How the RNID would assess Stephen’s behavior
Stephen has an intellectual disability and thus requires RNID care. The RNID is a registered expert proficient, and fortified, to act as a chief professional, mentor, promoter, tutor, and friend to the individual with an intellectual disability while offering a suitable assortment of specialized care, training, management, and support (McCarron et al., 2018). Significantly, the assessment procedure should consider various aspects that may cause physical, mental, or psychosocial harm to Stephen. In the assessment of the challenging behavior, it is crucial to note that the convolution and interval of the assessment progression are proportional to the rigorousness, impression, occurrence, and extent of the conduct. The RNID intricate in conveying assessments should comprehend the principles for moving to a more multifaceted and concentrated evaluation. For instance, by intensively assessing the vocabulary that Stephen uses and understands. The RNID should account for all present and previous individual and environmental aspects such as care and informative sceneries that may lead to challenging conduct that Stephen is encountering. Assessment is adaptable and ongoing while not a rigid course, since elements that prompt and uphold behavior may change over time. The RNID should therefore review valuations after any substantial modification in behavior (Sheerin et al., 2019). All the assessments should be dedicated to the upshots of decreasing challenging behavior.
The main assessment of Stephen would commence upon diagnosis and link the main conversion intervals to every phase of life advancing into the dusk existences. The assessment is more effective when carried out based on the age of the patient (Carey et al., 2022). For instance, according to the case study, Stephen is nineteen years old and thus he needs care that can help him transition from adolescence to early adulthood. The RNID can play the role of an activist to enhance appropriate scheduling to meet the extent of necessity. This would enhance more self-care programs that aid in managing the condition. The RNID may also complete assessments for, accurate settlement suitability, advanced education, operational daycare, and structured work placement as well as impart realistic life skills such as using automobiles securely, money management skills, and equal rights (Atherton and Crickmore, 2022). For instance, the RNID can assess Stephen’s likes and dislikes to ensure he does not feel frustrated due to a lack of understanding.
The RNID may also carry out regular risk assessments for Stephen. During the assessment, the RNID should review the probability of the patient harming others. For instance, Stephen has a behavior of biting others and throwing items that can cause harm to people. The RNID should therefore evaluate what triggers the patient to carry out such actions. The health professional should also assess any risk chances of suicidal ideation, personal harm, and self-injury (O’Dwyer et al., 2019). Additionally, a review of any prompt intensification of the challenging behavior is necessary. Efficient assessment of behavior is typically approved through consciousness and behavior help groups. This investigates the role of conduct in the perspective of its experiences and magnitudes. Following the preliminary assessment, it is vital to progress a formulation. That is a written statement that sets out apprehension of what has resulted in the challenging behavior and the purpose of the behavior. This will support in ensuring that appropriate care is given to Stephen and progress is noted. It would be used to progress the behavior support strategy (Botha et al., 2021).
Interventions the RNID should implement to support Stephen
A medication evaluation is also crucial. Succeeding a detailed assessment and eradicating physical and psychosocial aspects that demand to be tackled, and RNID may also require medication. The RNID can consider medication assessment to manage the challenging behavior if the other intermediations only do not result in transformation within a specific set period. The healthcare expert may also assess any synchronized complications that may participate in the retention of the challenging behavior. Additionally, if Stephen’s risk of harming others is quite mild, the expert should assess the best medication to incorporate into the management process to minimize aggression and any cases of self-injury. The healthcare expert should therefore review on suggesting new or any supplementary prescription that is contemplated useful (Doyle, 2022). When deciding on which medicine to provide, the RNID should assess Stephen’s preference or that of the close family as well as the side effects. The RNID should also review if there is any response to previous treatment and the interaction of the prescribed medicines with any other medication that the patient might be using. Therefore, during the medication trial, the specialist should; agree on a portion to monitor efficacy, recognize the aimed behavior and commence with a little dose and use the lowest operative dosage required (Doody et al., 2021).
Dialectical Behavior therapy (DBT) apprehends behavioral complications regarding the biosocial theory. Conferring to biosocial theory person’s expressive dysregulation is a result of the biological susceptibilities that they have alongside contact in an undermining environment. The RNID should therefore implement DBT in their care plan for Stephen. Individuals with intellectual disabilities are over-represented concerning psychiatric disorders. The health care expert should consider the patient’s session. This may include learning simple language terms and simple knowledge regarding his condition (Pearson et al., 2021). The learning will progress Stephen’s level of communication and thus advance his way of expression. Individual therapy will also help the patient elucidate unclear and maladaptive views about himself regarding emotional control. This will be much helpful to Stephen who gets frustrated when he does not get attention. In DBT the responsibility of the RNID (therapist) is to assist the patient to obtain skills and aid the advancement and emphasis of skills. The RNID should act as a cheerer every time (Bemmouna et al., 2021). For instance, Stephen enjoys using various vocabulary when motivated. Therefore, inspiring him will help in the progression of communication. The RNID should avoid judgmental instances when the patient acts inappropriately.
