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Management of Challenging Behaviour,Mike HolliganNurse ManagerScottish Neurobehavioural Rehabilitation ServiceRobert Fergusson Unit,FACTS AND FIGURES,Opened in January 1992National UnitTreatment of head injured adults with associated challenging behaviourMulti disciplinary approach (51.60WTE Nurses, 3 psychologists, 1.5 SALT, 2.5 OT, Physio, Art Therapy, Associate Specialist, Dietitian, Neuropsychiatry, Social work),FACTS AND FIGURES,19 BEDDED UNIT (12&7)TREATMENT APPROACH NON AVERSIVEIABA LaVIGNA & WILLISTREATMENT PHILOSOPHYRAID DAVIES APT,AIMS OF THE ROBERT FERGUSSON UNIT,TO PROVIDE A NATIONAL SERVICE FOR THE MULTI-DISCIPLINARY ASSESSMENT AND REHABILITATION OF PATIENTS WITH BEHAVIOURAL AND PSYCHIATRIC COMPLICATIONS OF ACQUIRED BRAIN INJURYTO PROVIDE THERAPEUTIC PROGRAMMES WHICH PROMOTE MOBILITY, OPTIMUM PHYSICAL FUNCTIONING, INCREASE COGNITIVE AND SOCIAL SKILLS AND REDUCE PHYSICAL AND MENTAL DISABILITY.TO PROVIDE OPPORTUNITIES FOR SOCIAL AND RECREATIONAL ACTIVITIES.TO PROVIDE SUPPORT AND ADVICE TO RELATIVES, CARERS AND RELEVANT PROFESSIONALS.TO PROVIDE A HIGH QUALITY AND STANDARD OF TREATMENT, CARE AND THERAPY.,HOW MANY TREATED,304 referrals (up to December 2002)114 patients admitted since January 1992Five patients have been re-admitted.,Define the Challenging Behaviour,Closely observe the behaviourDefine parametersAgree what is challenging behaviour,Positive Programming Strategies,Teaching New BehaviourCommunication StrategiesTeaching more appropriate alternative behavioursAssuming a meaning,THE RAID PHILOSOPHY,Two philosophies are fatally flawed,Punishment: whereby you spot the things the person does wrong, and ask yourself “What can I do so s/he doesnt do that again?”Extinction: whereby you work out what the person “gets out of” their behaviour, and reso