Behaviour modification in mental deficiency nursing

Abstract

The conventional custodial approach in mental deficiency nursing is no longer appropriate, according to current policy, to the needs of mental defectives. Behaviour modification is singularly effective in overcoming behavioural problems and deficits associated with mental deficiency. The present research investigates some implic¬ ations of behaviour modification for mental deficiency nursing. An experimental study evaluated the effectiveness and practic¬ ability of the implementation, by nurses, of a behaviour modification toilet training programme for a group of low—grade mental defectives in a typical institutional environment. Twenty-seven of the thirty-five patients involved achieved a reduction in incontinence and acquired an improved level of independent toilet behaviour. The overall prevalence of incontinence in the ward decreased as did the amount of linen used due to incontinence. Most patients evidenced an acceleration of progress in general level of functioning concurrently with the toilet training period. It appears that response generalisation may be an effect of specific training. A replicative experiment, involving the original control group as subjects, achieved similar results in all respects. Long-term evaluation produced no evidence of regression to pre-training level of performance. The study suggests that behaviour modification toilet training provides an effective, enduring and practicable solution which could be applied by nurses to the considerable problem of incont¬ inence in mental deficiency hospitals. A survey study ascertained the nature and extent of nurse involvement in behaviour modification. Nurses in the majority of mental deficiency hospitals in Scotland were found to be involved in a variety of behaviour modification activities. These activities are discussed and aspects of the role, function and training of nurses in behaviour modification are discussed. It is concluded that behaviour modification can make a significant contribution to the development of a therapeutic component in mental deficiency nursing.