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@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. Episodes 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 it’s World War III and there’s 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 haven’t 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 • ‘… there’s a lot of people here who have special needs and yeh, you’ve 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