Kelly O'Shea Carney, Ph.D., CMC and Peg McCarthy Schwartz, MSW, LSW of Community Services Group define behavior management for adults as "utilization of the interpersonal, social and physical environment to creatively meet the needs of the individual in an individualized, responsive, and caring manner, resulting in increased satisfaction, function and improved clinical outcomes for clients."
Significance
Therapists as well as caregivers use behavior management in dealing with diverse populations suffering from cognitive, functional and behavioral deficits. These deficits may be the result of dementia, psychiatric illness, neurological disorders such as Down's Syndrome, mental retardation or Attention Deficit Hyperactivity Disorder or ADHD. The goal of behavior management is to eliminate dysfunctional behaviors and encourage functional ones.
Benefits
Behavior management can help the individual to function in new ways and correct problem behaviors. Adults with ADHD usually suffer from learning disabilities, obsessive-compulsive disorders, mood disorders and chemical dependency. These individuals can be taught to organize themselves better, develop impulse control and find creative outlets for excess energy. Adults with dementia can achieve improvement in brain function and greater independence as a result of specially tailored activities.
Strategies
Carney and Schwartz report that behavior management must take into account the individual's preexisting strengths and weaknesses as well as his changing abilities. If you are caring for someone with dementia, for example, you begin by observing the person's behavior, gathering history and assessing his cognitive, medical and emotional status. Following this, you develop an individualized plan and evaluate it regularly. You should regard any small reduction in undesirable behavior and any small increase in desirable behavior as success.
Treatment goals
For patients who have the cognitive ability to identify their problem areas, you may be able to set goals with the patient for bringing about change. Goals are written in terms of what will be achieved and not what will be eliminated. For example, a patient who isolates himself in his room might form goals to explore community resources to gain employment and pursue certain interests. Sometimes the goals may be written in the form of a contract between therapist and patient.
Features
If you are a caregiver to a person with dementia, you should not take the person's behavior personally. An older person may need to be taught activities that will help redirect and replace problem behaviors. Some of these activities are: Group sing-alongs, light chair exercise, matching or pairing exercises with familiar objects, arts and crafts such as memory boxes and pet therapy. You can also rearrange furniture, lighting and noise level to change the atmosphere. Music, aromatherapy, movies, audiobooks and sensory toys also aid in behavior management.
Considerations
Behavior management is neither simple nor similar across the board. What works for one patient may not work for another. Human beings are complex, so it is impossible to identify all the factors that influence behavior. As a therapist or caregiver, apply techniques that are suited to the patient's age, interests, values, expectations and the expected length of treatment. You may have to use trial and error until you find the methodology that works best.
References
- Community Services Group: Behavior Management Principles For Older Adults With ID
- MedicineNet.com: Behavioral Treatments For Adult ADHD
- "Psychosocial Occupational Therapy"; Mary Ann Bruce and Barbara Borg; 1993
