Strengths Based Behaviour Support

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Strengths Based Behaviour Support

• Richard Mayers
• Psychologist
• Disability Services Queensland

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Outline

• Assumptions behind behaviour support approaches
  (ie behaviourist and strengths based)
• Review the role of clinician from each of these
  approaches
• The importance of relationships within therapy
  and behaviour support
• The landscapes in which behaviour support can
  occur
• The strengths of each approach
• Techniques relevant to a strength based approach
• Weaving these approaches together
• A case study Keith

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Assumptions

• Epistemology
• a branch of philosophy concerned with the study
  of theories of knowledge. Through investigation
  of the origin, nature, methods, and limits of
  human knowledge
• Positivism
• Constructivism
• Social Constructivism

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Modernism and Postmodernism
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How approach used effects the role of the
behaviour support clinician

• Behaviourist
• Belief in Objective reality/truth
• Clinician is expert/analyst
• Clinicians voice privileged
• Teach the person with disability/support network
  the clinicians assumptions and language
• Person with a disability has a problem

• Strength Based
• Truth is socially constructed
• Clinician is partner/catalyst
• Person with disabilitys voice privileged
• Learn the person with disability/support
  networks assumptions, use their language
• Person with a disability has a relationship with
  a problem

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Evidence from therapy outcome research, factors
that influence successful outcome in therapy
Data from Lambert, 1992
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The landscapes in which behaviour support can
occur

• Landscape of Action
• who, what, when, where and how
• Behaviourist approaches
• Landscape of Consciousness
• what those involved in the landscape of action
  know, think, or feel
• Strength Based Approaches

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How these relate to the strengths of both
approaches

• Behaviourist
• Technologies developed from 30 years of
  empirical enquiry
• Client skill development
• Mediator analysis
• Focus on the landscape of action
• Strength Based
• Focus on clients relationships (with issue,
  others)
• Respect for client power and power of
  relationships
• Privileging clients language to understand issue
• Success through promoting strengths (vs focus on
  deficits)
• Socially constructing preferred truths and
  outcomes.
• Focus on landscape of consciousness

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Techniques relevant to Strengths-based Behaviour
Support

• Recognition of Current Circumstances
  (Acknowledging, nomalising, reframing)
• Finding Strengths and Solutions (exceptions,
  celebrations, deconstruction, co-construction of
  positive narratives/alternatives)
• Power with the person with a disability (choices,
  externalising, narrative of choice)
• Reflective questioning and cueing (focused,
  structured, incidental)
• Reactive Intervention (active listening,
  preplanning, antecedent control, cognitive
  dissonance, acknowledging remorse)

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Can these approaches be weaved together?

• Foundation assumptions may differ, but in the
  pursuit of positive outcomes, the landscapes of
  action and consciousness cannot help but
  interact.
• Behaviourist approaches have strength in the area
  of developing competence through scientific
  educational techniques
• Strength based approaches have strengths in
  creating personal social meaning of experience

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Case study - Keith

• 25 year old male
• Autistic Spectrum Disorder, Mild/Moderate
  intellectual disability
• Living in supported accommodation since 15 years
  old (due to breakdown in family)
• Current accommodation setting at risk of
  breakdown
• Behaviours of Concern
• Verbal and Physical Aggression
• Self Injury
• Property Damage

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Keith

• Current Circumstances explored and recognised.
• Explored what happens when Keith gets angry.
  Staff said he just doesnt seem to care. Keith
  regularly said I dont care.
• Developed into dont care choices
• Explored exceptions to challenging incidents.
  Staff and family discussed Keiths desire for
  independence, his achievements in his regard and
  his ability to do things (eg arts crafts,
  certain domestic tasks) by himself
• Developed into Independence choices
• Developed narrative of choice around
  Independence and dont care choices. Gained
  agreement from Keith and support network for this
  behaviour support focus.

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Keith

• Reflective cueing and questioning relating to
  choice narratives built into a range of behaviour
  support strategies (eg positive programming,
  preplanning, antecedent control)
• Keiths interest in Arts Crafts (eg taking
  photos, scrap booking), was developed at a
  community access structured program level.
  Continual linking of independence choices to
  successful activities
• Developed Reinforcement Schedule linked to
  Independence and dont care choices

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Keith

• Through structured and active preference for
  Independence choices,
• there were increasing instances of independence
  choices being recognised and celebrated
• Keiths arts crafts skills improved
• there were decreasing instances of dont care
  choices being expressed
• A new narrative celebrating Keiths independence
  began to grow around Keith