HLTCSD306B Learning Guide & Assessment - National … · Difficult or Challenging Behaviour and Conflict ... Describe communication and conflict resolution skills that can help in

HLTCSD306C Respond Effectively to Difficult

or Challenging Behaviour

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F O R E W O R D

This publication is one of a number of Learning Guides produced by The Australian

Medical Association (WA) Inc as a resource for the health sector. It is utilised within AMA

Training Services and Health Training Australia as a training resource and within the

workplace as a support guide.

The development of this workbook was undertaken by a number of trainers and

developers within AMA and HTA, who have both industry knowledge and specific

expertise in the course content.

Although every effort has been made to present reliable and accurate information, the

AMA will assume no responsibility for outcomes and actions resulting from the application

of the information presented in this workbook. Users are encouraged to confirm

application in conjunction with protocols within their specific work environment.

This book is copyright. Apart from any fair dealing for the purposes of private study,

research, criticism or review, as permitted under the Copyright Act, no part may be

reproduced by any process without written permission. Please forward all enquiries to:

The Manager

Health Training Australia

PO Box 133

NEDLANDS WA 6909

Telephone: (08) 9273 3044

Facsimile: (08) 9273 3045

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CONTENTS INFORMATION FOR LEARNERS ......................................................................................4

Training ............................................................................................................................4 On and Off-the-Job Training.............................................................................................5 Assessment ......................................................................................................................5 Learning Guide Aid...........................................................................................................6 Tips for Learners ..............................................................................................................7

LEARNING OUTCOMES ....................................................................................................8

INTRODUCTION .................................................................................................................9

WHAT IS DIFFICULT OR CHALLENGING BEHAVIOUR ................................................10 Why is this Behaviour Challenging? ...............................................................................12 Factors Influencing Behaviour ........................................................................................13

PLAN RESPONSES..........................................................................................................15 How do you Respond to the Behaviour? ........................................................................15 Understanding the Causes .............................................................................................16

Recognising why there is a behaviour problem...........................................................16

APPLYING RESPONSES .................................................................................................17 Strategies for Dealing with Difficult or Challenging Behaviour ........................................17 Communication...............................................................................................................18 Difficult or Challenging Behaviour and Conflict...............................................................19

Five-step guide to the resolution of conflict .................................................................19 Occupational Health and Safety Requirements..............................................................21

Debriefing....................................................................................................................22

LEGISLATION AND STANDARDS ...................................................................................23

WHO BEHAVES IN A DIFFICULT OR CHALLENGING WAY .........................................24 Patient or client...............................................................................................................24 Patient/Client’s Family and Visitors ................................................................................25 Strangers........................................................................................................................26 Colleagues and Co-Workers ..........................................................................................27

REPORTING AND DOCUMENTING.................................................................................30

SUMMARY ........................................................................................................................31

BIBLIOGRAPHY ...............................................................................................................32

GUIDE TO ASSESSMENT................................................................................................35 Assessment Plan for Participant.....................................................................................36 Summary of Evidence Sources ......................................................................................37 Assessment Plan............................................................................................................37

WRITTEN ACTIVITIES......................................................................................................38

PRE-ASSESSMENT CHECKLIST ....................................................................................40

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HLTCSD306C © Health Training Australia (Inc) ISBN: 978-1-921559-97-6

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INFORMATION FOR LEARNERS

This learning guide will assist you in developing skills and knowledge to work effectively in

the health industry and to apply these skills to your workplace and daily tasks.

Training Competence means that you have the required knowledge and skills to do your job. These

are described in ‘competency standards’. Your training will be based on these to make

sure it is relevant to the needs of your job and yourself.

Your Participant Assessment Record and the Pre-Assessment Checklist in the Guide to

Assessment (included at the back of this Learning Guide) state the standards of

competence.

The purpose of the training is to develop your workplace competence, so you will be

expected to practise your skills whenever you can. This can be done through work

experience, practical sessions in a training organisation or through your full time or part-

time job. It is important that you have both theoretical and practical knowledge and skills.

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HLTCSD306C © Health Training Australia (INC) ISBN: 978-1-921559-97-6

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On and Off-the-Job Training Your training may consist of on-the-job coaching with your workplace supervisor and/or

trainer on a one-to-one or small group basis. It may also involve formal training sessions

conducted off-the-job in addition to working through your learning guide.

