In the context of a detailed behavioural plan there are a range of interventions which may be helpful in reducing behavioural difficulties and supporting positive behaviours.  These interventions will help to encourage and maintain positive behaviours in the longer term with the aim of supporting the person to enjoy a better quality of life.

 

The following interventions may be helpful:

  • Ensure that the person has access to meaningful social and leisure opportunities.  This should include ensuring regular opportunities for social interaction within their everyday environment.
  • Support the person to develop and maintain meaningful relationships and friendships. This should include support to maintain established relationships and to develop new ones. To achieve this, support for communication and cognition may be required.
  • Provide a range of activities to prevent boredom. It is important to remember that the person may not be able to self-direct their own activity, will need support to engage in activity and may no longer be able to engage in previously valued activities. Cognitive difficulties including reduced motivation, difficulties with initiation, poor ability to generate ideas and think of what they would like to do can be major contributory factors to reports of boredom.
  • Assist the person to experience a sense of achievement. This is important as it will help to increase confidence and self-esteem as well as help them recover their sense of identity post brain injury.
  • Assist the person to feel valued within their family and/or wider community. This can be facilitated by providing the person with a specific role/job. Some people may benefit from access to educational and vocational opportunities.
  • Support the person to have as much choice and control over their life as is practical and safe (within their ability to make informed choices) e.g. choice of social and leisure activities, clothes, meals etc.
  • Social skills training (i.e. the ability to communicate and interact with others in an appropriate manner) may be helpful for some people who have the cognitive skills to engage with this. Social skills training will require support from appropriate professionals (i.e. Clinical Psychologist, Speech and Language Therapist, Occupational Therapist, Nurse Specialist).
  • Support the person to understand what appropriate behaviour looks like and give clear information about the positive consequences of appropriate behaviour thereby being clear about future expectations.
  • Reinforce appropriate behaviours so they become more valued and effective than challenging behaviours.
  • It may be helpful to provide the person with feedback about episodes of challenging behaviour but also provide positive feedback when they have managed a difficult situation well.  Feedback should only be provided when the person is calm.
  • Assist the person to understand the potential negative consequences of their behaviour for themselves and others. Discussion should only be carried out when the person is calm: this will facilitate understanding and retention of information.