Editorial for ‘A unified approach to behaviours that challenge’

Citation

Bradshaw, J. (2020), "Editorial for ‘A unified approach to behaviours that challenge’", Tizard Learning Disability Review, Vol. 25 No. 3, pp. 97-98. https://doi.org/10.1108/TLDR-07-2020-056

Editorial for ‘A unified approach to behaviours that challenge’

This special issue focuses on the update to “Challenging Behaviour: A Unified Approach” (Royal College of Psychiatrists, 2007). Work on an update (led by Roger Banks, Alick Bush and Ashok Roy amongst others) began in 2014 and resulted in a partial update in 2016. This special issue came about as a result of an action arising from The Challenging Behaviour Foundation National Strategy Group. In spite of a national focus on making things better for those who present with challenges to services, it is clear that much still needs to be done.

This special issue begins with Ashok Roy and colleagues outlining the need for a care pathway, where services are coordinated across the lifespan of the individual. Peter McGill and colleagues explore the concept of capable environments, aiming to shift the focus from the individual to the social, physical and organisational supports. Harm Boer and Anupama Iyer discuss behaviours that challenge and offending behaviours in relation to secure services. They highlight areas where more research is needed. Theresa Joyce reminds us that admission to a hospital setting does not necessarily result in good outcomes and explores the role of governance in supporting improvements. Finally, Louise Denne and colleagues focus on implementation, using ideas from implementation science to highlight the complexities of implementation and the importance of systems in achieving change.

The commentaries explore issues across all the papers and provide insights and challenges from a number of different perspectives, highlighting key issues. People with intellectual disabilities highlight the importance of listening to those with lived experience, emphasising the role of communication, the need to value families and the need to develop a valued, caring, well-trained workforce. Viv Cooper also stresses the central role of family carers. She highlights the importance of joined up services and poses the questions of who might take responsibility to ensure that this will happen. John Ockenden describes the challenges in trying to implement high quality support and calls for urgent research to support the implementation of good practice in large organisations. Steve Carnaby reflects on the need for those working in multidisciplinary teams to work collaboratively and in partnership with others, including people with intellectual and development disabilities if we are to improve quality of life outcomes. Finally, Stacy Clifford Simplican argues against a unified approach and instead suggests we need a new interdisciplinary field of challenging behaviour studies.

Editorial note

Some papers for this special issue were developed from chapters written for the update in 2014. Though we planned to also include papers on commissioning and policy the global pandemic changed the priorities for the authors of those papers in ways that made contributing to this special issue impossible. I am very grateful to all contributors for working on the papers during such challenging times. Thanks also to Professor Julie-Beadle Brown who acted as guest editor for the paper on “Capable Environments”.