Challenging behaviour

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1. Dealing with challenging behaviour

Challenging behaviour that may impact on the person's ability to engage in a health literacy or words for wellbeing session includes:

Aggression
Disruptive or destructive behaviour
Inappropriate behaviour – for example, disrespectful personal or sexual comments.

Challenging behaviour is quite common in people with health problems that affect communication and the brain, such as learning disabilities , some mental health conditions, or dementia . People may also behave in ways that are not usual for them when they are highly stressed or anxious. Your organisation may already have a policy that you should consult on how to manage challenging behaviour. The following are some additional pointers to consider.

In this video, Stephen Harris, Libraries Development Officer with Midlothian Council, describes how he supported a library user with severe anxiety who became agitated during an exchange with library staff.

2. Preventing challenging behaviour

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Preparation

In the preparation for a words for wellbeing session, it is important to ask whether there are any known triggers that can cause the person distress or agitation, and to discuss whether they would feel more comfortable in a 1-1 or a group session.
Ensure that being free of drugs and alcohol is recognized as a ground rule for words for wellbeing sessions.
Suggest having a carer on-hand or providing their contact details for participants with learning disabilities, dementia or serious mental health issues

When challenging behaviour is triggered

Any situation or feeling can act as a trigger for challenging behaviour. This is frequently unpredictable. However the approach made towards the person as soon as the behaviour is triggered is very important.

	Please stand back and take a moment before approaching and assess the situation.
	Speak slowly and clearly in a calm voice.
	Explain what you would like the person to do and why.
	Try not to rush the person , act calmly.
	State clearly any action you are going to take.
	Always show respect and treat people with dignity. Remember that it is illness or a person's circumstances that cause their behaviour, not the person themselves.

Communication is key

	DON'T use harsh, aggressive or abrupt commands
	DON'T issue commands such as "You must....", "Don't....", "Stop....".
	DO use alternatives such as '"I" language - for example: "I would like you to...", "It would help me if", "I feel scared when....". Or if in a group session, explain the impact of the person's behaviour on the group and say something like "The group would like you to".

3. Managing challenging behaviours

If at all possible, have a colleague to hand so that you can call upon them if necessary to deal with challenging behaviours.

When challenging behaviour cannot be controlled:

	Back off where possible and keep calm.
	Be aware of body language and tone of voice used to the person.

In a physical meeting space:

	Call for help.
	Get help to remove/accompany the person from the room. If this cannot be done, remove others from the environment, if possible.
	If you are facilitating a group session, depending on the circumstances, if the person is not aggressive, it may be possible for a colleague to sit with them in a separate room and help them to calm down, while you continue with the group session.
	Contact the person's carer if they have provided their details. In a school setting you should follow school policy e.g. contact the guidance lead.

In a virtual meeting space:

If necessary, you have the ability to disconnect the person from the session. Explain first that this is what you need to do and why. If carer’s details have been provided, ask a colleague to contact the carer so that they can check that the person is okay.

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Module 6: Managing boundaries and difficult situations