A Life Study is an intensive clinical session focusing on the conduct challenge(s) of an individual with disabilities. The session is structured to produce a best practice Positive Behavioral Support Plan. This format is designed to serve as a learning experience for the attendees, teaching the clinical skills required in identifying and addressing the “unmet needs” of the individual. Skills learned in the Life Study are applicable to other individuals supported by the organization as well.
The format generally followed in conducting a Life Study Approach to Positive Behavioral Support is outlined below. It must be emphasized that this format is not intended nor cannot replace an Individualized Planning Session. This Life Study Approach requires the active participation of all individuals in attendance, to maximize the desired outcomes.
Background/History
Provide Biographical Information: interests, friends, family involvement, hobbies, positive rituals, living arrangements, skills, cognitive abilities, preferred lifestyle, work history, educational and training experiences, personality, gifts, food, preferences, sexuality.
Describe Environmental Influences likely to affect behavior status i.e. demanding staff, lack of personal space, need of meaningful employment, imposed routines and schedules, noise, incompatible housemates.
Describe Psychiatric/Psychological influences upon the individual’s behavior. Note DSM IV diagnosis and comment on its validity. Identify psychological influences both situational i.e. loss of parent as well as indigenous influences to psychological state i.e. history of child abuse. List medications currently prescribed for psychiatric and psychological purposes.
Describe Medical/Biological concerns likely to impact behavior, i.e. diabetes, migraine headaches, menopause, temporal lobe epilepsy, M.R. diagnosis and its likely etiology, sleep patterns.
Barriers to Success
Describe the challenging behavior manifested by the individual. Describe behaviors empirically. Provide descriptions for frequency and intensity. Note setting events, triggers and vulnerabilities, which may be influencing the behavior i.e., fatigued, sexually frustrated.
Proactive
Detail the modifications that are recommended in the individual’s environment. Focus on the importance of life enhancing activities identify non-negotiables. Speak to giving the individual a life. Provide recommendations to enhance relationships and things in the person’s life. Focus on maximizing the individual’s prestige. Recognize the value of natural consequences.
Detail medical issues that would appear to indicate additional opinions or initial examination. Emphasize the importance of obtaining accurate diagnosis, a prognosis and recommended treatment. Detail interventions in the psychological/psychiatric areas. Discuss the role of counseling relaxation techniques, sex education, setting boundaries, inpatient psychiatric hospitalization, medication review, and desensitization.
Reactive
Detail the responses that should be delivered by staff contingent to the undesired behavior. Primary purposes of contingent response are to protect from harm. Analyze contingent response to assure it does not serve as an unintended reinforcer (aberrant contingencies). If positive reinforcement is used as a consequence, make sure it does not become the basis for a struggle i.e. withholding a preferred activity or item that is a non-negotiable i.e. cigarettes.
Detail procedures for data collection.
Additionally as a strategy to promote socially acceptable behavior the following values will be discussed and applied to the “focus person”:
- People have the ability to control themselves.
- People who stay calm in stressful situations can assist others to remain calm.
- Anger is an expression of frustration, anxiety or fear.
- Anger communicates unmet need.
- Negotiation skills are more valuable than control methods.
- People change when supported by strong, positive relationships.
- People who can make choices and control their own lives have less need to attempt to control others.
- People are responsible for their own behavior.