Make sure you ask lots of questions, complete the activities, and do additional research to

ensure you know everything listed in the Pre-Assessment Checklist.

If you do not understand any part of the unit please contact your Trainer.

Assessment Once you have completed your training and practised your skills, you will be ready to have

your skills and knowledge assessed. The purpose of this is not to see if you can pass a

test, but to determine if you can perform work tasks competently.

Refer to the Guide to Assessment for detailed information on this unit’s Assessment Plan.

Complete the Pre-Assessment Checklist in the Guide to Assessment. This sets out the

skills and knowledge you will need to demonstrate during your assessment to be deemed

competent in this unit.

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Learning Guide Aid

You will see the following icons throughout your Learning Guide. They will help you with

your learning by telling you what type of information that is being presented in the Learning

Guide. The icons are listed below with explanations on the use of each one.

REMEMBER - used for specific points to note or helpful tips to remember.

THINK / IDEA – when asking you to think about your response to a statement or situation. What do you do in your workplace?

INFORMATION – when providing additional information or giving links to further information – e.g. website, reference book, workplace policies and procedures.

IMPORTANT – for any information that is considered important and critical to demonstrating competence in the unit, or in relation to an occupational health and safety issue.

ACTIVITY – may form part of the evidence of competency for this unit.

The activities are designed to make the theory practical to your individual situations and

you are encouraged to complete them all.

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HLTCSD306C © Health Training Australia (INC) ISBN: 978-1-921559-97-6

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Tips for Learners

Read through the information in the Learning Guide carefully. Make sure you understand

the material. If you come across anything you do not understand:

Discuss your training with your trainer and make sure you understand what is required

and how the training will be organised.

Ask for feedback on your progress as you work through the activities.

Ask for help when you need it. Talk to more experienced colleagues or your trainer and

ask for their guidance.

Listen, take notes, ask questions and practise your new skills as often as possible.

This way you will improve your speed, memory, and your confidence.

During your training, you should seek other sources of information as well, e.g.

reference books, the Internet. Some of these are suggested in the guide.

Try to relate the information presented in this Learning Guide to your own experiences

and to what you already know.

Work through the activities. They are there for a reason and even if you already have

the knowledge or skills relating to a particular activity, doing them will help to reinforce

what you already know. If you do not understand an activity, think carefully about the

way the question or instructions are phrased.

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LEARNING OUTCOMES

This Learning Guide will provide you with information that will assist in your learning and

development of skills associated with handling difficult incidents during the workday rather

than managing ongoing behaviour difficulties.

Completing this workbook aims to provide you with a greater understanding of the

principles and techniques associated with:

Planning responses.

Applying responses

Reporting and reviewing incidents.

In order to be competent in this unit you will be able to:

Identify the difficult or challenging behaviour.

Describe the different kinds of difficult or challenging behaviour that may be

encountered.

Recognise some of the factors that can cause difficult or challenging behaviour.

Describe what you need to know that will help you to recognise difficult or challenging

behaviour in the workplace.

Demonstrate how to respond to difficult or challenging behaviours.

Identify a range of strategies for dealing with different kinds of behaviours.

Describe communication and conflict resolution skills that can help in dealing with

challenging behaviours.

Identify the OHS requirements of your organisation when dealing with these

behaviours.

Identify who in your workplace could respond to you in a difficult or challenging way.

Describe how you would report and document incidents related to difficult or

challenging behaviour in your workplace.

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INTRODUCTION

This unit is provided as a collective unit for Health Support Workers who have a multi-

functional role within a heath care facility but can also be adapted for workers who have a

more specific support role in relation to providing quality health care services.

If you are working in an area that exposes you to difficult or challenging behaviour,

including aggressive actions, then you will require effective communication, conflict

resolution and mediation skills.

How you respond to a situation is determined by:

Your ability and experience.

Your knowledge of established organisational procedures.

Knowledge of individual persons and underlying causes of their

difficult behaviour.

Depending on your role in the health care facility you will need to develop skills that enable

you to:

Speak in an assertive (not aggressive), diplomatic and culturally appropriate manner.

Remain calm and positive in adversity.

Think and respond quickly and strategically.

Remain alert to potential incidents of difficult or challenging behaviour.

