Posted: November 28th, 2022

Topic 1 – APPLY A PERSON-CENTRED APPROACH TO MINIMISE BEHAVIOURS OF CONCERN

CHCDIS002 Learner Guide V2.0 Page 1 of 58
CHCDIS002
Follow established person-centred
behaviour supports
Learner Guide
CHCDIS002 Learner Guide V2.0 Page 2 of 58
Table of contents
Table of contents………………………………………………………………………………………………………………..2
ABOUT THIS RESOURCE ……………………………………………………………………………………………………….5
ABOUT ASSESSMENT …………………………………………………………………………………………………………..5
Assessment Conditions………………………………………………………………………………………………………11
pre-Requisites…………………………………………………………………………………………………………………..11
Topic 1 – APPLY A PERSON-CENTRED APPROACH TO MINIMISE BEHAVIOURS OF CONCERN………12
Social model of disability ………………………………………………………………………………………………..13
The impact of social devaluation on an individual’s quality of life………………………………………..13
Legal and ethical considerations for working with people with disability: ………………………………..13
Dignity of risk ………………………………………………………………………………………………………………..13
Duty of Care ………………………………………………………………………………………………………………….13
Human rights, including the United Nations Convention on the Rights of Persons with
Disabilities (UNCRPD)……………………………………………………………………………………………………..14
Mandatory reporting ……………………………………………………………………………………………………..14
Privacy, confidentiality and disclosure ……………………………………………………………………………..14
Work health and safety…………………………………………………………………………………………………..15
Codes of conduct …………………………………………………………………………………………………………..15
Constraint/Imprisonment……………………………………………………………………………………………….15
Abuse …………………………………………………………………………………………………………………………..16
Practice standards………………………………………………………………………………………………………….16
Support the person to maintain their activities of daily living in accordance with organisation
policies and procedures and the individualised behaviour support plan…………………………………..18
Consider the person’s individual needs, strengths, capabilities and preferences when engaging in
activities of daily living and routines ……………………………………………………………………………………20
Specialist services and referral options …………………………………………………………………………….21
Provide a safe environment for the person conducive to positive and adaptive responses………..25
Organisation policies and procedures relating to behaviour management, including: accident
and incident reporting ……………………………………………………………………………………………………28
Critical incidents/emergency situations ……………………………………………………………………………30
Restrictions on the use of aversive procedures………………………………………………………………….30
Least Reasonable Restriction …………………………………………………………………………………………..31
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Factors that may contribute to behaviours of concern, including: environmental………………….32
Consider the person’s emotional well-being in the context of the behaviour…………………………. 33
Factors that may contribute to behaviours of concern, including: emotional………………………..33
Consider the person’s health status in the context of the behaviour……………………………………..35
Factors that may contribute to behaviours of concern, including: physical……………………………35
Consider the person’s medication in the context of the behaviour ……………………………………….36
Factors that may contribute to behaviours of concern, including: medications……………………..36
Record all observations accurately and objectively in consultation with supervisor using terms that
can be clearly understood …………………………………………………………………………………………….37
Topic 3 – Provide positive behaviour support according to individualised behaviour support plan 39
Recognise the difference between appropriate and inappropriate interventions when addressing
behaviours of concern and Interpret and follow behavioural support strategies and Ensure that all
interventions are in line with the plan and organisation policies and procedures…………………….39
Indicators that people have unmet needs…………………………………………………………………………39
Risk assessment …………………………………………………………………………………………………………….40
Positive behavioural support………………………………………………………………………………………………41
Principles and practices of positive behaviour support which focuses on the individual person 41
Positive lifestyle enhancement strategies…………………………………………………………………………42
Principles of effective communication and ways to implement these to minimise behaviours of
concern ………………………………………………………………………………………………………………………..43
Follow organisation procedures to ensure safety of the person, self and other people and Respond
to critical incidents in accordance with organisation’s intervention and notification procedures..46
Reducing or changing setting events and triggers………………………………………………………………….46
Incentive programs……………………………………………………………………………………………………………47
Monitor strategies to determine effectiveness in consultation with supervisor………………………. 48
Identify and report changes in person’s needs and behaviours in consultation with supervisor….49
Behaviour recording ………………………………………………………………………………………………………….49
Follow referral procedures in consultation with supervisor…………………………………………………51
Specialist services and referral options …………………………………………………………………………….51
Topic 4 – Complete documentation ……………………………………………………………………………………..53
Comply with the organisation’s reporting requirements………………………………………………………..53
Maintain documentation according to organisation’s requirements ……………………………………….55
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CHCDIS002 Learner Guide V2.0 Page 5 of 58
This resource covers the unit CHCDIS002 – Follow established person-centred behaviour
supports.
This unit describes the skills and knowledge required to implement behaviour support
strategies outlined in an individualised behaviour support plan for a person with a disability.
This unit applies to workers in varied disability services contexts. Work performed requires
some discretion and judgement and may be carried out under regular direct or indirect
supervision.
The skills in this unit must be applied in accordance with Commonwealth and
State/Territory legislation, Australian/New Zealand standards and industry codes of
practice.
ABOUT THIS RESOURCE
This resource brings together information to develop your knowledge about this unit. The
information is designed to reflect the requirements of the unit and uses headings to makes
it easier to follow.
You should read through this resource to develop your knowledge in preparation for your
assessment. At the back of the resource are a list of references you may find useful to
review.
As a student it is important to extend your learning and to search out textbooks, internet
sites, talk to people at work and read newspaper articles and journals which can provide
additional learning material.
Your trainer may include additional information and provide activities, PowerPoint slide
presentations, and assessments in class to support your learning.
ABOUT ASSESSMENT
Throughout your training we are committed to your learning by providing a training and
assessment framework that ensures the knowledge gained through training is translated
into practical on the job improvements.
You are going to be assessed for:
• Your skills and knowledge using written and observation activities that apply to
your workplace.
• Your ability to apply your learning.
• Your ability to recognise common principles and actively use these on the job.
UNIT Introduction
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You will receive an overall result of Competent or Not Yet Competent for the assessment of
this unit. The assessment is a competency based assessment, which has no pass or fail. You
are either competent or not yet competent. Not Yet Competent means that you still are in
the process of understanding and acquiring the skills and knowledge required to be marked
competent. The assessment process is made up of a number of assessment methods. You
are required to achieve a satisfactory result in each of these to be deemed competent
overall.
All of your assessment and training is provided as a positive learning tool. Your assessor will
guide your learning and provide feedback on your responses to the assessment. For valid
and reliable assessment of this unit, a range of assessment methods will be used to assess
practical skills and knowledge.
Your assessment may be conducted through a combination of the following methods:
• Written Activity
• Case Study
• Observation
• Questions
• Third Party Report
The assessment tool for this unit should be completed within the specified time period
following the delivery of the unit. If you feel you are not yet ready for assessment, discuss
this with your trainer and assessor.
To be successful in this unit you will need to relate your learning to your workplace. You
may be required to demonstrate your skills and be observed by your assessor in your
workplace environment. Some units provide for a simulated work environment and your
trainer and assessor will outline the requirements in these instances.
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1. Apply a person-centred
approach to minimise
behaviours of concern
1.1 Support the person to maintain their activities of daily
living in accordance with organisation policies and
procedures and the individualised behaviour support plan
1.2 Consider the person’s individual needs, strengths,
capabilities and preferences when engaging in activities of
daily living and routines
1.3 Identify problems with engaging or motivating the
person and seek appropriate assistance
1.4 Provide a safe environment for the person conducive to
positive and adaptive responses
2. Review context of
behaviours of concern
2.1 Recognise behaviours of concern outlined in the
individualised behaviour support plan
2.2 Consider what happened before, during and after the
behaviour of concern
2.3 Consider the type, frequency and triggers of the
behaviour
2.4 Consider environmental factors in the context of the
behaviour
2.5 Consider the person’s emotional well-being in the
context of the behaviour
2.6 Consider the person’s health status in the context of the
behaviour
2.7 Consider the person’s medication in the context of the
behaviour
2.8 Record all observations accurately and objectively in
consultation with supervisor using terms that can be clearly
understood
3. Provide positive behaviour
support according to
individualised behaviour
support plan
3.1 Recognise the difference between appropriate and
inappropriate interventions when addressing behaviours of
concern
3.2 Interpret and follow behavioural support strategies
3.3 Ensure that all interventions are in line with the plan
and organisation policies and procedures
3.4 Follow organisation procedures to ensure safety of the
person, self and other people
3.5 Respond to critical incidents in accordance with
organisation’s intervention and notification procedures
3.6 Monitor strategies to determine effectiveness in
consultation with supervisor
3.7 Identify and report changes in person’s needs and
behaviours in consultation with supervisor
3.8 Follow referral procedures in consultation with
supervisor
Elements and Performance Criteria
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4. Complete documentation 4.1 Comply with the organisation’s reporting requirements
4.2 Maintain documentation according to organisation’s
requirements
This
describes the essential knowledge and skills and their level required for this unit.
