title: Facing up to the challenge: a view of the capacity of services to meet the needs of people with challenging behaviour.
abstract: Challenging behaviour is a descriptive rather than a diagnostic term. It is applied to various types of behaviour shown by people with learning disabilities, to which caregivers react strongly. Caregivers respond in this way because these types of behaviour are either proscribed by law or contravene a general perception of what is normal behaviour. Recently, services have responded to the challenge presented by certain clients by seeking to relocate them in less institutional settings and by employing staff with the necessary skills to modify their behaviour. However, there is considerable disagreement about what forms of intervention are effective and ethically acceptable, and consequently, confidence in the ability of caregivers to bring about change has been reduced. More recent work has emphasized the importance of an organizational response to the challenge, focusing on the need for service managers to be more explicit about what staff are required to do and to provide consequences for appropriate staff performance. The health service reforms are considered to provide sufficient incentives for organizations to change.
authors.forename: J
authors.initials: J
authors.lastname: Turnbull
mesh_terms: D018166:Health Care Reform; D006301:Health Services Needs and Demand; D006801:Humans; D008607:Intellectual Disability / Q000150:complications / Q000534:rehabilitation*; D001523:Mental Disorders / Q000209:etiology / Q000534:rehabilitation*; D008605:Mental Health Services / Q000458:organization & administration*; D017146:Models, Organizational