Sunday, May 29, 2011

Challenging Behaviour

I thought it was time I reflected on what I percieve is a complex and common issue I have been experiencing whilst working in the spinal unit.
The topic of:

A good starting point is the definition...Good old wikipedia
Behaviour or behavior (see American and British spelling differences) refers to the actions of a system or organism, usually in relation to its environment, which includes the other systems or organisms around as well as the physical environment. It is the response of the system or organism to various stimuli or inputs, whether internal or external, conscious or subconscious, overt or covert, and voluntary or involuntary.

Then on a google search of "behaviour and spinal cord injury" -1,240,000 results

I have to keep reminding myself about the word "adjustment"
Adjustment is defined as adapting to a new condition. Everyone makes adjustments during their lifetime. Some of the conditions that you adjust to may be planned and you have time to think about how you are going to react to the situation. For example, you may have to make adjustments in your work hours when you start a new job. Other events may be a surprise, and you are forced to adjust to an unplanned event.

"Adjustment" and SCI...

A spinal cord injury (SCI) is one of the most devastating of all traumatic events. It results in a loss of some or all of an individual’s sensation and movement. It is common for individuals who are newly injured to have health problems. Plus, it takes time to build enough strength to be able to fully participate in daily activities.

Individuals who are newly injured will likely experience grief. This is a period of mourning that is similar to that following the death of a loved one. The difference is that you are grieving the loss of your sense of touch along with your ability to walk or use your hands. You will likely experience many different thoughts and feelings after injury. Some may seem extreme and others mild. There is no step-by-step grieving process, but some thoughts and feelings are common after injury.

Seeing that feelings are directly related to behaviour its obvious that almost everyone who has a SCI must have a change in behaviour at some stage post injury and during recovery.
Therefore it is vital that I am able to deal with behavioural changes/responses within a therapy session.

So where am I at now???
I get very frustrated when dealing with challenging behavours. I feel inadequately prepared to deal with behavioural outbursts, and I feel I lack the abililty to be assertive and respond to behavioural outbursts. It almost feels like Im too immature to deal with this - especially when working with client who have alot more maturity.

New Learning......
I feel everyday I am experiencing some type of interaction with clients that could have gone better - directly related to challenging behaviour usually impacted by environmental stimulus or as a direct result of the grief process.

How am I going to develop my professional skills?
Well firstly taking note of all of them and talking about them in supervision is key
Then analysing/relflecting on each experience and identifying how I could have dealt better with the situation in order to learn through my experiences.
Talking to the team psychologists - having a session or organising a session for the OT's about this issue.

I think its important to remember that i am probably not the only OT or team member that struggles with this issue and I want to remind myself that it is an important learning area and it will assist my professional development and growth.


Georgia Coghlan PO1 said...

hi i am an OT student at the moment, I have just read your blog, and i understand what you are saying whilst on placement i saw first hand the way a patient can react to an OT, it was not easy to watch but the OT who was only 6 months handled it very professionally and showed the patient that no matter what he said she was the professional and nothing he said had an effect on her. if only we could all handle situations like that.

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