Performance Evidence
The candidate must show evidence of the ability to complete tasks outlined in elements and
performance criteria of this unit, manage tasks and manage contingencies in the context of
the job role. There must be evidence that the candidate has:
• Provided positive support in response to at least 3 different situations of
behaviours of concern
• Responded to at least 1 critical incident relating to adverse behaviour in
accordance with individualised behaviour support plan and organisation’s policies
and procedures
Knowledge Evidence
The candidate must be able to demonstrate essential knowledge required to effectively
complete tasks outlined in elements and performance criteria of this unit, manage tasks and
manage contingencies in the context of the work role. This includes knowledge of:
• Principles and practices of positive behaviour support which focuses on the
individual person
• The social model of disability
• The impact of social devaluation on an individual’s quality of life
• Positive lifestyle enhancement strategies, including:
o positive reinforcement
o motivation
o stress management
o engagement in meaningful activities
Performance and knowledge evidence
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o support relationships
o nutrition
o environmental and systems improvement
• Organisation policies and procedures relating to behaviour management,
including:
o critical incidents
o accident and incident reporting
o restrictions on the use of aversive procedures
• Principles of effective communication and ways to implement these to minimise
behaviours of concern
• Indicators that people have unmet needs
• Factors that may contribute to behaviours of concern, including:
o physical
o emotional
o environmental
o medications
• Specialist services and referral options
• Legal and ethical considerations for working with people with disability:
o codes of conduct
o dignity of risk
o duty of care
o human rights, including the united nations convention on the rights of
persons with disabilities (UNCRPD)
o constraint
o imprisonment
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o abuse
o practice standards
o work safety and health
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Assessment Conditions
Skills must have been demonstrated in the workplace or in a simulated environment that
reflects workplace conditions. The following conditions must be met for this unit:
• Modelling of industry operating conditions, including:
o scenarios that present behaviours of concern that occur in real work
environments
o individualised behaviour support plans
o the organisation’s policies and procedures in relation to behaviours of
concern and critical incidents
Assessors must satisfy the Standards for Registered Training Organisations (RTOs)
2015/AQTF mandatory competency requirements for assessors.
pre-Requisites
This unit must be assessed after the following pre-requisite unit:
There are no pre-requisites for this unit.
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Topic 1 – APPLY A PERSON-CENTRED APPROACH TO MINIMISE BEHAVIOURS
OF CONCERN
Welcome to the unit CHCDIS002 – Follow established person-centred behaviour supports.
This unit describes the skills and knowledge required to implement behaviour support
strategies outlined in an individualised behaviour support plan for a person with disability.
This unit applies to workers in varied disability services contexts. Work performed requires
some discretion and judgement and may be carried out under regular direct or indirect
supervision.
The skills in this unit must be applied in accordance with Commonwealth and
State/Territory legislation, Australian/New Zealand standards and industry codes of
practice.
In this unit you will learn how to:
• Apply a person-centred approach to minimise behaviours of concern
• Review context of behaviours of concern
• Provide positive behaviour support according to individualised behaviour support
plan
• Complete documentation
Let’s begin!
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Social model of disability
According to the social model of disability, ‘disability’ is socially constructed.
The social model of disability sees ‘disability’ is the result of the interaction between people
living with impairments and an environment filled with physical, attitudinal, communication
and social barriers. It therefore carries the implication that the physical, attitudinal,
communication and social environment must change to enable people living with
impairments to participate in society on an equal basis with others.1
The impact of social devaluation on an individual’s quality of life
Social devaluation is an outlook or view of persons value to be less than the others in the group or society.
The impact can be somewhat great to a person’s needs, psyche, and care in that they our undervalued thus
less respected. The outcome becoming they are looked over and not appreciated for their potential value or
actual value. This can not only affect the individual though the society itself. Society can be negatively
affected because the underestimating of that person’s value could harm the group. In other words if the
person is assessed more positively of their values or given more value on their first perception of this person
the group has greater chance to succeed.
If this person feels devalued they will become resentful, shielded, and this will cause conflict between parties
(the person that feels valued versus the person that feels devalued). Within psychological boundaries the
person’s care or needs go neglected, making that person feel useless, angry or ashamed often without fault
of their own. If this person is under medical care, these responses can trigger anxieties, health problems that
may have been in recovery, or were recovered. Thus, the needs are harder to meet for this person when they
are perceived as having less value.2
Legal and ethical considerations for working with people with disability:
In order to work with people with a disability, you need to understand your legal and ethical
responsibilities and consider them at all times.
Discrimination
It is essential to ensure that the person with a disability is not discriminated against and
receives the same level of care, choice and respect as any other person.
The disability discrimination Act must be adhered to at all times throughout service delivery
and contact with the client.
Dignity of risk
Dignity of risk is the legal requirement to ensure that all persons with a disability has the
legal right to choose their own medical treatments even if the professionals involved feel
that this is not the correct choice for them.
Duty of Care
Duty of care is ones legal obligation to take reasonable care to prevent others from being
harmed. This means that if a worker identifies something that could reasonably be
considered to be a risk, then that employee must, in response take reasonable action to
1 https://pwd.org.au/resources/disability-faqs/social-model-of-disability/
2 https://www.quora.com/What-is-social-devaluation-How-does-it-impact-a-person-s-cares-and-needs
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eliminate that risk. This means that if a client is presenting with indicators of harm it is
important that these are responded to according to legal requirements and duty of care
needs.
All relevant risk assessments, observation tools and activities should be carried out when
any of these indicators are present. It is essential that when a client presents with a need for
a particular service they will in fact be referred on to that service.
Legal requirements and duty of care obligations include:
• Ethical referral
• Comply with state and territory legislation
Human rights, including the United Nations Convention on the Rights of Persons with
Disabilities (UNCRPD)
It is essential to ensure that all of the person’s human rights are respected and upheld at all
times. All human rights legislation as well as the United Nations conventions on the rights
of persons with a disability is respected and upheld. These treaties provide persons with a
disability with a range of rights including, respect, dignity, self-determination and the right
to choose what happens to them in their lives.
Mandatory reporting
In addition to the general level of duty of care and ensuring that adults risks are minimised
and managed it is important to keep in mind that in some instances such as when a child is
presenting with indicators of harm, neglect, abuse or risk of harm that appropriate legal and
ethical factors are considered.
Child protection requires knowledge of relevant state mandatory reporting legislation and
its application. It will be necessary for all community services workers to ensure that they
both know and comply with the legislation related to the reporting of these indicators in
children for their jurisdiction.
Privacy, confidentiality and disclosure
In regards to community service work is viewed to in legal terms as the protection of personal
information. In order for one to comply legally with regulations surrounding confidentiality, an
individual is not permitted to share a client’s personal information with co-workers, third parties or
even friends and family of the client. The legal exception to this rule is when sharing the information
could prevent harm being done to the client or anyone in the greater community.
There are many ways to keep information confidential. The following are examples of some of these
methods:
• Individual files are locked and secured
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• Support workers do not tell other people what is in a client’s file unless they have
permission from the client
• Information about clients is not told to people who do not need to know
• Clients’ medical details are not discussed without their consent
• Adult clients have the right to keep any information about themselves
confidential, which includes that information being kept from family and friends
Work health and safety
It is essential that all aspects of the work health and safety Act are upheld at all times and
that appropriate controls and steps are taken in order to effectively identify any hazards in
the environment and to take appropriate measures to minimise, manage and report on
them.
Codes of conduct
This Code of conduct outlines an organisation’s expectations for the standards of behaviour
and conduct expected from paid staff, contractors, volunteers or business partners. They
are expected to be familiar with the Code and use it always. It applies in all circumstances
and at all times including when working or otherwise representing organisation.
