Managing Challenging Behaviour of People With Acquired Brain Injury in Community Settings: The First 7 Years of a Specialist Clinical Service

Abstract

This article provides a review of the development and clinical practice of the ABI Behaviour Consultancy (the ‘Consultancy’), a specialist clinical service that provides outreach behaviour management support across the state of Victoria, Australia, to people with acquired brain injury (ABI) and their social network (i.e., family members, friends, support workers, and therapists). The Consultancy is a small, unique service that has developed ways of providing behaviour management strategies in community settings, despite the difficulties presented by changing and uncontrolled environments. The aim of this article is to provide a detailed account of this service. Information from the first 7 years of full operation, 1998 to 2004, is presented, during which a small number of psychologists saw more than 800 clients. A detailed description is given of behaviours referred and associated risks, assessment procedures, intervention approaches, and research activity. A variety of key service aspects are detailed, including the qualifications required of specialised staff, the service funding levels, and funding and service issues. These detailed accounts of service delivery are placed in the context of several major themes: specialist versus generalist services, the deployment of targeted interventions throughout the lifespan of a brain-injured individual, the role of specialist behaviour management services in the continuum of brain-injury support services, and broader equity issues.