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Positive Systems Approach

PSA

morwenna
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Positive Systems Approach

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    6. Positive Systems Approach & Applied Behaviour Analysis Using: Functional Analysis of Behaviour Behavioural Assessment techniques; Data Collection/Analysis; Reinforcement Theory and how this may be working to maintain behaviours and how it can be used to develop new, alternative and incompatible behaviours; Stimulus Control and Stimulus Change techniques

    7. PSA & Systems Theory Looking at components of the system and the changes that occur when the interactions are changed, with emphasis on the environment and the ability to make changes in the environment to benefit the individual.

    8. PSA & Sytems We cannot change the way that a person behaves without having a thorough understanding of the system that that person functions in. We are often able to change behaviour simply by changing the environment and the way that we interact with that person – as opposed to trying to change the individual (e.g. – through behaviour modification techniques). This is a much less intrusive and positive approach to changing human behaviour – and, often, much more successful in terms of achieving enduring changes that generalize to various situations.

    9. PHILOSOPHY OF PSA The underlying philosophy of PSA is that every individual functions within a system, and behavioural change cannot occur without first considering all aspects of that system and its synergistic effect (i.e. – the individual affecting they system and the system, in turn, impacting on the individual.

    11. Gentle Teaching … Learning requires …. HUMAN PRESENCE - this is the antecedent of all behaviour. We need to learn that human presence signals safety, security & reward, not frustration, punishment or threat. HUMAN PARTICIPATION & INTERACTION - this is the actual behaviour necessary to learn that reward is the result of our behaviours with other people, that by participating and interacting we gain a sense of pleasure, and a belief in the mutual value of people. HUMAN REWARD - the sense of pleasure from being in contact with others. This is (or should be) the result of the majority of all our interactions. It is certainly the motivation for social beings to interact. A second key assumption is that all teaching, learning and behaviour change is a mutual and reciprocal phenomenon i.e. behaviour change is not something to be done to somebody,it is something we attempt to do with somebody. It is a two-way affair that can either strengthen our humanity, or weaken it.

    12. Evaluating Attitudes Necessary for PSA Exercise 1: ASPECTS OF A HEALTHY RELATIONSHIP LIST ALL ASPECTS OF A HEALTHY RELATIONSHIP Discuss: If a healthy relationship exists, how does this impact on challenging behaviour?

    13. Attitudes - Roles Exercise 2: ROLE OF THE SUPPORT PERSON List words that describe or define your role vis a vis the people that you support: define each of these roles discuss objections and disagreements about any of these roles

    14. Attitudes – more role work In our society who has power and control? If we consider how these trends affect minority groups in our society, what impact does it hold for the persons we support? Are they valuable? Can they overcome the power imbalance that they have inherited? What is ablism - how is it defined? What barriers do persons with disabilities (power imbalances) face due to ablism?

    15. Attitudes – power & control… SCENARIO A You go to the doctor and he advises you that you have high blood pressure and need to lose weight and quit smoking. How do you respond? SCENARIO B You take a person you support o their family doctor, the doctor tells the person and you that the individual has high blood pressure and needs to lose weight and quit smoking. How do you respond?

    16. POWER AND CONTROL ISSUES (Group Exercise) SCENARIO A You go to the doctor and he advises you that you have high blood pressure and need to lose weight and quit smoking. How do you respond? SCENARIO B You take a person you support o their family doctor, the doctor tells the person and you that the individual has high blood pressure and needs to lose weight and quit smoking. How do you respond?

    17. Attitudes – punishment..? Defend this statement: It is ethical and practical to use some forms of punishment in our work , in order to shape behaviour. Defend this statement: It is unethical and not practical to ever use any kind of punishment in our work , in order to shape behaviour.

    18. Attitudes – punishment… Do you use punishment in your work? List some ways that punishment is disguised?

    21. PSA – Individual Factor - Identification finding all the possible triggering factors that might have caused the behaviour through extensive interviewing of all individuals who have good knowledge/history with the person; conducting functional analysis (behavioural assessment); examining all possible medical factors that might be impacting on the situation; examining environmental factors that could be contributing to problems.

    22. PSA – Individual Factor - Reinforcement looking at the amount of non-contingent reinforcement available to the person and findings ways to increase this, while improving rapport/relationship factors with caregivers.

    23. PSA – Individual Factors – Re-Direction findings was to re-direct (physically, emotionally) the individual at the earliest possible stages to stimulating activities that are, hopefully, also incompatible with engaging in the problematic behaviours.

    24. PSA – Individual Factors - Coping recognition that problematic behaviours often reflect a skill deficit in some area that needs to be addressed (e.g. – dealing with stress, anxiety, change, transitions, etc.) and finding ways to teach the individual new skills in these areas.

    25. PSA – Individual Factors - Communication recognition that behaviour is usually just a form of non-verbal communication and caregivers need to become more adept at trying to determine what communicative function that behaviour has for the person (e.g. – attention, boredom, escape/avoidance, pain/discomfort, etc.)

    26. PSA – Individual Factors – Relationship/Rapport This starts with ourselves, our warmth toward others, our willingness to give without any expectation of receiving anything in return, and our intense desire to form feelings of companionship and community with those who are the most pushed to the very edge of society.

    27. PSA – Individual Factors - Stimulation Many negative behaviours are an attempt to gain attention, or escape/avoid undesirable situations, or to provide some form of stimulation – and non-contingent, intensive stimulation which the person finds enjoyable can prevent negative behaviours.

    28. PSA – System Factors - Flexibility addressing the need of the system to be flexible to the needs of the individual in important areas such as: staffing, day program requirements, living arrangements.

    29. PSA – System Factors – Perseverance & Tolerance Challenging individuals will require considerable commitment and perseverance on the behalf of the agency that is providing the supports. There needs to be a recognition that crises and challenges are going to occur on a regular basis with some individuals and rather than give up or look for an easy and passive approach to the problem (e.g. – medication, admission to hospital) that we need to persevere in exploring additional resources that might assist. We also need to be more tolerant in recognizing that some behaviour may be a long-standing and entrenched part of a personality or communication strategy as well as an inherent part of a specific syndrome or disorder (e.g. – autism) and may always be present in this individual to some degree.

    30. PSA – System Factors - Consistency This involves finding ways to develop a consistent interactional approach amongst all the caregivers that have contact with the individual. Lack of consistency in approach is one of the biggest problems that we face as it frequently leads to confusion and may even inadvertently reinforce the very behaviours that we are trying to reduce.

    31. PSA – System Factors - Portability This addresses the need for a Positive Systems Approach to move between all of the different environments that an individual functions in.

    32. PSA – System Factors - Intensity This involves finding ways to provide the required levels of resources and human interactions when they are most needed.

    33. PSA – System Factors - Change This involves examining ways to change the stimulus conditions that are precipitating the behaviours (using stimulus change and stimulus control techniques); finding ways through advocacy and management to achieve changes in the individual’s support system.

    34. PSA – System Factors – Team Health Agency, Team and Individual level - addressing ways to foster a spirit of cooperation and team between all caregivers to maximize consistency and opportunities to make the required changes. This factor discusses the importance of developing a “core team” as well as the advantages of support circles for some individuals.

    35. Support Circles Movie – Dorothy’s Story

    41. Peter’s Story

    42. Peter’s Story PSA Introduced Peter moved to new home Home staffing and approach designed around PSA All agency staff trained in PSA

    43. Peter’s Story Case Manager/Primary Counsellor choice is critical Professional Supports are critical Family Supports are critical Medical/Psychiatric supports are critical

    44. Pete’s Movie

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