A code of conduct cover aspects of expected behaviour such as:
• Respect
• Professionalism
• Safety
• Leadership and management
• Legal requirements
• Breaches
Your organisation will have a written code of conduct, that you must abide by. Check your
workplace to identify your responsibilities in relation to the code.
Constraint/Imprisonment
Restrictive practices involve the use of interventions and practices that have the effect of
restricting the rights or freedom of movement of a person with disability. These primarily
include constraint/imprisonment/restraint (chemical, mechanical, social or physical) and
seclusion. People with disability who display ‘challenging behaviour’ or ‘behaviours of
concern’ may be subjected to restrictive practices in a variety of contexts, including:
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supported accommodation and group homes; residential aged care facilities; mental health
facilities; hospitals; prisons; and schools. 3
Abuse
People with disabilities are among some of the most vulnerable people in our society due to
their dependence on others for care and support or because of social isolation, their place
of residence or the nature of their disability.
• People with a disability, especially women and girls, are twice as likely as other
women and girls to experience violence.
While anyone can experience violence, abuse or neglect, people with disabilities are at
greater risk. And of all people with a disability, women and girls with disabilities are at even
greater risk.
A person with a disability, has the rights to freedom, respect, equality and dignity. They
have the right to live to their full potential, to have control over their own life and to live
free from abuse or neglect.4
Practice standards
In Australia we have the NDIS Practice Standards. The NDIS Practice Standards create an
important benchmark for providers to assess their performance, and to demonstrate how
they provide high quality and safe supports and services to NDIS participants. Together with
the NDIS Code of Conduct, the NDIS Practice Standards will assist NDIS participants to be
aware of what quality service provision they should expect from NDIS providers.
The core sections of the practice standards cover things such as:
• Rights and responsibility for participants:
o Person-centred supports
o Individual values and beliefs
o Privacy and dignity
o Independence and informed choice
o Violence, Abuse, Neglect, Exploitation and Discrimination
• Provider Governance and operational management:
o Governance and operational management
3 https://www.alrc.gov.au/publications/8-restrictive-practices/restrictive-practices-australia
4
https://www.betterhealth.vic.gov.au/…/people-with-a-disability-who-experience-violen…
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o Risk management
o Quality management
o Information management
o Feedback and complaints management
o Incident management
o Human resource management
o Community of supports
• The provision of supports:
o Access to support
o Support planning
o Service agreements with participants
o Responsive support provision
o Transitions to or from the provider
• The support provision environment:
o Safe environment
o Participant money and property
o Management of medication
o Management of waste5
5
https://www.ndiscommission.gov.au/sites/…07/NDIS%20Practice%20Standards.pdf
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Support the person to maintain their activities of daily living in accordance
with organisation policies and procedures and the individualised behaviour
support plan
Working in disability, aged or community services, your clients will have a range of
dependence and autonomy over their daily activities. This will depend on their living
arrangements (living in an aged care facility, a group home, with their family or
independently in the community. They may have total control of their routines, some
control or need to be assisted in almost every area of their lives.
A routine provides your clients with stability, predictability and safety. There are a number
of ways you can help your client to maintain their daily routines.
Where ever possible, your client should be engaged to develop suitable and practical
routines that will support their own goals, hopes and aspirations for now, and the future.
These goals might be something as simple as making breakfast, through to catching public
transport, studying or finding employment.
Your organisation will have its own policies and procedures to support both you and your
clients manage their daily routine. It is essential you understand and work within the
organisations policies; procedures, resources and authorisations when assisting your client
manage their routines.
There are a number of ways you can support your clients in maintaining routines. These
include:
• Ensuring their routines fit in with existing Workplace Health and Safety
requirements, ensuring that their daily routines do not have WH&S impediments
preventing them from undertaking their routines. A WH&S impediment may be
something like a faulty wheelchair, slippery bathroom floor or a lack of knowledge
or aptitude to utilise kitchen appliances in a safe manner
• Working with your client to develop skills to manage their daily routines. This may
include engaging the client to note down (if possible) the tasks they are required
to do in a time period. You may need to engage your client and physically teach
them skills, such as brushing their teeth, making a cup of tea or making their bed.
• Engaging the client to help them own their daily routines. When a client feels
engaged and has a sense of ownership and control over their routine, they are
more likely to have healthy attitudes and reception to the development of their
routine.
• Focusing on self-care. For many clients, developing a new routine and new skills
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may cause them significant anxiety and stress. It is important to help your clients
recognise when they may be feeling overwhelmed, anxious or stressed in a
particular situation. This can be coupled with appropriate relaxation techniques,
such as breathing exercises, light stretching, a glass of water or a relaxing activity.
• Developing reinforcement and remembering strategies. Your client may benefit
from a daily ‘tick chart’ to mark off what tasks they are required to do, the times
they want to achieve them by, any materials they require to complete the task
and who they can contact for assistance to complete the task.
• When establishing a new routine, it may be appropriate to interrupt and redirect
the client, if they are getting off track, anxious or stressed over an activity. You
may need to discuss with the client what their train of thoughts and actions are,
how these thoughts and actions are assisting the completion of their routine and
what they may need to do to adjust and realign with their routine
• There may be instances where you will need to seek assistance, or make referrals
to the client’s other support services. The client may have other health, or mental
health issues that require more in-depth management or advanced strategies. It is
integral that you work within your organisations policies and procedures with
your client. By stepping outside these boundaries, especially when it comes to the
client’s health or mental health, you risk putting yourself, the client and the
community at risk by mismanaging the client and their conditions.
Routine formation and management may be a constant requirement with some clients,
depending on their capability, skills and motivations. Some clients may need gentle
guidance, others will need more intensive management and support to assist them in
forming and maintaining a new routine. Whenever you are supporting your clients, it is
essential that you do so within your organisation’s policies and procedures.
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Consider the person’s individual needs, strengths, capabilities and
preferences when engaging in activities of daily living and routines
As well as an individualised plan for your clients, over time, you will develop a professional
working relationship. You should see trends emerging on how your clients prefer to
undertake their daily routines and activities. Similarly, you will uncover their strengths and
areas where they may want to develop the capability.
Inherent in an individual plan is that your client’s activities are centred on them, their
health, goals and needs. It would be counter-productive to disregard an individualised plan
and institute a strict routine that prevents a client from being empowered to control their
own activities and growth.
When developing an individualised plan and cultivating a working relationship with a client,
there are a number of ways you can ascertain their needs, strengths and preferences. These
include:
• Discussing with them what their needs, strengths and preferences are. As simple
as this sounds, the client may be a great source of knowledge about themselves.
Depending on their level of communication and capability, they may be able to
articulate a range of preferences, needs and desires they have.
• Discussing with the clients previous caseworker, if possible. When a client’s case
manager changes, a ‘best practice’ case management approach is for the old and
new case managers to have a handover discussion. This involves the old case
manager discussing each client, their individualised plan and any informal
knowledge they have gained, to assist supporting the client and the new case
manager.
• Discussing with the clients spouse or approved contact person. There may be
situations where the client is unable to communicate, for a variety of reasons. In
these situations, the client may have a parent, representative, trustee or contact
person who is authorised to discuss issues on their behalf. This contact person
may have considerable knowledge of the client and be able to direct you towards
how to perform and undertake effective daily routines for the client.
As you work with your client, their needs, preferences and capabilities may change. They
may develop capability in a particular area, or inversely, have diminished capacity in other
areas. An example of this may be a client in an aged care facility with failing health. They
may initially have a high degree of independence and capability, but this fades as they age
or health issues arise. You will need to adapt the client’s daily routine to suit their particular
phase in life, being receptive to changes, however small, to their needs or preferences. It is
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integral whenever changing a plan, activity or routine that this is documented in the client’s
individualised plan. This ensures that any future caseworkers can quickly see any
improvements / reductions in the client’s capability and any changing needs they have.
Specialist services and referral options
You may also need to seek services, advice or referrals from other areas within your
organisation, or external referral services. You may notice that a client has trouble with their
daily showering or bathing routine, which could mean specialist assessment or equipment is
required to help the client. By consulting the client (or organisations) specialist, you may
need to introduce new appliances or apparatus to support the client, meaning a change to
their daily routine.
Situations where outside referral may need to be sought include:
• The client may need to be assessed by a specialist
• Counselling services may be required
• Special or expert support may be required
Referral in the act of referring or directing a client to a service that is able to better meet
their needs when you cannot.
