Recommended Policies
Policies are a set of rules or guidelines for an organization and employees to follow to achieve a specific goal, in this case, addressing challenging behavior. An effective policy should outline what an organization, executive, administrator, professional staff (i.e., clinical supervisors), and/or direct care employees must do or not do and will provide directions, limits, principles, and guidance for decision making. Any organization that provides services to assess, treat, and/or to otherwise manage challenging behavior should develop their own policies with attention to relevant federal, state, and local statutes and regulations. The intention of this document is to serve as a model.
Behavioral Treatment Policy
1. Guiding Principles for Behavioral Treatment for Challenging Behavior.
Behavioral treatment refers to interventions aimed at producing lasting behavior change, including those that prevent or reduce the occurrence of challenging behavior. Behavioral interventions should be applied in a manner consistent with established ethical guidelines, and in accordance with best practices. Treatment plans should be:
- developed in collaboration with caregivers
- individualized
- minimally restrictive
- based on assessment findings
- developed and implemented by appropriately trained and credentialed professional staff
2. Recommended Policies for the Development, Application, and Monitoring of Behavioral Treatment
Organizations should develop policies to ensure behavioral treatments are applied in accordance with the guiding principles described above. Organizations should hire qualified professional staff and develop and provide knowledge and skill-based training to direct care staff working with clients or students to ensure competency. Policies should ensure that:
- Professional staff who are responsible for developing behavioral treatment plans are qualified by training and experience.
- Direct care staff responsible for implementing behavioral procedures are regularly trained, and their competency is documented. The organization provides supervision, oversight, and training to staff who implement behavioral interventions with clients or students.
- Informed consent is obtained from caregivers with decision making authority.
- Behavioral interventions are developed and applied in a manner consistent with best practices.
- Behavioral treatment procedures are clearly described and objectively monitored for safety by qualified professional staff.
Crisis Management Policy
1. Guiding Principles for Crisis Management
Crisis management refers to a particular type of management that is more reactive when challenging behavior has escalated to crisis levels and risks are imminent. Crisis management is warranted or medically necessary given the severity of behavior and immediate risks, after lesser interventions have been tried and failed, or are deemed insufficient. Crisis management procedures are not a replacement for an individualized treatment plan but are used in addition to treatment when the need arises.
2. Policies for the Development, Application, and Monitoring of Crisis Management
To ensure safe and effective management, organizations must adhere to the policies outlined for behavioral treatment in addition to specific crisis management policies summarized below. The organization develops policies to ensure that:
- Crisis management procedures are developed by professionals with special expertise on crisis management procedures.
- Procedures are utilized in crisis situations for dangerous or harmful behaviors that occur at unpredictable times and place the individual or others at risk for injury.
- Crisis management procedures are applied as a safety measure and used according to well-defined, predetermined criteria.
- Crisis management procedures are implemented by staff who have been trained and demonstrate competency in their application.
- Use of crisis management procedures requires informed consent.
- Use of crisis management procedures are clearly documented and objectively monitored for safety.
