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Below are the recipients of the APT-RAID® Award for Excellence in Working with Challenging Behaviour 2017. These annual awards were established to keep people 'enthused' and thinking about how they can apply training in risk assessment and management in their practice.
Brigstocke Road Approved Premises’ Approach.
(Avon & Wiltshire Mental Health Partnership NHS Trust and the National Probation Service.)
We loved this example of the RAID® approach being adapted for use in a Community Offender Personality Disorder Service and of joined up working between the NHS and the National Probation Service.
The RAID® training was followed by focussed formulation sessions building an enthusiastic team, on board with the RAID® approach and consistent with each other in interactions with clients. The team demonstrate use of the RAID® principles and incorporate these into their programme such as building strong therapeutic relationships and looking for the individual’s personal motivation and rewards. We especially liked the examples of building hope and positive habits for mental health. There are also great examples of encouraging green behaviours as a means of reducing the opportunities for red behaviours alongside feedback and agreed targets.
We can not help but feel it is a shame for "Noel" his time in the approved accommodation came to an end after the course of three months.
Priory Brain Injury Services.
This project describes a programme developed and then adapted to provide Real Work Opportunities for people with Acquired Brain injury and Progressive Neurological Conditions.
We particularly liked the application of the fundamental RAID® concept of ‘nurturing green behaviour to displace the red’. By making meaningful activity accessible and available the team provide both rewarding activities and the opportunities and potential motivation for ‘green’ behaviour, simultaneously aiming to replace and reduce the ‘red’ behaviour.
We were pleased to also see the importance of meaningful feedback noted, delivered in appropriate and timely ways for the specific patient group, along with consideration of the thorny ethical issue around how to pay people for the work to do, without offering unfair competition to those in the national workplace.
St Andrew’s Healthcare, Birmingham.
This project looks at embedding The RAID® approach within an organisation and highlights the importance of person centred care, patient involvement and ongoing review in the development of care plans. The care plans described allow and encourage staff to spot ‘green behaviour’ and there are examples of what constitutes ‘red’ and ‘green’ behaviours for a specific person with a visual aid for the patient.
We especially liked the modification of the behavioural plan to facilitate more immediate and positive feedback for the patient, and staff thinking about what may be rewarding and motivating for the specific individual.
We are also pleased to note the recognition of how important it is to create the culture in which RAID® approaches are used by staff in day to day interactions and that this is supported by regular training for staff and time to reflect and discuss cases.
Below are the recipients of the APT-RAID® Award for Excellence in Working with Challenging Behaviour 2016. These annual awards were established to keep people 'enthused' and thinking about how they can apply training in risk assessment and management in their practice.
Partnerships in Care, East Midlands Region (incorporates: Calverton Hill, Meadow View, Hazelwood House, Annesley House, and The Willows).
Judge’s remarks: Set in a service for residents with learning disability, this is a first class submission detailing how RAID provides Positive Behaviour Support and how to build it inextricably into the system, including the details of staff and service-user involvement, implications for training, policy and documentation, and how to integrate RAID-PBS into the electronic systems. Miraculous to cover it in around 1000 words.
Tusla Children's Residential Services, St Stephen's Hospital (Glanmire, Ireland).
Judge’s remarks: Set in a children's residential unit this paper describes the impact of RAID interventions. Surprisingly comprehensive for such a short paper, it highlights the benefits of (A) refraining from criticism and "consequences" wherever safety allows, (B) analysing the challenging behaviour, (C) providing positive feedback, and (D) the teaching of new behaviours and skills. Moreover it looks at the (very positive) results and the specialist input required to maintain the RAID service.
Rose Ward, St Andrew’s Healthcare (Northampton, UK).
Judge’s remarks: Set in a medium secure unit for patients with acquired brain injury, this neat piece of work strikingly demonstrates the effectiveness of giving feedback to patients as to whether their behaviour is red or green.
Nest Lane, Together (Wellingborough, UK).
Judge’s remarks: Set in a supported accommodation service for people with a range of complex needs, this paper describes the use of the RAID approach in such a setting, in clear simple terms. There are one or two theoretical glitches but the strength of the paper is that it demonstrates the power of simply playing down red behaviour as far as safety allowers and making every effort to notice and acknowledge green.
Goal-setting, St Andrew's Healthcare (Northampton, UK).
Judge’s remarks: Set in a neuropsychiatry service, this detailed study describes the importance of goalsetting when working with patients with brain injury and the role of the RAID ladder in breaking down goals into subgoals. A thoughtful and detailed piece of work with good statistical analysis.
Spencer South, St Andrew’s Healthcare (Northampton, UK).
Judge’s remarks: Set in a low secure specialist DBT unit for women diagnosed with BPD, this is a well written submission which highlights how DBT and the RAID approach can work hand-in-hand, and indeed how big the overlap is, with both approaches aiming to "pour in" adaptive green behaviour, both seeking to understand the function of behaviours, and both trying to utilise contingency management. Differences are played down, which is very RAIDy.
The MAK Café, St Andrew's Healthcare (Northampton, UK).