Your relationship with your client, along with their ongoing needs and capabilities will
develop over time. It is important that you remain aware and responsive to these changes.
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Identify problems with engaging or motivating the person and seek appropriate assistance
In an ideal world, you will establish great relationships with your clients, they will engage in
their individual plans and you will work together to make their lives better. Without a
doubt, a career in the community, aged and disability sectors can be richly rewarding and
you will help many people. There will be instances, however, where you may find it difficult
engaging a client, where you do not see the results you otherwise expected and you are
finding a client, or clients particularly challenging.
Issues that may arise with engaging clients may include:
• Communication issues, where you find you do not understand your client’s
communication style, or they are not understanding you
• Personality issues. Any relationship can be strained at times due to personality
clashes
• Differences in implementing an individualised client plan. An example of this is
where a client has different (even unrealistic) expectations on the implementation
of their plan, and this is a barrier for them in engaging in their plan.
• A client who has health or mental health issues that require support outside of
your expertise or training
• A client who does not believe they require any assistance and refuses to engage in
ongoing support
There may be a number of underlying reasons why a client may not be engaging you, many
of which have practical remedies. These remedies focus around you, the client’s
engagement and the clients individualised plan.
Self-awareness and self-identification of any issues you may bring to a relationship is always
the most important aspect to look at, when you find your client is not engaging with you in a
positive or practical way. Self-reflection can often be a difficult process, especially if you are
engaged and want to help your client reach their goals. Some ways that you can investigate
if your actions or behaviours are impacting the client’s engagement include:
• Asking your supervisor / team leader for honest feedback on how you may appear
/ act to others. Your supervisor may be able to identify a particular trait / aspect of
your approach that could need development. It may be something as simple as
engaging your client in friendly conversation or working on being patient with
clients when they are not managing a particular activity in a timely manner. Your
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supervisor may be able to suggest some practical changes to your outlook or
approach that can improve your clients engagement
• Asking your client, if possible, on their expectations with engagement with you.
Caution should be taken with this approach, as if the client is already feeling
uncomfortable or disengaged with you, this may be seen as a threat to them.
Alternatively, you could ask a co-worker or your supervisor to tactfully ask the
client how you can improve the relationship.
• Investing time into your own personal and professional development. You may
need to brush up on personal communication skills or your professional approach.
Any extra skills you have is like an extra ‘tool in the belt’. You might not have to
use every tool in every situation, but sometimes having extra knowledge can help
bring a difficult or disengaged client around to engagement in you and their
individualised plan.
Your client too may have their own reasons for not being engaged. It could be a personal
preference, bias or prejudice they have. Sometimes, there may be a health, mental health
or medical issue that prevents them from engaging in their individualised plan. There could
be a range of other reasons why they may not be engaging. In these situations, you can
positively impact the client in the following ways:
• Demonstrating that you are trained, motivated and engaged in them. You might
not be able to change their personal preferences or biases; however, you can
demonstrate that you can make a difference in their life. It is up to them to decide
if they engage in you professionally.
• Ensuring that, where possible, you understand any underlying health, mental
health or wellness issues that impact on the client’s ability to engage. An example
may be that the client is suffering from chronic pain and is simply unable to focus
on anything except pain management. In these situations, you may need to
engage the clients treating medical practitioner and inform them of their inability
to fully engage, due to their pain. The treating medical practitioner may be able to
suggest an alternative method of pain relief or referral for pain management.
• The client may not be engaged in their actual individual plan. You will always be
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monitoring and referring to the clients individual plan. However, you may find
that the client themselves needs a ‘fresh start’. If possible, you may want to start
fresh with the client and re-write their whole plan. Their current plan may be
totally unsuited to their current situation, needs or plans.
If you find your client is not engaging, despite your best efforts, it is always appropriate for
you to discuss the issues you have observed with your supervisor or team leader. They may
be able to suggest some alternative actions or activities that may help the client engage in
their individual plan.
Other areas you may be able to refer to, or seek advice from could be senior caseworkers
who may have had a similar experience in the past, the client’s family or spouse, to see if
they can make any suggestions or a past case manager, to see how they managed a
particular situation.
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Provide a safe environment for the person conducive to positive and
adaptive responses
Working in the community, aged or disability sectors, an employee can usually expect to
work with individuals who have come from a marginalised, disadvantaged and even
sometimes, a violent background. Clients may come from a range of backgrounds, have a
history of mental health issues, alcohol or substance abuse, physical or mental abuse and
chronic health conditions.
Many of your clients will have individualised care plans or individualised action plans. An
individualised care plan or action plan usually contains:
• A brief summary of the clients health / mental health concerns
• A list and contact details for any treating practitioners they may have
• Any privacy concerns, restrictions or permissions they have to who can access, or
not access their information
• An agreed upon plan for the organisation to support the client, including any
regular appointments, health referrals and support services
• Any incident reports
• The clients goals, hopes and aspirations
• Any case notes pertaining to the client
As many of your clients have experienced unpredictability and often unsafe environments in
the past, it is integral that you keep your routine interactions and actions with your clients
as safe and predictable as possible.
You can do this by:
• Ensuring you are on time for any appointments or meetings with the client. This
fosters trust and an environment of predictability. It also supports the client
manage and keep their commitments to you and others. By being on time and
present for appointments with your client, you demonstrate your willingness to
help, your commitment to their health and rehabilitation and the importance of
them being involved and engaged in their health and wellbeing
• Ensuring, where possible and practical, you alert your client of any changes to
appointments or meetings well ahead of time. If your client is required to utilise
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public transport or rely on others to help them get to appointments, it is integral
that this is communicated with them as soon as possible. This keeps the client
safe by ensuring they are not travelling or exposed in a manner that will make
them feel distressed or unsafe
• Ensuring your work environment, external activities and client visits are compliant
with relevant WHS requirements. Your office and any external activities your
client is engaged in should already be WHS compliant. However, your clients place
of residence may not be.
• In consultation with your client, you may need to engage a WHS consultant to
ensure their home is safe – not only for them, but you and any other members of
your organisation that is required to provide in-home services.
• Identifying, reporting and rectifying any unsafe situations, equipment or instances
at the first available opportunity. This could be as simple as reporting a chair in
your office as broken, through to notifying your organisation of an unsafe vehicle
or equipment. You will have your own statutory requirements for reporting
unsafe, broken or malfunctioning equipment to a relevant person or department
in your organisation. It is recommended you understand your organisations
policies in relation to any WH&S reporting with broken or faulty equipment
• Being prepared for any interactions with your clients. This means having followed
up on any previous meetings, being prepared for any issues the client may bring
up, any discussion points or concerns you may have. This helps foster a safe
emotional environment for your client.
As well as providing a safe environment for your client, it is important to create a safe
environment for yourself and your co-workers. This could be as simple as ensuring you use
any organisational equipment and vehicles in a safe manner, reporting any broken or
damaged equipment in accordance with WH&S reporting requirements and ensuring any
workplace hazards are addressed in an appropriate manner.
There are a number of ‘external’ factors you can influence or control to create a safe and
predictable environment for clients. In addition to this, your clients may need their own
boundaries or behavioural expectations to help them create a safe and predictable
environment for themselves.
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In some cases, your client may display inappropriate behaviours that can endanger
themselves, you, other clients, other staff members or members of the community.
These behaviours may include:
• Inappropriate sexual behaviours, such as public masturbation or making sexually
inappropriate comments
• Violent or inappropriate physical behaviours, such as aggression towards others,
yelling or screaming
• Destruction of property
• Not undertaking tasks in a safe manner, such as kitchen tasks or workplace
activities
You may be required to develop positive, predictable strategies that will keep the client safe
if they are exhibiting inappropriate behaviours. These may include:
• Reminding the client on what the appropriate behaviours are
• Distracting the client, if they are exhibiting inappropriate behaviours and redirecting them into positive or appropriate behaviours
• Engaging in other staff members, if interaction is required
• Having a clear action plan, developed in consultation with the clients family,
treating medical practitioners and specialists if the client is displaying increasingly
violent, inappropriate or dangerous behaviours.
By reinforcing predictable (and positive) responses to inappropriate behaviour: you help
foster an environment that encourages the client to display and model appropriate
behaviours. This creates a safe, predictable for the client, you and any other people involved
in the client interaction.
