Individuals with acquired brain injury (ABI) may present with challenging behaviours (CB) that place themselves and others at risk of harm and impact their community integration. It is crucial for community ABI therapists to successfully train in and implement behaviour interventions. The current study aimed to investigate community ABI therapists’ experiences of using, training in and implementing behaviour interventions. An additional aim was to determine these therapists’ understanding of Positive Behaviour Support (PBS), one approach to addressing CB with a focus on improving quality of life.

Semi-structured interviews were conducted with 24 Australian community ABI therapists about their experiences of using, training in and implementing behaviour interventions and understanding of PBS. Inductive thematic analysis and content analysis were performed on interview transcripts.

The thematic analysis resulted in the generation of six themes which described the difficulties participants faced in training in and delivering behaviour interventions and identified their training and implementation needs. The content analysis resulted in 10 categories that characterised participants’ understanding of PBS, which centred around the absence of consequences, a focus on antecedents, person-centred practice and encouraging prosocial alternatives to CB.

The findings highlight a need and desire for more practical and interactive clinician training in behaviour interventions for individuals with ABI. Moreover, the findings suggest a limited understanding of PBS amongst community ABI therapists. Important considerations for the development of clinician training in ABI behaviour interventions and subsequent implementation into community practice are discussed.

Individuals with acquired brain injury (ABI) may experience persistent and distressing challenging behaviours (CB), and therefore, effective delivery of behaviour interventions is crucial. This study aimed to investigate community ABI therapists’ experiences of using, training in and implementing behaviour interventions with a focus on Positive Behaviour Support (PBS).

A sample of Australian community ABI therapists (n = 136) completed an online survey about their experiences with behaviour interventions, including PBS. Data from open-ended questions were analysed using content analysis. Frequency and descriptive statistics were computed, and a multiple regression was performed to determine factors predicting readiness to learn and implement new behaviour interventions. Rank-based non-parametric tests were conducted to investigate the influence of clinical role on experiences with behaviour interventions and training preferences.

Consistent with PBS, participants indicated that the following were important in addressing CB: teamwork and collaboration, person-centred practice, working with antecedents, environmental modification, improving quality of life and skill-building. Despite a high level of desire and readiness, 80% of participants reported facing barriers to learning and implementing new behaviour interventions (e.g., lack of time). Participants’ confidence in using behaviour interventions (β = 0.31; p = 0.002) and the number of barriers faced (β = −0.30; p = 0.002) predicted their readiness to learn and implement new behaviour interventions. Confidence, duration of past training in behaviour interventions and preferred duration of future training did not differ based on clinical role.

Implications for the development of training in behaviour interventions such as PBS and implementation into community practice are discussed.

To describe the characteristics and progress of the first 50 patients with severe and enduring mental illness who accessed inpatient rehabilitation services in Dublin North East Mental Health Service between 2001 and 2006.

Retrospective collection of data on the first 50 inpatients from case notes and staff interviews. Data included demographics, psychiatric history, results of rehabilitation interventions and assessment tools. The results were compiled and analysed using descriptive statistics.

Fifty patients were identified. The majority were male (68%) with a diagnosis of paranoid schizophrenia (60%). The levels of co-morbid alcohol and drug misuse were 40% and 30% respectively. Histories of verbal/physical aggression were found in 92% and impulsive behaviour in 70%. The majority of patients had a past history of being detained under the Mental Treatment Act (1945). High levels of co-morbid physical health problems were identified. New long-stay (NLS) patients showed a trend towards requiring the shortest admissions prior to being ready for discharge to lower levels of support.

One third of patients moved on to reside at lower support levels and accessed vocational training programmes following active inpatient rehabilitation interventions. However, there remained a cohort of patients who required prolonged inpatient admissions due to their high levels of disability. This study further highlights the need to ensure that a range of rehabilitation services from inpatient to supported community placement are provided to meet the needs of patients with severe and enduring mental illness with complex needs.