MH49 Enable people who are a risk to themselves and others to develop control


This standard covers challenging behaviour that causes problems to the individual or others and helping individuals to develop a greater degree of understanding and control within agreed boundaries of behaviour.

This standard is about challenging behaviours and helping to develop control through day-to-day interactions with individuals.  This standard applies to those who work with individuals with mental health needs who are at risk to themselves or others because of their behaviour.  The behaviour may be aggressive, abusive or criminal.

Users of this standard will need to ensure that practice reflects up to date information and policies.

Version No 1

Knowledge and Understanding

You will need to know and understand:

  1. research on methods of working with people whose behaviour creates difficulties, and the outcomes
  2. theories on the causes and origins of violence and aggression
  3. individual’s and group’s need(s) and your role in maintaining boundaries
  4. approaches to engaging reluctant, aggressive and withdrawn individuals
  5. the impact of behaviour on significant others, local people, the public and yourself
  6. methods of challenging behaviour which creates risk and research on their outcomes
  7. techniques and resources to promote learning and alternative behaviour and monitoring change and the participation of individuals and carers in planning and evaluation
  8. theories of behaviour and learning
  9. group processes and peer support and development
  10. statistics on the incidence of violence, aggression, depression and social isolation amongst individuals with different mental health needs, e.g. dementia, schizophrenia
  11. current guidance on restraint and control
  12. methods of planning and providing feedback
  13. negotiation methods and skills
  14. identification of conflict and skills in conciliation
  15. change in identity, relationships and processes of coping with these
  16. the rights and responsibilities of individuals
  17. methods of setting up boundaries and exercising control and their effectiveness with individuals with different mental health needs
  18. reporting and recording systems for agencies, courts and allied agencies
  19. support needs of workers
  20. the range of support and advocacy services available to individuals whose behaviour causes concern
  21. the impact of individual and structural discrimination on identity and approaches to increase options and promote positive identity
  22. impact on people’s relationships and options
  23. research and outcomes of intervention and support aimed to reduce risk and need to enhance coping skills in different contexts
  24. explanations of delinquent and criminal behaviour and research on outcomes of different forms of intervention or non-intervention, including
    1. criminal behaviour
    2. re-offending
    3. sexual, physical and racial abuse
    4. violence
    5. suicide
    6. delinquency
    7. mental health
  25. how different factors contribute to behaviour, including
    1. past history
    2. stress factors
    3. lack of understanding of information
    4. dysfunctional coping mechanisms
    5. prejudice and stereotyping
  26. political views and policies on groups or types of behaviour which present a social risk
  27. group work, peer learning and self-help
  28. the rights and responsibilities of individuals and groups
  29. methods of identifying and understanding the impact of self and behaviour on others

Performance Criteria

You must be able to do the following:

  1. explore and assess aspects of behaviour which create risk to the individual or others
  2. take full account of cultural, religious or other factors which may influence the individual’s behaviour
  3. correctly identify boundaries and expectations which will minimise unwanted behaviour and encourage positive behaviour
  4. establish boundaries and expectations of behaviour that are realistic and contribute to safeguarding the individual and others
  5. fully discuss the boundaries and expectations and their significance with the individual and encourage their support and agreement.
  6. identify examples of positive aspects of behaviour which correspond to agreed expectations as they occur and explain them in a manner which the individual is likely to understand
  7. provide positive reinforcement in such a way as to encourage the repetition of positive behaviour
  8. correctly identify behaviour which exceeds agreed boundaries and take constructive action to minimise it
  9. request an appropriate level of support when maintaining boundaries becomes difficult
  10. make interventions consistent with:
    1. the individual’s assessed needs
    2. the risks involved
    3. agreed procedures and policies
  11. take prompt action to protect yourself and others when needed and summon further assistance as soon as practicable
  12. take constructive action to defuse behaviour which threatens others
  13. accurately record incidents of behaviour that exceed agreed boundaries.
  14. develop hypotheses about the individual’s behaviour and the risk which this causes and test these against research, theory and practice
  15. encourage the individual to accept responsibility for their behaviour, to acknowledge the impact it has on others and to face up to the consequences
  16. assist the individual to explore and adopt positive alternatives
  17. encourage the individual to identify factors contributing to their behaviour patterns
  18. take active steps to review these factors and identify appropriate sources of support
  19. accurately assess the needs of victims of difficult, dangerous or criminal behaviour and make realistic plans as to how they will be met

Additional Information

This National Occupational Standard was developed by Skills for Health.

This standard links with the following dimension within the NHS Knowledge and Skills Framework (October 2004):

Dimension: HWB4 Enablement to Address Health and Wellbeing Needs
MH49 Enable people who are a risk to themselves and others to develop control
Final version approved June 2010 © copyright Skills For Health
For competence management tools visit tools.skillsforhealth.org.uk