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Recognise behaviours of concern outlined in the individualised behaviour
support plan and consider the type, frequency and triggers of the behaviour
Working in the disability, aged or community sectors, you may come across some clients
who, on occasion, display disruptive or even violent behaviour. This behaviour can
sometimes impact:
• The client
• You, the caseworker/ case manager
• Any other clients
• Members of the community
• Other caseworkers / case managers
Behaviours that are likely to put the client at risk may involve:
• Aggressive behaviour towards themselves or others
• Acting in an unsafe manner, or against instructions
• Undertaking activities in an unsupervised manner
When any type of aggressive, violent or disruptive behaviour occurs, it MUST be
documented in the client’s file, in line with organisational policies and procedures, at the
most practicable time.
Organisation policies and procedures relating to behaviour management, including: accident
and incident reporting
Many organisations will have an incident report that should be used, whenever a client is
displaying these types of behaviours. An incident report typically has information such as:
• The client’s name, date of birth and address
• The location or locations of the incident
• The actual behaviours that you observed the client display
• If the client was hurt during the incident, including a catalogue of what injuries
Topic 2 – Review context of behaviours of
concern
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the client sustained
• If any other persons were hurt or injured, including a catalogue of any injuries
they sustained
• If there were any identifiable triggers of the event. This may include loud noises,
an unfamiliar environment or occurrence, after eating a particular type of food,
after a difficult or stressful activity or any other identifiers preceding the client’s
behaviour
• How the client was managed during the episode, such as diversionary tactics, selfrelaxation techniques, physical restraint
• If any third parties or referrals were made. This may include contacting the police,
ambulance or fire services; the clients treating medical practitioner, family or
emergency contact person
• Any first aid that was administered to the client or other persons
• Post-event treatment for the client and any persons involved, including
counselling or de-briefing
• Any other observations that have been made around the event (such as the client
has had a change in medication, a change in routine or a disruption to the client’s
usual routine).
If the behaviour is ongoing, these reports will provide valuable insight into possible triggers,
warning signs or danger points that may predict the client’s behaviour escalating. When
trends can be identified, measures can be put in place to mitigate or prevent these
episodes. Any trends can be documented in the client’s individualised plan, to help prevent
future events.
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Critical incidents/emergency situations
These are incidents or situations where challenging behaviour occurs for the first time or so
infrequently that it is unpredictable. The challenging behaviour must be of such an intensity
and duration that it is highly likely it will cause injury to the person, staff members or others
without the use of restraint or seclusion. If the behaviour recurs a Challenging Behaviour
Intervention plan must be developed. Guidelines for the management of emergency
situations should be located in your organisations policies and procedures.
Restrictions on the use of aversive procedures
Aversion therapy is a form of behaviour therapy in which an aversive (causing a strong
feeling of dislike or disgust) stimulus is paired with an undesirable behaviour in order to
reduce or eliminate that behaviour.
There may be occasions where some form of restrictive practice may need to be employed to
manage some instances of challenging behaviour. Except in emergency situations, but they:
• Should only be used as part of a challenging behaviour intervention plan
• Should involve the least reasonable restriction of the person’s rights
• Should be used only when all other options have been explored and
• Should be time-limited
Examples of aversive practices or punishment include:
• Physical abuse (e.g. pushing and hitting);
• Psychological abuse (e.g. Ridicule, threats);
• Any practice involving the application of unpleasant conditions (e.g. Cold bath,
squirting liquid into a person’s face, etc…);
• The cancellation of an activity as ‘punishment’ for challenging behaviour which
occurred earlier in the day.
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Least Reasonable Restriction
• an intervention that:
o a) is not more restrictive or intrusive than is necessary to prohibit the
person from inflicting harm on themselves or others; and
o b) is applied no longer than necessary to prevent or contain the danger.6
6 https://www.nwss.org.au/policies-procedures/aversive-restrictive-and-intrusive-treatment-practices-policyand-guideline/
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Consider environmental factors in the context of the behaviour and consider
what happened before, during and after the behaviour of concern
Factors that may contribute to behaviours of concern, including: environmental
As mentioned in the previous section, it is important to document the facts around a client
incident. This is typically done on an incident report.
Incident reports should be able to demonstrate the following trends:
• Any particular locations / environments where the client has displayed behaviour
that harms themselves or others
• What was occurring at the time the client displayed these behaviours. The client
may not display dangerous behaviour at any particular location (such as a
shopping centre or doctors surgery), however, they may seem to escalate when
they are in a confined space, such as a lift, a car or small room. Similarly, there
may be other wider environmental factors that are linked with the client’s
behaviour – loud noises, bright lights, crowded areas or unfamiliar stimulation,
such as a change to their home environment
• What any other clients were doing when the incident occurred? Your client may
‘feed’ off other client behaviour, if in a group or after being with the group. Your
client may find it difficult managing their reaction to another client’s behaviour,
and react in a similarly negative manner
Your client may have very predictable responses to environmental cues, or react in very
unpredictable ways when presented with the same environmental stimuli.
Environmental factors can often bring unpredictable situations, many of which are
unavoidable. You may find trends. However, that allows you to mitigate or lessen the
impact of environmental factors on the client’s behaviour. You may note that the client
sometimes displays risky behaviour whilst in shopping centres. However, this seems to be
less noticeable when there are not as many people in the shopping centre, such as during a
weekday, as opposed to the weekend. There may be environmental factors as simple as if
the client had a good sleep the night before if their behaviour is brought about by being
hungry or thirsty or even the time of day. For these reasons, it is integral that your incident
reports and daily interaction notes with the client document the severity of risky behaviour,
any foreseeable environmental impacts and mitigation practices you employed to reduce
the impacts of the behaviour.
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Consider the person’s emotional well-being in the context of the
behaviour
Emotional wellbeing is important for everyone. An emotional strain can place stress on
almost everybody, and without the skills to channel, manage and deal with emotional strain,
some clients may react in negative or risky ways.
You may have clients who can clearly articulate how they are feeling, any causes of their
thoughts and emotions and be able to suggest ways to mitigate any anticipated risky
reactions. If your client can do this, it is essential that you document this and modify plans
to prevent this from occurring. An example of this could be if you are working in an aged
care facility. An elderly client may be able to articulate that they find the communal dining
setting can cause them significant emotional distress, leading to them feeling frustrated,
agitated and unable to sleep. You can look to mitigate this by organising the client to eat
after the main dinner sitting, or, if practicable, eating in their room.
You may have other clients, however, that are unable to articulate any emotional concerns
they have and seem to react out of the blue.
Factors that may contribute to behaviours of concern, including: emotional
Sources of emotional frustration or diminished emotional resilience in clients may stem
from:
• A difficult situation or interaction in their home, care facility or activity they are
involved in
• A sense of tension in their family or social environment
• A lack of sleep
• Unmanaged pain
• A change in carer, caseworker or nursing staff
• A feeling of helplessness in treatment, recovery or communication
In situations where your clients may not be able to articulate their emotional concerns, it
may be appropriate to seek further information on a client’s mental state from other carers,
the client’s family or any other treating practitioners. Even an informal conversation with
one of these people may uncover significant, helpful information that could assist mitigating
or reducing negative or risky behaviour. An example of this may be a client who lives in a
group home with other girls who have a mental disability, such as Downs’ Syndrome or
severe autism. By ‘checking in’ with the group home leader, you may be able to ascertain
that there is a new resident who has changed the dynamic of the home. This may influence
your client’s emotional well-being and contribute to risky or dangerous behaviour.
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The more information you have about the client’s emotional well-being, the better you can
prepare, anticipate and even explain a negative or risky behaviour in the client. This can
help prevent injury to the client or others prevent damage to property and help keep the
client in a positive state of emotional well-being.
The results of poor or diminished emotional wellbeing may be manifest in a number of
ways. These may include:
• Acting out in a dangerous or unsafe manner, either as a single incident or a
sustained number of incidents
• Displaying behaviours or symptoms such as screaming, scratching skin, rocking or
appearing to be in an escalated or withdrawn state
• Displaying behaviours that make others feel uncomfortable, such as inappropriate
sexual behaviour. This may include inappropriate sexual touching of others, public
masturbation or inappropriate sexual conversations.
• Interfering with others privacy, especially in a residential facility. This may include
going through another’s belongings without their consent or permission, invading
their personal space or asking inappropriate personal questions.
