All behaviours have consequences. It is the consequences of behaviour that determine if a person is likely to engage in the behaviour again. For example:
- A person goes to work and gets paid, thus increasing the likelihood of them repeatedly returning to work.
- One person smiles at another, they smile back, thus increasing the likelihood that the first person will smile again and commence interaction.
- A person has a headache, takes Paracetamol, the headache disappears. The next time they have a headache, they are likely to repeat the same behaviour.
- A person falls off their bicycle sustaining a serious injury. This consequence may reduce the likelihood of the person cycling again for some time.
The consequences which follow our actions determine how likely it is that we will or will not behave in that way again. Some consequences are desirable and increase the likelihood of the behaviour occurring again. Undesirable consequences may reduce the likelihood of the behaviour occurring again.
Consequences which increase the likelihood of behaviours occurring again are known as reinforcers.
Following brain injury, there is strong evidence that reinforcing positive behaviours can be effective in reducing challenging behaviours. Therefore reinforcement of positive behaviours is an essential component in any attempt to help the person with challenging behaviours.
Warning: If the wrong behaviours are reinforced, this may lead to an escalation in behavioural difficulties (e.g. if a person becomes agitated when being assisted with personal care and consequentially strikes out, this may cause the carer to withdraw from providing assistance. Hitting the carer is therefore reinforced and the behaviour is likely to be repeated).
There are two broad types of reinforcement which make it more likely that positive behaviour will be repeated i.e. positive and negative reinforcement.
Positive Reinforcement
This involves giving the person something they value following a particular behaviour. This increases the likelihood of the person repeating the behaviour again. Examples of positive reinforcement include provision of:
- Praise.
- Opportunities for social interaction with someone they enjoy spending time with.
- Meaningful social and leisure activities.
- Extra things which the person values (over and above that which is normally provided) e.g. CDs, outings, game of football, computer game, cosmetics.
- Positive feedback about how well the person is doing in managing their behaviour. However this type of reinforcer is only effective if the person providing reinforcement has built a good, therapeutic and trusting relationship.
Negative Reinforcement
This involves removing something disliked by the person following a positive behaviour, which increases the likelihood of this behaviour recurring. For example, following a period of positive behaviour, something the person does not like is removed e.g. the person is excused from doing a chore which they do not like but normally have to do (e.g. doing the washing up).
Please note that negative reinforcement does not include punishment. Punishment is not a helpful strategy in facilitating positive behavioural change.