What is Behavior Coaching?
“Hit the deck!” he yells, as he pushes an ailing gentleman to the ground. “The babies are dead,” the woman is wailing. “HEY!!!” you hear, as a walker is hurled toward your head. Behaviors are usually ways of communicating needs. Generally, we don’t exhibit risky behaviors when our needs are being met. Needs, and the behaviors people use to communicate those needs, are very individual, and are partially influenced by presets. Presets are the factors that contribute to who we are, what is important to us, and why we act and react the way we do.
Presets include physical conditions, effects of medication, events in ones personal history, occupations, preferences, relationships, cultural influences and more. The man yelling “Hit the deck!” had been on a Navy ship in WWII. What could have been perceived as a violent behavior was actually an attempt to save his fellow “ship mates”. The woman who saw dead babies on the floor had suffered eight still births. And the woman throwing her walker had been a loving mother to four children, and wanted to give and receive some hugs and attention.
Pain, infections, medication interactions and side effects, too much or too little stimulation, boredom and many other conditions create needs. When one is unable to express these needs with words, behaviors communicate the need. Possibly the most common unmet needs is the need to belong. Research demonstrates that when we feel excluded, the dorsal anterior cingulate cortex (dACC) activates our fight, flight or freeze system. Fight behaviors include hitting, scratching, yelling, biting, kicking and others. Common flight behaviors are crying, resisting, hiding, and running away. Freeze behaviors include stiffening, staring, or even compliance. Sadly, we can inadvertently retraumatize someone who complies, for example, during personal care routines.
Presets are one of the key components assessed and considered by Certified Behavior Consultants. Setting events and triggers, what happens prior to the behavior, are part of the behavior analysis. The process also includes clearly describing the behavior(s) of concern, and identifying the de-escalation. A team approach is used in the analysis. Everyone involved including the client (as able) are interviewed.
After the key components are identified, the Certified Behavior Consultant presents a behavior plan which identifies the unmet need(s), and proposes an alternative pathway to meet the need. The goal of the alternative pathway is to render the risky behavior unnecessary. It usually involves establishing or reinforcing a reliable routine with a flow of active and passive meaningful activities. A monitoring process is established, extinction burst (an increase in the unwanted behavior prior to the behavior diminishing) is watched for, and follow up visits are implemented to adjust the plan as needed.
Higher quality, more meaningful life is the result, for all involved. If you have a loved one or client who experiences memory loss or confusion, or other cognitive challenges, who is exhibiting a risky or difficult behavior, a consultation with a Certified Behavior Consultant is a very valuable step toward a better and safer life for both of you. State of Oregon Certified Behavior Consultants have had extensive education, passed a mentorship and testing process, and obtain approved CEU’s each year.
"Behavior coaching can pull the whole team together and truly make a difference for all!"