This type of behaviour may indicate an emotional upset in the client. It should be
documented in the client’s file. Appropriate referrals should be made to follow up any
subsequent symptoms and causes of this behaviour.
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Consider the person’s health status in the context of the behaviour
Factors that may contribute to behaviours of concern, including: physical
Physical health and wellbeing can have an impact on anyone. An injury that incapacitates a
person can lead to frustration, anger, boredom and even a sense of helplessness. Coupled
with pain, poor physical health or injury can produce undesirable or risky behaviours in your
clients.
Notes pertaining to a client’s physical health should be recorded in their individual plan and
any diary notes in the client’s file. The client may have given your organisation to seek some
information from their treating practitioners, for the purpose of assisting them in their
personalised plan. Their treating practitioners may supply a letter when the client’s physical
health has changed or be able to discuss the client’s situation over the telephone.
Some medications may have a negative impact on a client’s ability to control or regulate
behaviour, leading to the client displaying negative or risky behaviours. Where possible, you
should try to be informed of any new medications, or changes in dosages of medication for
your client. This is particularly relevant if your client is suffering from mental illness, changes
in medication, however slight, can sometimes produce negative results quickly. These
changes should be documented in the client’s individualised plan and any diary / case notes.
If a client is suffering from a health, mental health or physical issue, this should be taken
into consideration when planning activities or making routines. It may take the client longer
to undertake even basic activities, and pressuring them to complete a task in the usual time
will frustrate the client, possibly leading to negative behaviours. Extra consideration should
be given to your clients when they are suffering from these conditions, to prevent risky or
dangerous behaviours.
It is integral to document any information you have about the clients health, mental health
or physical injuries they may have, to allow for any.
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Consider the person’s medication in the context of the behaviour
Factors that may contribute to behaviours of concern, including: medications
Similar to health issues or considerations, a client’s medication may have an impact on their
behaviour. Whilst a client’s medication may influence their behaviour, a client not taking
prescribed medication may also have a negative impact on behaviour.
Some mental health issues are managed with a combination of medication and other
therapies. Mental health medication is usually prescribed by the clients General Practitioner
or a psychiatrist – only they are authorised to prescribe, alter the dosage or change a
client’s medication. The clients treating General Practitioner or psychiatrist may be able to
supply you with a list of any medications the client is on, the dosage and fact sheets on any
possible impacts / side effects of the medication. These fact sheets similarly should
document any effects on the client should they cease or change their medication.
This information must be kept on the client’s individualised plan and in their client notes.
Your organisation may be required to administer this medication (especially if the client is in
a registered care facility) and it is essential to know the precise dosage information for the
client.
If a client has been instructed to change or modify their prescribed medication, you may
want to document any changes in their behaviour, even if these changes are not negative or
risky. This information may be fed back to their treating practitioner for analysis.
It is essential to remember that in your role, you are not authorised to modify, change,
remove or increase a client’s medication. If you have concerns over the clients medication,
have any pertinent information or observations on the impact the medication is having on
the client, you are best placed to document and discuss this with the clients treating
medical practitioner. The treating medical practitioner will then determine the best course
of medical treatment for the client.
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Record all observations accurately and objectively in consultation with
supervisor using terms that can be clearly understood
When a client has displayed risky or dangerous behaviour, especially if this behaviour has
been sustained over a period of time, you should have collated considerable information on
the possible causes, triggers, impacts and follow-up of these episodes.
You should have collated information on the environmental factors and observed emotional
state of the client. You may be able to identify any health issues impacting behaviour and
chart the effect of medication on the client’s behaviour.
Your documented observations will be utilised to formulate an individual response plan to
prevent, manage and recover from any risky or dangerous incidents.
An individualised action plan will typically include:
• Any known impacts on the client exhibiting risky or negative behaviour. These
may include any known environmental, emotional, health, medicinal or other
factors that have been identified to cause distress and risky behaviours
• Any known mitigating or moderating measures that can be put in place, when the
known stressors are present. This may include delaying an activity if a client has
changed medication, reducing the intensity of a routine if a client has sustained an
injury or temporarily cease an action if a client has experienced a significant
emotional event
• An action plan for if a client starts displaying risky or dangerous behaviours. This
may include removing a client from a situation (such as locating a quiet room, free
from stimulation), diversionary tactics, appropriate physical restraint, appropriate
contact of emergency police or ambulance services, if this is deemed to be a
suitable action
• Post-event follow-up. The client’s ongoing wellbeing is a priority after an event.
They may suffer from significant embarrassment, loss of face, dignity (especially if
emergency or police are called to respond to an incident) or even possible legal
consequences, if during an event, the client committed a crime. Post-event
follow-up is essential to assist the client in resuming the care they need, to
support them and to re-engage in their rehabilitation and management
• Review of the action plan. Even though a plan may be in place, there may always
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be room for improvements, review and updating. The individualised action plan
should be responsive to the client’s current needs, not a static document
primarily based on past events.
The individual action plan needs to focus on the inclusion of the client, not their exclusion.
Plans that remove or isolate the client from their usual activities, such as working, social
outings or spending time with family or friends need to be avoided where possible. It is
paramount to have an individualised action plan that assists with the continuation of their
education, development of skills and capability.
Once a suitable individual action plan has been formulated and implemented, future events
should be reduced and the impacts of such events should be reduced, assisting the client.
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Recognise the difference between appropriate and inappropriate
interventions when addressing behaviours of concern and Interpret and
follow behavioural support strategies and Ensure that all interventions
are in line with the plan and organisation policies and procedures
Indicators that people have unmet needs
This theory argues that people may exhibit behaviours of concern when their needs are not
met for example hunger, thirst, toilet, pain, fatigue, temperature, over/under stimulation
and lack of social engagement.
The strategy suggested in this theoretical approach is to seek to understand the individual
unmet needs and manage these needs before the behaviour occurs.
Unmet needs may relate to:
• Physical well being
• Emotional well being
• Environmental context
• Medications
• Conditions and dual diagnosis
Having unmet needs may relate very heavily to behaviours of concern.
A behaviour of concern is any behaviour which causes stress, worry, the risk of or actual
harm to the person, their carer’s, staff, family members or those around them. The
behaviour deserves consideration and investigation as it is an obstacle to achieving the best
quality of life for the person with dementia and may present as an occupational health and
safety concern for staff.
These behaviours must be addressed in an appropriate manner; remember, you are dealing
with adults, not children!
Some of the behaviours you may identify could include:
• Raised voices/angry tone
• Threatening language
Topic 3 – Provide positive behaviour support according to individualised
behaviour support plan
CHCDIS002 Learner Guide V2.0 Page 40 of 58
• Screaming
• Damaging property
• Throwing things
• Infliction of injuries on themselves
• Restlessness
• Fighting
• Pacing back and forth
• Not speaking at all
Of course, there will be many more to add to this list but this gives you a guide to the types
of behaviours you may witness.
If you do come across any of these behaviours, there are things you can do.
Risk assessment
Performing a very quick risk assessment will get you on the way to deciding the most
appropriate response to their behaviours.
• Assess the risk. Is anyone in danger?
• Leave the situation (if possible) and remove others from the situation.
• Decrease stimuli for the person (if there is something that is visibly upsetting
them, remove it from the scene)
• If the behaviour continues, you will need to escalate the crisis according to your
policies and procedures. (this may mean contacting supervisors, police or
emergency services)
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Positive behavioural support
Principles and practices of positive behaviour support which focuses on the individual person
Positive behavioural support (PBS) is based on decreasing behaviours of concern and
improving the person’s quality of life. Positive behaviour support planning tells us the best
way to work with an individual who shows behaviours of concern and gives us ways to
improve the quality of life for the person and does not just deal with behaviour.
This approach places an emphasis on the need for responsiveness to a person’s feelings and
needs and has the following defining features:
• Valuing the person, deliberately building a sense of self-worth, and acknowledging
all attempts at positive interaction
• Creating situations where the person is placed at their best advantage
• Acknowledging and trying to interpret what the person is communicating via the
behaviour
• Analysing the functions of the behaviour
• Teaching the person other ways to meet their need or communicate their feelings
• Gently supporting and leading the person to a calmer state
• Providing encouragement and feedback about personal successes along with
aspects of
• Difficult situations the person may have handled well.
