Psychological Interventions for Severely Challenging Behaviours Shown by People With Learning Disabilities

Psychological Interventions for Severely Challenging Behaviours Shown by People With Learning Disabilities

By T Ball, A Bush & E Emerson

One of the most frustrating things about working with people with challenging behaviours is the gulf that often exists between academic research and traditional professional practices on the one hand, and the needs of people with challenging behaviours on the other. The publication of the clinical practice guidelines by the British Psychological Society goes a long way towards setting a standard for professional practice. In doing so, the authors have successfully unified research and practice into a single strand that, in our current state of knowledge, is likely to improve the treatment of perhaps the most marginalised group of people with learning disabilities.

In essence, the guidelines propose that positive behavioural support (PBS) is the benchmark for intervention in the field of challenging behaviours. There are 52 guidelines in total, each of which is based on research evidence and described as either 'essential' or 'good' practice. Three essential core guidelines set out the value base of PBS. They focus on recognising the person's unique strengths and needs and unique social context, adopting a coherent process of assessment-driven intervention and considering the person and the environment as well as the behaviour. Assessment is therefore idiographic rather than diagnostic; intervention is systemic as much as intra-psychic. Seeking consent before assessment, maintaining confidentiality, eliciting feedback, assessing risk and preventing abuse are all essential practice.

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