Working as a behavior analyst in an acute psychiatric hospital, has posed many challenges, to say least. One afternoon, as I sat with my supervisor discussing how difficult it was to get the staff to follow the recommendations of a behavior plan, she asked me why I thought they didn’t follow my recommendations. “Fear”, I said, “They are afraid of our patients.” For a moment, we just stood there, thinking of the stories we had heard through the years, and then she asked me: “Are you afraid?” I shook my head. She followed, “why are you not afraid and they are?” Without thinking much, I answered “I understand behavior. When a patient is in crisis, I can see more than just the crisis behavior, and that guides me on what to do. I am not afraid.”
Years have gone by since that supervision session. I still see staff reacting to patients based on what they don’t know, and that leads to fear. In general, we have very little knowledge about a patient’s triggers, preferred coping strategies, history, not to mention function of the problem behaviors; and because we don’t know, we fear.
Understanding behaviors, particularly how the environment affects it, and training yourself to constantly look for the contingencies around particular behaviors will help you keep safe as you work with aggressive or violent clients. Here are some examples of functionally based psychossocial interventions that can help you keep safe: Functionally based psychossocial interventions