For positive behaviour support to be successful it requires:
• Teamwork
• Seeing the person’s strengths and being committed to the person
• Seeing the person and seeing the behaviour
• An appreciation that all behaviours have a purpose
• Being positive
Possible consequences and outcomes of the consistent implementation of positive behaviour
support strategies. The person may learn:
• That their feelings will be noticed and acknowledged
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• Where and when behaviours are appropriate and valued
• How to manage situations and emotions that have previously led to difficult
situations
• That considerate and cooperative behaviour is acknowledged, gets things achieved
and
• Leads to good feelings
• That they can make a difference by influencing others in ways that are mutually
pleasing
• And positive7
Positive lifestyle enhancement strategies
In order to provide positive behavioural support you can also make some changes in the
persons lifestyle. There are several strategies that can be used to encourage positive
behaviour. These include:
• Positive reinforcement – positive reinforcement involves the addition of a
reinforcing stimulus following a behaviour that makes it more likely that the
behaviour will occur again in the future. When a favourable outcome, event, or
reward occurs after an action, that particular response or behaviour will be
strengthened.
• Motivation – everyone has motivation for something. Whilst one person has the
motivation to go to the football, others have motivation for shopping. We are all
different. Finding out what motivates each person can help in managing
behaviour that is unacceptable.
• Stress management – managing stress is vital to ensuring behaviours are
acceptable. If a person is feeling stress and possibly cannot convey that, then
negative behaviours are often the end result. Take care to look for things that
stress the person and where possible, try to remove that stressor.
• Engagement in meaningful activities – if people feel they are participating in
7 http://www.dhs.vic.gov.au/__data/assets/pdf_file/0004/603463/pbs_facilitators_manual.pdf
CHCDIS002 Learner Guide V2.0 Page 43 of 58
meaningful activities they are more likely to manage their behaviours. This is
linked to motivation. If people feel like they are participating and what they are
doing means something to them, their families and the outside world, then they
are likely to be happier.
• Support relationships – making sure people have supports in place is very
important. If people feel supported and feel they have somewhere to go when
they need to talk or need a hand, then they are less likely to feel helpless or alone.
This will have a positive impact on their behaviour.
• Nutrition – poor nutrition can contribute to stress, tiredness and capacity to be
motivated, and over time, it can contribute to the risk of developing some
illnesses and other health problems such as: being overweight or obese. tooth
decay and high blood pressure.
• Environmental and systems improvement – Every person has special needs of
some kind, and some people cannot handle an environment that fails to
accommodate theirs. For example, an easily-distracted person surrounded by
environmental stimuli could be a problem. People who have trouble hearing or
seeing may act up because they’re frustrated about not being able to effectively
interact. Irritating stimuli, such as strong aromas or uncomfortable proximities,
which may impact high-sensitivity people.
Each person will have a plan that outlines the behaviour management strategies that are
implemented for this person. Please make sure you follow that plan and report any changes
to the behaviour to your supervisor.
Principles of effective communication and ways to implement these
to minimise behaviours of concern
There are numerous ideas on effective communication principles, so a quick look on google
can give you more ideas, however, the following are fairly standards across all theories:
• Establish a Warm Atmosphere
• Actively Engage People’s Interest
• Be Believable
CHCDIS002 Learner Guide V2.0 Page 44 of 58
• Speak With Your Own Voice
• Use Gestures Well
• Remember That Your Knowledge Is Limited
There are a number of communication strategies that can be applied when working with
people who are expressing behaviours of concern. Using communication effectively to
achieve the desired outcome can be a challenging process. The following techniques can be
helpful:
• Use a calm tone of voice and lower your own voice to respond to loud aggressive
tones
• If you know the person’s name, attempt to establish a rapport with them by using
their name and introduce yourself by name to remind the person that you are a
person too.
• Indicate that you acknowledge the grievance and offer to help by asking openended questions about why the person is behaving the way they are. Avoid talking
about past grievances by insisting on asking what had happened on that day.
• Use non-verbal communication methods to express concern such as nodding your
head and saying “I understand how you feel…”
• Provide the person with space to think about their response to your questions by
offering them some time to think. Step back and move away to give them a sense
of physical space.
• Discuss realistic option to resolve the situation by being clear about what you are
trying to achieve.
• If there is a quiet room or private space that you can direct the person to where
the room promotes calm try to take the client to that space.
• Try to appear confident even if you don’t feel that way.
• Avoid the use of the word “no” which may promote a hostile outburst
• Don’t use threats and avoid arguing with the client when they are expressing
behaviours of concern
CHCDIS002 Learner Guide V2.0 Page 45 of 58
• It is important not to make promises that cannot be kept
• Try not to block the client’s access to the exits and find a way that you are not
blocked from the exits yourself.
• It is important not to make the assumption that the client will become violent
because this will lead you to unintentionally adopt a defensive posture that may
trigger an aggressive response.
CHCDIS002 Learner Guide V2.0 Page 46 of 58
Follow organisation procedures to ensure safety of the person, self and
other people and Respond to critical incidents in accordance with
organisation’s intervention and notification procedures
The Victorian Charter of Human Rights and Responsibilities 2006 is one important law that
sets out our freedom, rights and responsibilities. This formal recognition of our rights
protects all people from injustice and allows everyone to participate in and contribute to
society. Disability support professionals, therefore, have the right to work in a safe and
supportive environment.
At all times, you must ensure you are safe in these situations. Your safety is just as vital as
those around you and you will be required to know and understand the procedures around
working in these types of situations.
Disability support professionals have the right, especially when supporting people who show
behaviours of concern and are subject to restrictive interventions, to:
• Adequate information and training in positive behaviour support
• Be actively involved in the assessment process and not just be informed of what
to do
• Receive appropriate ongoing professional development
• Access debriefing following a stressful workplace incident
So too do your clients have the right to be safe. This includes the person that you are caring
for.
It is your duty of care to keep them and yourself safe and to ensure you notify the relevant
people in relation to the incident.
Reducing or changing setting events and triggers
This consists of setting the occasion for positive behaviour by increasing the events that
produce desired behaviour. For example:
• Providing the person with greater access to preferred activities
• Providing the person with clear instructions
• Giving the person more time to spend with favourite staff
• Placing a tray with books on the lap of a person when you know this inhibits them
CHCDIS002 Learner Guide V2.0 Page 47 of 58
from breaking the bus windows.
It also consists of decreasing or eliminating setting events that trigger the behaviour. Some
examples include:
• Reducing the number of demands made.
• Giving instructions in a way that is not directive (for example, ‘The table is ready
to be set when you’ve got a chance’) if assessment reveals that directive
instructions act as triggers.
• Providing the person with a room of their own.
• Slowing down the morning routine if you know the bus will be late and waiting has
been shown to act as a trigger.
• Often putting together a Do’s and Don’ts lists to ensure staff consistency.
Incentive programs
These provide the person with some very strong incentives to stop the person needing to
use behaviours of concern.8
No matter what the intervention, always make sure it is in line with the individual plan,
support plan and/or policies and procedures for your organisation.
8 https://manualzz.com/doc/2984272/positive-behaviour-support-getting-it-right-fro…
CHCDIS002 Learner Guide V2.0 Page 48 of 58
Monitor strategies to determine effectiveness in consultation with
supervisor
At the forefront of all that you do as a carer is to ensure the safety, dignity and self-esteem
of your clients.
There will be times that you will need to intervene in the client’s actions or behaviours. You
will have established action plans in place to ensure this is done in the most productive
manner.
In reviewing the client’s action plan, you must ensure that the strategies involved uphold
the client’s dignity and self-esteem.
Things that will demean or belittle the client are inappropriate. Ways to uphold a client’s
dignity and self-esteem include:
• Not berating the client, or talking down to them if their behaviour or actions are
escalating
• Not making fun or mocking the clients ability, capability or impairments
• Not acting in a violent or cohesive manner towards the client
• Not ‘punishing’ the client for an inability to complete a task or activity
Your strategies should be reviewed, where possible, with the engagement and input from
the client. They may be able to articulate how they feel in situations, how they like to be
helped and what would affirm their dignity and self-esteem.
You should also constantly review your own attitudes, responses and behaviours towards
your client’s dignity and self-esteem. You can monitor your own responses by thinking
through how you reacted to a client in a particular situation. Were you too firm in a
situation? Did your response take away their ability to think, input or decide for themselves
to react? Did you ‘follow all the rules’, yet talk in a disparaging or negative way towards the
client? It is essential that you review and monitor your own responses to the client, ensuring
they uphold their dignity and self-esteem.
