This blog post is based on a webinar by Simon Holding, Adult Care Lead at Team Teach. Watch the recording of the webinar here.
Triggers are virtually impossible to avoid and, at some point, we all have a strong reaction to certain environments, situations, people and words. But what exactly is a trigger? In a nutshell, a trigger can be thought of as a cue, prompt or call to action that results in powerful emotions such as anger, fear or frustration.
It is tempting to view triggers in a negative light and try to reduce the chances of exposure to them in both our personal and professional lives. But what if we were to reframe them as experiences instead? And how could this help us to better support the individuals in our care to lead full, happy, and rich lives?
Behaviour management vs behaviour support
In our varied educational and health and social care settings, there are times when the individuals we care for can become triggered, resulting in behaviours that need support. Our natural instinct as professionals is often to try and protect the individual and prevent a behaviour from happening by interrupting, anticipating, and avoiding known triggers where possible.
Depending on our context, we put a variety of strategies in place to try and manage behaviour triggers, if and when they occur: guiding individuals to different rooms or spaces, distracting and redirecting, offering suggestions and alternatives, and avoiding certain environments altogether.
There is no doubt these practices can be effective and, of course, where safety is concerned, there are times when we need to manage behaviour triggers, especially when making a dynamic risk assessment and recognising a risk.
The ‘ARE’ response
However, an avoid, reduce, and eliminate response (ARE) is usually only successful in the short term by helping us to manage a person’s feelings and behaviour. If triggers are continually avoided, reduced or eliminated, then we run the risk of denying individuals the opportunity to grow their tolerance in different situations and be exposed to new and exciting experiences.
Instead, in the longer term, we perhaps need to shift our perspective of triggers and develop ways to use them as a vehicle to support the individuals in our care.
The speed camera analogy
When thinking about behaviour management compared behaviour support, a useful analogy is that of a speed camera: when we see a speed camera on a road, we immediately check and alter our speed to comply with motoring regulations. However, once we have passed the camera, we tend to revert back to our usual driving style.
In that respect, it could be argued that while speed cameras are an effective way of managing our behaviour as drivers, they don’t always support or encourage lasting behaviour change.
The question is: how can we reframe triggers in a positive way and use them to support behaviour in the longer term?
Reframing triggers as experiences
Triggers are a valuable source of information. Rather than labelling them as negative, it can be helpful to reframe them as experiences, and to use these experiences to support individuals. This shift in language and thinking allows us to ask ourselves questions like:
- How can I positively influence this experience?
- What can I do to support this person’s feelings during this experience?
- How might this help the individual to grow and develop their tolerance?
- Which behaviours might I expect to see as a result?
- What opportunities are there to reduce the intensity of the reaction?
Consider an individual who finds transitions difficult. It is not necessarily the transitions themselves that are tricky; it is the feelings they cause that can be hard to navigate.
Over time, and guided by an emotionally available professional, gradual exposure to transitions and appropriate use of support tools such as ‘now and next’ boards provides the opportunity to reduce the intensity of the reaction and behaviour.
It is vital to involve the individual as much as possible when working on triggers, and to capitalise on time when they are regulated, to slowly increase exposure. Handled sensitively and patiently, we can change the perception of the trigger, downgrade the severity of the response, and enable individuals to tolerate more and more each time.
We must also remember to involve other agencies and recognise when specialist support is needed. We must work together as a team in a planned way, rather than attempt to “go it alone”.
Recording, reviewing and using information
Adopting a wholesale approach to reframing triggers as experiences can be key to supporting individuals’ feelings and behaviour in the long term. This strategy starts with leadership and should permeate every level of an organisation if it is to be successful. Once information has been recorded, we need to be asking questions about how we are using it in our daily interactions.
It is also crucial that we revisit and review information, such as care plans, on a regular basis as triggers can change and evolve over time. For example, it could be that an 8-year-old child finds noisy environments challenging, so this information, quite rightly, is noted on their record or care plan. However, it might be the case that, over subsequent years, this issue becomes less and less problematic for them, but the record is not updated. On paper, at least, that same individual is still triggered by noise but, in reality, this is no longer the case.
Out-of-date information may skew how staff and other professionals interact with an individual and may, unwittingly, perpetuate a situation that is no longer relevant. By regularly reviewing and updating our information, we can ensure we are in the best position to support those in our care.
The key to building agency and autonomy
Of course, there is no silver bullet and there are no quick fixes when it comes to reframing triggers as experiences. It takes patience and persistence, along with buy-in across all members of our organisations.
But when we approach the process in a structured, planned and gradual way, with the consistent involvement of all stakeholders, the benefits are numerous:
- Downgrading the severity of a reaction
- Reducing, or even eradicating, behaviours that need support
- Reducing the likelihood of incidents
- Forging strong relationships built on mutual trust
- Fostering a positive approach to behaviour support
- Developing individuals’ agency over their own lives
- Building individuals’ capacity and confidence to respond differently
By embracing triggers and reframing them as a positive, integral part of behaviour support rather than behaviour management, we empower the individuals in our care, helping them to access rich and enjoyable experiences.