Monitor and/or maintain security in the workplace.

Effectively use techniques for monitoring own service area including patient/client

satisfaction, observation of unusual happenings e.g. a stranger in a place they

shouldn’t be, doors open or closed that shouldn’t be etc.

In reading through the Learning Guide you may well come across information and tasks

that are not your everyday responsibility. However, by completing this unit you will gain a

better understanding of your role and responsibilities in a health care setting and thereby

improve your existing skills and knowledge in your current work role.

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WHAT IS DIFFICULT OR CHALLENGING BEHAVIOUR

Any behaviour that upsets another person can be described as difficult. The behaviour

becomes a problem when it is harmful or distressing to the other person(s) affected.

The term ‘challenging behaviour’ is used as a way to label the behaviours as challenging, rather than label the person as the problem.

In a health care facility difficult or challenging behaviour can include:

Aggression, with or without threats.

Confusion or other cognitive impairment.

Noisiness.

Manipulation.

Wandering.

Self-destructive or suicidal acts.

Intoxication.

Intrusive behaviour.

Confabulation – verbalisations about

people, places and events with no basis

in reality.

Refusing assistance.

Spitting.

Screaming and/or calling out constantly.

Suspiciousness, accusations.

Sleep disturbance.

Hiding and losing items.

Anxiety.

Clinging.

Withdrawal, apathy.

Incontinence

Disinhibition – inability to suppress

impulsive behaviour and emotions.

Verbal offensiveness.

Rocking.

Clamping mouth shut.

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You may be presented with difficult or challenging behaviour from patient/clients, their

relatives or other visitors, co-workers or strangers.

Co-worker or supervisor bullying, which includes such things as derogatory remarks,

sexual or racial comments and threats are no longer tolerated in the workplace.

There may be reasons such as stress that make people go into a rage and take it out on

others but it is not an excuse for the behaviour.

Select three (3) behaviours from the list on page 10 and think about each of the behaviours that you have listed: 1. Which behaviours do you think you should accept? 2. Which ones should you not accept? 3. Why?

Behaviour Acceptable Unacceptable Why?

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Why is this Behaviour Challenging?

When dealing with difficult or challenging behaviour you need to ask yourself why is the

behaviour a challenge for me?

“I just don’t like

it”

“The patient/client

might get hurt”

“It’s stopping me from

getting my job done”

“Me or someone else

could get hurt”

“Other people

won’t like it”

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“I’m feeling

confused”

Factors Influencing Behaviour

Ask yourself what is this person trying to tell me?

Difficult or challenging behaviour rarely happens without a reason. Often there are quite

simple and understandable reasons why a person behaves in the way that they do.

The behaviour can be the outcome of very ordinary problems and common emotional

experiences. It's not just something that comes from within the person; rather it is an

outcome of a combination of things, how the person feels and what is happening around

them or being done to them. The person is often in an unfamiliar environment and what is

happening to them is usually out of their control.

“I’m in pain and unwell”

“I’m unhappy”

“I don’t understand or speak English, what are you

saying”?

“I’m bored”

“Nobody is listening to

me”

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Other factors that can influence difficult or challenging behaviour may include:

Health issues Environmental Activity issues

Medications.

Acute illness.

Urinary tract infection.

Flu or chest infection.

Constipation.

Fatigue.

Chronic illness.

Poor hearing and/or

vision.

Over Stimulation.

Under Stimulation.

Strange surroundings,

Things which trigger bad

memories.

Other peoples

behaviour, e.g. anxiety,

aggression.

Task being attempted is

too long or complicated.

Unfamiliar tasks.

Not understanding the

task or what is

expected.

Bad memories of

previous experiences.

If you have relatively good communication skills you may be able to negotiate with those

around you and diffuse the situation, take back some control and feel more secure.

But what happens when a person doesn’t have that understanding or ability to control and influence their situation or environment?

Then the Health Support Worker may need to deal with the person’s difficult or challenging

behaviour.

There will need to be responses and strategies in place to assist the Health Support

Worker to deal with a person’s needs and issues, these can include:

How you can learn to understand each other better and communicate your needs and

wishes more successfully?

Short term strategies for supporting the person when he or she is upset, angry and

confused.

How to help the person cope when they are in the middle of a crisis?