It is important that whilst you monitor the strategies to determine their effectiveness, this
must be done in consultation with your supervisor.
CHCDIS002 Learner Guide V2.0 Page 49 of 58
Identify and report changes in person’s needs and behaviours in
consultation with supervisor
Behaviour recording
Key steps in completing functional behaviour assessment
Step 1 – Defining the behaviour of concern. You need to write the behaviour in a way that
the actual behaviour of concern can be easily understood by others, that can then be used
to gain reliable documentation on when and when it does not occur.
Step 2 – Finding out as much information as possible about the behaviour, for example:
• What happens before the behaviour?
• What happens during the behaviour?
• What happens after the behaviour?
This will require the use of recording forms such as STAR Charts or questionnaires like the
Motivational Assessment Scale.
Step 3 – From information collated via the recording forms/questionnaires, come up with an
idea (hypothesis) about why the behaviour is occurring, that is what purpose/function does
the behaviour appear to be serving for the person. Some of the most common reasons why
behaviours of concern occur:
• Gaining social interaction
• Escape or avoidance of demands
• Gaining access to preferred activities or tangible objects
• Sensory feedback (hand flapping, eye poking)
• Pursuit of power and control over own life
• Reduction of arousal and anxiety.
Step 4 – Test your idea (hypothesis) by systematically introducing strategies such as
environmental changes, skill development strategies and planned responses to behaviours.
These strategies must be linked to why the person is using the behaviour. The introduction
and consistent implementation of these strategies should result in a reduction to the
frequency and intensity of the target behaviour and over time, an increase in the person’s
quality of life.
CHCDIS002 Learner Guide V2.0 Page 50 of 58
Step 5 – Regularly monitor, evaluate and review the effectiveness of the strategies: Thinking
about what worked and what needs to change. Ongoing data collection will be required to
monitor or check that your ideas about the behaviour are correct.9
If you would like further information on this subject, please go to
https://manualzz.com/doc/2984272/positive-behaviour-support-getting-it-right-fro…
You will find a full discussion and instruction on behaviour support there.
9 https://manualzz.com/doc/2984272/positive-behaviour-support-getting-it-right-fro…
CHCDIS002 Learner Guide V2.0 Page 51 of 58
Follow referral procedures in consultation with supervisor
Specialist services and referral options
Your organisation will have policies and procedure relating to referring clients for
behaviours of concern. This could include referrals to:
• G.P.
• Counsellor
• Specialists
• Another referral source
Before you refer any client for further assistance, you must always check with your
supervisor. They will have the authority that you need to refer and will probably have a list
of preferred specialists to refer to along with all their contact details.
In most cases, you will be required to complete a referral form similar to the one below.
CHCDIS002 Learner Guide V2.0 Page 52 of 58
CHCDIS002 Learner Guide V2.0 Page 53 of 58
Comply with the organisation’s reporting requirements
Documentation and good record keeping are at the heart of best practice with ongoing
client management.
Good documentation allows for the:
• Accurate recording of events, incidents and observations
• Identification of trends, ongoing issues
• Identification of strategies that assist a client
• A secure and central location for any actions plans for the client
• A central point of reference for all the client’s documents, rather than a
haphazard system where information can easily get lost
Documentation will also be a legal requirement in many situations, especially with incident /
client management, medications, treatment schedules and privacy requirements.
You will need to be familiar with your organisations policies and procedures in relation to
reporting requirements. Information on what the reporting requirements can usually be
located:
• With your team leader or supervisor
• On your organisation’s intranet
• Within HR or personnel
• With your training and development department.
Ignorance is no excuse for poor or bad documentation. The risks of poor or bad
documentation to the client, yourself and the organisation can be great.
Your organisation’s reporting requirements will clearly define what needs to be
documented, where, how, why and when.
Your organisation may have an electronic database for recording information. These may be
electronic client files, electronic documents or electronic recording of information.
Inversely, there may be paper-based files or information. Usually, each client will have their
own file – this could be paper or electronically based. This file will typically be divided into
Topic 4 – Complete documentation
CHCDIS002 Learner Guide V2.0 Page 54 of 58
basic client information, medicinal or treatment information, treating practitioners and
specialists, emergency contact information, any private information or concerns,
information release waivers, any action plans or strategies in place and generalised
observations. You need to become familiar with each section of the clients file, to ensure
you know where to document what information.
Each organisation will have its own style of documentation. This ensures that all employees
are documenting using the same ‘codes’, style and ways. As there is often much that needs
to be documented, many organisations have their own style of shorthand to quicken the
process of documentation. This may be formal, or informal. Regardless of this, it is essential
that you understand the style of documentation, to keep the flow and tone uniform for any
other organisation’s employees.
Each different type of document will need to be completed in different timeframes. An
example of this is you may need to document immediately once a medication has been
administered. Other documents may not be able to be completed immediately – an incident
or accident report for an example. These may take considerable time and cannot be
completed on the spot. Generalised observations may be documented at the end of a shift
or interaction, to ensure the clients observations and records remain current.
Documentation is important as it gives a clear record of the client’s actions, behaviours,
interactions and any other observations made. Documentation is often both a legal and
organisational requirement. It is an important and serious part of your role, the proper time
and attention needs to be given to it.
CHCDIS002 Learner Guide V2.0 Page 55 of 58
Maintain documentation according to organisation’s requirements
Your organisation will have clear requirements for documentation. This will include:
• What to document
• Where to document
• The style of documentation
• When do document
There will be a wealth of information that needs to be documented. This can be clientspecific information, program information, plans or strategies, inter-organisational notes,
emails and any other organisational files.
Client-specific information will be documented in a range of places, depending on the
nature of the information. This may include:
• Client observations, medical notes and generalised client information to be
documented in the client’s file
• Clients individualised plan, action plan or any other health or rehabilitation plans
also to be included in the clients file
• Any referrals made to the organisation for the client to be filed in the client’s file
• A copy of any documents / referrals made to external organisations, health
partners or specialists, as well as any responses from these stakeholders to be
held in the clients file
There will be information that is not client specific that does not need to be filed in the
client’s file. You may be required to prepare inter-organisational notes or communications,
such as meeting minutes, emails confirming a new decision or direction or organisational
contact lists. These will usually be documented in individual, organisational documentation
templates. For example, your organisation will usually have its own template for meeting
agendas and minutes. It is essential that you correctly document organisational notes in the
correct places, using the correct template. This ensures uniformity of messages,
documentation and assists with the ease of reading.
Working in aged, disability or community services, you may also be required to create
documents or information for your clients, groups or facility. These could be simple
documents, such as a safety sign for a particular activity or equipment, instructions for using
an appliance or directions for an activity or strategy. Your organisation will have policies and
procedures on how this is to be documenting, considering any linguistic or cultural
CHCDIS002 Learner Guide V2.0 Page 56 of 58
requirements. It is always advisable to contact a communication specialist in your
organisation if you have any queries on public communication or messages.
By following organisational documentation requirements, you ensure that you keep an
accurate record of what has happened, what needs to happen and any other directions. It
keeps the flow of information uniform and allows for the quick and easy identification of
important information, as it is required.
CHCDIS002 Learner Guide V2.0 Page 57 of 58
Now that you have completed this unit, you should have the ability to follow established
person-centred behaviour supports.
If you have any questions about this resource, please ask your trainer. They will be only
too happy to assist you when required.
summary
CHCDIS002 Learner Guide V2.0 Page 58 of 58
“Aversive, restrictive and intrusive treatment practices – Policy and guideline.” (n.d.) Web.
01 July 2019. https://www.nwss.org.au/policies-procedures/aversive-restrictive-andintrusive-treatment-practices-policy-and-guideline/
“Social model of disability.” .” (n.d.) Web. 01 July 2019.
https://pwd.org.au/resources/disability-faqs/social-model-of-disability/
“What is social devaluation? How does it impact a person’s cares and needs?” (n.d.) Web.
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“Positive Behaviour Support Getting It Right From The Start …” (n.d.) Web. 01 Jul. 2019
https://manualzz.com/doc/2984272/positive-behaviour-support-getting-it-right-fro.
“Restrictive Practices; Restrictive practices in Australia.” (n.d.) Web. 02 July 2019.
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