Posted By J Knight
Tony,
This is a very complex question. In essence, I suggest that providing the best care and support entails effective management of challenging behaviour. Nobody can participate fully in society while they behave in a way which would exclude them from public spaces and so on. So at the end of the day, there isn't a conflict between managing CB and providing the best possible care.
I have no experience with CB in a Children's setting, but all three of my most recent employers have had to deal with CB to a lesser or greater extent. In one case the 'reason' was learning disability, and here the solution was careful planning and management, with clear goals. In the most extreme cases people who had been 'unmanageable' were eventually able to go out to the shops and for walks in the country side and so on. Yes, they still had occasional outbursts of frustration and temper, but to a much reduced and much less damaging extent. The planning and management, incidentally, was done by psychologists and highly trained nurses, I can take no credit. In the meantime, while all the behaviour management stuff was being implemented, staff were given training in breakaway, situation management and so on, and lots of management support. All done without coercion and non-aversively, of course.
In other situations it has been more difficult, especially where degenerative neurological diseases are concerned, as behaviour modification won't work in anything like the same way. Then its is much more about staff support, and careful observation, with detailed planning, again done by specialists.
In other words, the behaviour shouldn't just be accepted, and your staff need support while efforts are in train to help people express their needs in a more appropriate and less challenging manner. If that sounds hopelessly pie in the sky and woolly liberal it isn't, believe me, I've seen it happen,
John