You need to understand how you can feel when you are at the receiving end of

someone else’s aggression, anxiety or distress?

How can you stay calm and useful and avoid making things worse for the person you

are trying to support?

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HLTCSD306C

RESPOND EFFECTIVELY TO DIFFICULT OR CHALLENGING BEHAVIOUR

GUIDE TO ASSESSMENT

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GUIDE TO ASSESSMENT


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Assessment Plan for Participant

Unit of Competency: HLTCSD306C Respond effectively to difficult or challenging behaviour Unit Description: This unit describes the skills and knowledge required to respond effectively to difficult or challenging behaviour or patient/client or others. Work will be within a prescribed range of functions involving known routines and procedures with some accountability for the quality of outcomes. The workplace context may be: Specific community. Community or regional service. Department of a large institution or organisation. Specialised service or organisation.

Plan: Assessment

Training, mentoring and support in relation to each unit of competency will be provided to participants on a regular basis in person, on the phone or via email.

More intensive training will be provided to participants if required, as identified by the trainer/assessor (this may include off-the-job training).

Participants on the job performance is discussed with the coach/supervisor (through the use of the Participant Assessment Record) forming the Third Person Report.

Verbal and written instructions will be given to all participants prior to assessment. Ask your trainer/assessor for additional support if there are particular cultural and language needs.

Alternative assessment methods are available – these are outlined in the Participant Assessment Record

The assessment report is discussed with participant providing feedback on the outcomes of assessment and guidance on future options. Participant receives a copy of the final assessment report.

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GUIDE TO ASSESSMENT


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Summary of Evidence Sources

ASSESSMENT ON-THE-JOB OFF-THE-JOB Elements /

Performance Criteria

Demonstration / Simulation

Oral Questions

Direct Observation

Third Person Report

Written Activites

Case Studies /Projects

Workplace documents

Diary / Journal

Other

1.1 1.2 1.3

2.1 2.2 2.3 2.4 2.4

3.1 3.2 3.3 3.4

Assessment Plan

Verbal and written instructions will be given to all participants prior to assessment. Ask your trainer for additional support if there are particular cultural, language, literacy or numeracy needs.

Assessment

Type Assessment

Task Brief description of Task Resources

required Date of

Assessment1 Written

Assessment Knowledge-based assessment.

Directed activities/written questions in the Learning Guide and Guide to Assessment.

Learning Guide.

2 Observation Effective communication techniques Planning responses to difficult or challenging behaviours.

Direct observation of skills/performance in workplace or simulated environment using effective communication techniques, documenting and reporting.

Workplace

Organisation policies/procedures.

Assessment Tool.

3 Questioning Oral questions. These questions will accompany observation of workplace tasks relating to providing care and services to patient/client and others who may display difficult or challenging behaviour.

Organisation policies/procedures.

Assessment Tool.

4 Third Person Report

Workplace performance.

Assessor determines work performance of participant through consultation with supervisor.

Participants Record Book.

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WRITTEN ACTIVITIES

1. Planned responses to difficult or challenging behaviour may include? (Circle correct answer/s, there may be more than one answer)

a. Availability of appropriate staff b. Knowing when assistance is required c. Following your organisations policies and procedures d. Recognising the causes for the behaviour

2. Effective communication when dealing with difficult or challenging behaviours may include?

(Circle correct answer/s, there may be more than one answer)

a. Using clear simple language b. Focusing on solving the problem not the causes c. If the person yells at you, you yell back louder d. Being aware of own body language

3. The term ‘challenging behaviour’ is to emphasis the behaviour is a challenge to us and the situations we find ourself in?

TRUE FALSE

4. Health care facilities will have debriefing mechanisms to assist the Health Support Worker after a challenging incident?

TRUE FALSE

5. You need to document and report all difficult or challenging behaviour within your workplace?

TRUE FALSE

6. What strategies you can use that may assist you deal with a person who is behaving in a difficult or challenging way?

(Circle correct answer/s, there may be more than one answer)

a. Recognising you own limitations b. Taking up offers of help or counselling c. There is nothing you can do d. Remain and not take it personally

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Documents

HLTCSD306B Learning Guide & Assessment - National … · Difficult or Challenging Behaviour and Conflict ... Describe communication and conflict resolution skills that can help in