Meeting-The-Challenge-Making-a-Difference-Practitioner-Guide

How can we deal
with challenging
behaviour?
Challenging behaviour in the
service user, usually in the
form of self-harm or
aggression, is a problem for
the worker because it makes
them feel anxious or angry,
and therefore less able to
respond in the interests of
the service user. It’s a problem
for the service user because
it can invite rejection from
the worker. It is also often
regretted afterwards, and it
can get in the way of someone
learning about themselves
and how to deal with their
feelings constructively – with
‘emotional growth’.
It helps if there is clarity about
what the consequences are if
these challenging behaviours
occur.This should be made explicit
in the service’s operational
policy. For example, the service
might have an explicit policy
that verbal abuse of reception
staff will not be tolerated, or
that anyone cutting in the
building will be sent to A&E.
But these boundaries need to sit
alongside an acknowledgement
that challenging behaviour
serves a function, either
emotionally for the service
user, or in the relationship
between worker and service
user, and that the person
needs help to manage these
impulses in a different way.
Sometimes one of the primary
tasks of a service will be to
address these challenging
behaviours with the service user
and to think together about
what has triggered the
behaviour, what the service user
is thinking and feeling at that
moment, and whether there is
a different way of dealing with
these thoughts and feelings or
with similar situations.
Self harm
‘Self harm’ is when someone
damages or injures his or her own
body on purpose.There are many
forms of self harm including:
• Cutting, biting, burning or
picking at the skin.
• Taking overdoses of
medication.
• Deliberately not taking
prescribed medication.
• Misusing drugs or alcohol.
• Hitting or punching oneself,
or head-banging.
• Engaging in risky sexual
behaviours like unprotected
sex with strangers.
• Deliberately starving oneself
or binge eating.
• Deliberately consuming
substances that are
poisonous or cause
disgust or illness.
Self-harm and suicide usually
have different intentions; if
someone is self-harming they
do not usually intend to kill
themselves, though sometimes
the behaviour can result in
accidental death. In fact,
many people use self-harm
as a coping strategy to stop
themselves committing
suicide. Regardless of the
injury or degree of harm it is
helpful to find out what the
person intended, rather than
make assumptions.
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