No abstract

The effect of a brief in‐service training programme on the psychosocial management of behavioural disturbance in residential care is described. Although the incidence of problematic behaviour did not change 3 months after training, staff in the experimental homes reported a significant improvement in their management of problematic behaviour, as compared to the control home. However, these effects were not maintained a year later. The importance of post‐training supervision and the sociocultural context of the home in the maintenance of psychosocial intervention in residential settings is discussed. © 1998 John Wiley & Sons, Ltd.

Some, but not all, 'trained' CMHNs used the PSI to help family carers reduce behavioural problems. A relatively long but not intensive PSI of 12-18 months was needed to moderate carer mood. Dementia-specific practice arrangements, training and sustained clinical supervision are important for the delivery of effective psychosocial interventions in dementia.

The CBS is quick to complete and may have potential for the evaluation of psychosocial interventions in care settings. It is, as far as we know, the first staff observational rating scale that is based on the reports of care staff, who constitute the backbone of residential care provision. Suggestions for improvements in criterion and content validity are outlined.

Psychosocial interventions in five people, who presented with uncooperative and difficult behaviour at mealtimes and during assistance with self-care tasks, are described. In four cases, a single case experimental design was used. The results are discussed in the context of 'rementia' and a broadly defined functional analytic perspective to assessment and intervention. In contrast to the standard neurogenicdisease paradigm, a person-centred holistic model of dementia is proposed for the understanding and amelioration of distress in people with dementia who are seen as difficult or 'challenging'.