Judge’s remarks: Set in a neuropsychiatry service this paper describes the usefulness and effectiveness of a "pop-up cafe" staffed by service users. Intended to develop patients' vocational and social functioning, the MAK cafe appears to do just that. As one of the service users put it: "We sell coffee, hot chocolate, ice cream and tea, it's always bloody good."
ADHD Parenting Programme, Family Intervention Team, Gateshead Council (Gateshead, UK).
Judge’s remarks: This submission describes a programme to help parents of children diagnosed with ADHD. It is clear on the aims of the program, the topics covered in the nine weeks it lasts, and the strategies that are covered to respond to those problems. We would like to have heard more about the strategies but even so, the information given provides a clear lead for anyone wishing to create a similar program, and results suggest that the parents who attend appreciate it and benefit from it significantly.
Brain Injury Services, Partnerships in Care (UK).
Judge’s remarks: This short, well written paper describes the background to and development of neurobehavioural rehabilitation for people with acquired brain injury and compares it with other forms of neuro rehabilitation. It goes on to describe the development of one particular neurobehavioural rehabilitation service and the impressive results it has achieved.
Salisbury Support 4 Autism (West Drayton, UK).
Judge’s remarks: This is an impressive single case study featuring a 25-year-old man with a diagnosis of autism spectrum condition and a breakdown of his relationship with his family. The study tells the story of analysing the function of his challenging behaviour and implementing contingencies to virtually eliminate it and re-establish the family relationships. It is notable for the correct understanding of negative reinforcement, sophisticated communication strategies, and the deliberate encouragement of choice. A very attractive study.
St Andrew's Healthcare (Northampton, UK).
Judge’s remarks: Set within a neuropsychiatry service this paper shows that those staff who attended RAID reminder-sessions subsequently record more green behaviours from patients than do staff who don't. We would like to have seen some discussion on whether this reflected a clinical improvement for the patients concerned or whether it was simply a recording phenomenon; we suspect the former. This paper will appeal to those who like statistics and statistical tests.
Cygnet Health Care (UK).
Judge’s remarks: Set in a psychiatric intensive care ward this submission focuses on occupying patients with activities that provide choice, and promote engagement in spite of security requirements. The absence of any statistics limits what can be claimed for this, but knowledge from other research tells us of the importance of social and occupational activities, and the real interest of this paper is in the listing of the activities provided by this service.
Below are the recipients of the APT-RAID® Award for Excellence in Working with Challenging Behaviour 2015. These annual awards were established to keep people 'enthused' and thinking about how they can apply training in risk assessment and management in their practice.
Arkwright Ward, Kemple View Hospital.
Cons: Would have been nice to see some figures attached to the statement: Mr G has made significant progress in terms of his challenging behaviour.
Pros: Demonstrates the all-important empathic understanding of a person with challenging behaviour. Nice talk of the RAID ‘tube’.
Overall: A good clear exposition of the RAID approach as applied to an individual displaying significant levels of challenging behaviour.
Neuropsychiatry Pathway, St Andrew’s Healthcare.
Cons: The stats are a bit obscure. 6 months gaps for collecting accounts of green behaviour seems like a long time.
Pros: Very clear grasp and exposition of the RAID principles involved, especially the idea of finding behaviour that the patient enjoys. The statistical evaluation which comes out strong. The determination and energy which went into operationalising the approach.
Overall: An outstanding submission.
Salisbury Support 4 Autism.
Cons: A bit jargony.
Pros: A new, simple and effective way of communication for the client, and uses good measures of how effective this is.
Overall: A simple clear strategy which improves the quality of life not only of the client but also those around him. Including the staff.
The Family Action Support Team (FAST), North East Lincolnshire Council.
Cons: Weak on providing an illustrative case study.
Pros: Strong on providing a description of positive aims and targets in relation to many of the key problem areas associated with children and families.
Overall: A good descriptive framework for what positive interventions aspire to.
Wainwright Ward, Kemple View Hospital.
Cons: We thought initially this was just going to be a copy and paste job from the RAID website. It would be good to see figures attached to the positive results.
Pros: Good to see RAID champions on the ward, RAID care plans, RAID ladders being used, RAID posters, and RAID meetings.
Overall: A heart-warming description of a thoroughgoing application of RAID to a ward.
Women's Service, St Andrew’s Healthcare.
Cons: Would have been nice to see some figures attached to the statement: "Results show that an increase in on-ward training and more training time devoted to prevention and de-escalation was reflected in reductions in risk behaviours, seclusions, time spent in restraint and staff injuries".
Pros: A very nice summary of the important components of de-escalation training. And how it can fit in with an overall positive philosophy.
Overall: Gives a good picture of how a thorough positive philosophy can set the scene for other components such as de-escalation training.
These annual awards were established to keep people 'enthused' and thinking about how they can apply training in risk assessment and management in their practice. Application is simple: just 2,000 words and the preparedness to discuss what you have written. The application may be on your own behalf or on behalf of your service and each successful submission will be published on our website.