Student Tutorial - Working With Challenging Behaviours

Mental Health conditions can occasionally involve difficult behaviours including disinhibition, verbal or physical aggression, disengagement and wandering.  There are a lot of variables to consider when considering potential client behaviours given the large variety of mental health settings, so it is important to address this area with the clinical educator early in the placement experience.  It is important that you are aware of how you might feel and react when faced with difficult behaviours.  It is really important to start thinking about how you might address the behaviour while keeping yourself and your client safe.

Talking with acutely psychotic people provides a comprehensive guide to assist engaging with patients in this mental state. Some key areas include ‘Moral foundations’ (p. 17), ‘Preparing for interaction and its context’ (p.20), ‘being with the patient (relationship building, maintaining and assessment)’ (p. 23), ‘non-verbal communication, vocabulary and timing’ (p. 32) and ‘getting things done’ (p. 39).

Further reading:

The  Dementia Collaborative Research Centre – Assessment and Better Care (DCRC-ABC) at the University of New South Wales (2012) produced the Behaviour Management- A Guide to Good Practice - Managing Behavioural and Psychological Symptoms of Dementia (BPSD).  This guide provides excellent learning modules outlining the types of behaviours one might face with dementia, risk assessment and strategies to manage difficult behaviours.  The key focus areas of behaviour include aggression, agitation, anxiety, apathy, depression, disinhibited behaviours, nocturnal disruption, psychotic symptoms, vocally disruptive behaviour and wandering.  It also includes information specific to working with Aboriginal and Torres Strait Islander and Culturally and Linguistically Diverse populations. This is a large resource so it would only be recommended as a supplementary resource.