interventions
Ongoing problems
9
Causal factors

• Interactions and relationships
• Um, cos when David and Luke, when David and and
  Luke clash its World War III and theres got to
  be about six or seven members of staff to stop
  it
• Behaviours
• So being called that how does that make you feel
  if you get called that? What happens? A bit
  upset. You do get a bit upset? Yes. And what do
  you do? Shout.
• Contexts
• But you havent been hit. Not from Braeburn,
  only here (day services).

10
Moral characterisations

• Bad
• Awful, really, a really awful word, when you say
  that F-in (pronounced as f-in) word
• Has negative consequences
• I got angry and annoyed and I told someone
• Altered by intention
• theres a lot of people here who have special
  needs and yeh, youve got to be tolerant.
• Altered by quality of relationships
• I like her. Even though she used to throw
  things.? Yes... She can be nice. She can be.

11
Consequences

• Emotional
• Negative for those responsible?
• Lifestyle
• Staff sorting it out
• Staff care
• and staff control

12
Positioning theory

• Interactions involve taking and ascribing
  positions, which are
• Sets of rights duties and obligations
• Positing power relations
• Influence future interactions
• Positions, interpretation of speech acts and
  storylines
• Misunderstanding others positions, meanings and
  stories can lead to conflict

Törrönren, 2001 Harré and Slocum, 2002 Phillips
et al., 2002
13
Challenging behaviour as position taking

• Positions taken by most participants
• innocent victims or bystanders
• Position ascribed to people who challenge
• Aggressive or irritating transgressors
• Unjustly assume powers and entitlements
• Positions ascribed to staff
• Powerful saviours and righters of wrongs

14
Implications

• Interactional nature of challenging behaviour
• Quality of relationships
• Social care and social control
• Moral element of social work through positions
  ascribed
• Blurring boundaries

15
Practice Implications

• Attending to moral assessments
• Understanding relationships
• Raise awareness of different levels of
  understanding
• Develop realistic expectations of staff
• Developing skills of conflict resolution
• Further research