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As some people with profound intellectual and multiple disabilities ( PIMD) are at a high risk of developing a challenging behavior, it is useful to look at measures taken to prevent or diminish this type of behavior. The authors undertook a study of how self-injurious, stereotypical, destructive, or aggressive behaviors are addressed in daily practice in residential facilities. A stratified sample of 30 people with the most severe and frequently reported challenging behaviors was selected from a dataset of 181 children and adults with PIMD. Individual comprehensive service plans were used to determine whether challenging behaviors were present and how these problems were addressed. In total, only 51.8% of the challenging behaviors that occurred were described in the individual plans, and for 53.7% of the challenging behaviors, strategies or interventions were included in the individual service plans. Only 17.2% of the cases contained goals formulated to prevent or diminish such behavior. A significant positive relationship was found between the severity of challenging behavior and the extent to which it was described in the individual comprehensive service plans. The authors also noted that interventions that were aimed at diminishing or preventing challenging behavior were highly simplistic, and virtually no goals were formulated to document, diminish, or prevent challenging behavior in people with PIMD. [ABSTRACT FROM AUTHOR]

Solution-focused coaching ( SFC) represents a short-term, future-focused, and person-directed therapeutic approach that helps people focus on solutions rather than problems. Thirteen cases of SFC of staff dealing with people with severe and moderate intellectual disabilities ( S/MID) are described. In all 13 cases, the progress toward the team goal, proactive thinking of staff, and the quality of the relationship ( QOR) between staff and people with S/MID were measured directly before SFC, directly after SFC, and 6 weeks after SFC. After SFC, progress toward the team goal was found in seven out of 13 teams, improvement of proactive thinking was found in 5/10 teams and improvement of the QOR was found in 7/13 teams. With regard to individual staff members, improvement of proactive thinking was found in 12/34 staff members and improvement of the QOR was found in 22/42 staff members. The authors note that SFC stimulates dealing with support problems in a behavioral, proactive way and that SFC can be a useful approach to build useful relationships. The findings are in line with results of earlier research on the value of solution-focused brief therapy applied to carers (parents or professionals) of people with ID. Future investigation of SFC, preferably using a randomized controlled design, could test the hypothesis that SFC can increase self-efficacy and proactive thinking in teams, can positively alter staff's perceptions of people with ID, and that teams find it a useful approach. [ABSTRACT FROM AUTHOR]