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A change in behaviour – Breaking the cycle of power and control

In health and social care settings, staff, managers and relatives can sometimes perceive the behaviour of a person being supported as a problem to be controlled or ‘managed.’  This is particularly true in dementia care. 

In reality, behaviours which challenge are not a specific feature of dementia or any other illness or disability, but a way in which all human beings communicate.

In this course we will help you explore how we can change our perspective of behaviour, focussing on it as an expression of emotions or needs.  We can then explore ways of responding to these feelings in a more person-centred way.

The course will also explore ways in which care settings can both unconsciously and, at times consciously, exert power and control through the language used, the environmental features and the actions and approaches of team members and families.

This training course also explores a range of theories, models and tools that have the potential to break the damaging cycle of behaviour and control. 

Whilst the content and example in this course have a strong focus on dementia care, there is much which will be relevant to the care of people who have learning disabilities or people living with mental health needs.

This learning package aims for you to:

Specific learning aims:

  • Be aware of how we all have behaviours that others may perceive as ‘difficult,’ ‘challenging’ or ‘a problem.’
  • List typical behaviours that you may find difficult and assess why this may be the case.
  • Explain how the concepts of power and control relate to how people behave, particularly in institutional settings.
  • Describe what is meant by a ‘malignant social psychology’ and the ways in which we can ‘detract’ from or ‘enhance’ someone’s sense of self.
  • Assess the level to which controlling words, actions and environmental features are prevalent within the care culture in your care setting.
  • Explain 8 communication strategies which can be used in situations where a person is confused about reality or experiencing distress.
  • Describe the origins of the medical model in response to behaviour in dementia care and its influence on people with dementia and others.
  • Identify controlling words and actions that can occur in care settings and how they can impact on people we support
  • Explain the concept of ‘behaviour as a gift’ and an opportunity to understand how a person living with dementia may be feeling.
  • Become more like a detective and discuss what may lie behind common behaviours
  • Recognise the impact of perception and how this can lead to assumptions or impact on our judgement
  • Compare how we might react or respond to situations and the difference between focussing on what we can influence, rather than the problem/concern
  • Be more confident that you probably already have many transferable skills for responding to difficult situations
  • Recognise the potential benefits and drawbacks of using medication to address expressions of emotion and behavioural responses in dementia or other physical and mental health conditions
  • Develop your understanding of attachment theory and be aware of how behaviours can be expressions of insecure attachments and feelings such as fear, anger and loss.
  • Describe and apply a variety of different approaches and strategies for helping people who sometimes avoid or resist your help.
  • Choose from a selection of theories, models and tools about responding to behaviours. You will summarise and contrast at least two in the context of your own care practice and experience or apply one of the approaches to a situation in your own work.
  • Recognise a range of ways in which we can restore voice, choice and power to and for the people we support.
  • Choose 3 strategies to respond to specific behaviours you may find difficult and evaluate the results
  • Create your own action plan for moving forward and put your learning into day-to-day practice in your care-setting.

How long does it take?

Duration: Approximately 28 hours

There are eight learning modules set out for you and one Action Planning exercise to complete.

Each learning Module should take approximately 1.5-4 hours to complete including the reading. You may want to complete the ‘Assessment: Post-Module Reflection and Learning Log’ (approximately 15-20 minutes) at the end of each module prior to moving on to the next module.

This will help towards your final Action Planning at the end of the course.

Overall, it should not take more than 28 hours to complete all eight modules.

Continuing Professional Development – This course has been submitted for accreditation from the Continuing Professional Development Standards Office ( The application will be for 24 hours of digital learning and will be recognised worldwide. To qualify,you will need to complete the course and submit your action plan to Meaningful Care Matters, and we will send a certificate of confirmation of your work.

The primary aim for you as learners is to effectively apply the principles from this course in your workplace environment and provide person-centred care.

You will see core links/references/videos/podcasts that are key to your learning, and you will see additional resourceswhich are there for you to access should you wish to build upon your learning.

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