The RNID should also involve Stephen in group activities. Group training sessions can be regularly organized to improve the patient’s interpersonal skills. The DNID should encourage group physical activities that will keep Stephen engage and help in averting his challenging behavior. In the DBT sessions, the therapist should educate the dangers and risks of injury that may result from biting and throwing items (Jones et al., 2021). This could hurt him or the people around him. Alternatively, the RNID should give the patient more interesting play games other than throwing objects and grabbing people. Moreover, the DBT is entirely patient-centered. The nurse should therefore listen to and validate the patient’s concerns. For instance, the therapist can ask the patients which therapy skill they have used in the session and the one they feel is helpful to them. Through these dialogues, the therapist should easily the therapy program and redirect the patients on the failed behavioral achievements. DBT is therefore beneficial to individuals with intellectual disabilities in several ways. First, DBT is a skills-oriented ideal that is dependable on psycho-educational and habilitative practice. Secondly, DBT is essentially non-judgmental in its language and optimistic in its ambitions without reproaching the casualty. Finally, DBT has a durable emphasis on training persons to advocate for themselves within the coordination of benefactors which is reliable with values of confidence, unconventionality, inspiration, and self-advocacy (Ritschel et al., 2022).
Interpersonal art psychotherapy is an intervention regarding practice-oriented analysis of a patient with intellectual identity. The therapist gives directions in detail on the therapy approach. The RNID should organize at least fifteen therapy sessions for the whole process. The sessions may take approximately an hour. The therapist should therefore discuss and introduce the therapy content to Stephen and a guided art activity (Hackett et al., 2020). For instance, the RNID can include drawing activities in the therapy to keep Stephen active and aver the behavior of biting. This will also enhance his reasoning and remembrance. Preliminary treatment sessions emphasize helping the patient to recognize instant complications followed by ascertaining their prevailing progressive coping proficiencies and how they are being utilized. It also involves introducing extra handling abilities if required. The patient is later asked to provide justifications of their relations and instances of social interfaces (Hackett and Aafjes-van, 2019). The RNID should then ask the patient to think about existing or previous occurrences and draw representations of them to support the conversation with the counselor.
This therapy is also useful in verbal comprehension. This denotes the aptitude to comprehend and use written and articulated language, tap into overall realization, and contemplate intellectual impressions such as time, distance, and direction. These proficiencies permit an individual to participate in a series of daily discussions and social relations. It also helps one to obey guidelines and recognize the necessities of others as well as communicate their own needs. Therefore, individuals with intellectual disabilities require support in these sectors. Since Stephen has limited verbal communication, adapting written materials by adding pictures or symbols to make the meaningless abstract enhances the learning of language (Dew et al., 2019). Attentional coordination is also achieved in interpersonal art psychotherapy. Within the therapy sessions, the therapist should include additional guided activities. The principles for evaluating the suitability of the attentional circumstance may include the partaker’s discernment of the relevance of the intervention for directing the target difficulty and disposition to follow treatment (Safonicheva and Ovchinnikova, 2021).
An intellectual disability affects an individual’s normal life and they are unable to operate independently. The family is involved in their day to day activities and it is also affected by the behavior of their family member (person with intellectual disability). Family members secure the well-being of the patient (Ruth 2018). It is therefore important to involve the family members in Stephen’s care plan since he requires support in various circumstances. Stephen depends on his family for various self-care needs. They may help him with transportation, attending school, and the healthcare visits. His family associates may help in giving any prescribed medicine and also keep him company when he is not in the community group home. Stephen has a problem with verbal communication. This may be a barrier when communicating to the RNID or other health care specialists. The family members may be therefore required to speak on his behalf for the better conveyance of the message. The family members will therefore assist in informing the RNID about Stephen’s present and pre-existing health conditions. In the case of medications, the family members help in giving the patients the prescribed medicine as well communicating to the specialist on any recognizable side effects regarding the medicines (Chinn, 2020).
Family members also provide emotional and moral support to patients who are intellectually disabled. For instance, Stephen and his family have a close relationship. This is so significant in the care process since it will enhance easy coping skills (Shalaby and Agyapong, 2020). Family members also need to be involved in Stephen’s care process to accompany him in various social activities to facilitate his maximum participation in the therapy activities. Another benefit of involving family members in the patient’s care plan is to enable any required payments in case of supplementary services since Stephen is not in a position. Stephen’s parents can also extend the counseling process in absence of the RNID. This collaboration is also beneficial to the family members. It helps them advance their character traits such as patience, empathy, compassion, acceptance, and positive perception regarding other people with disabilities (Scholten and Gather, 2018).
References
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