Treatment methods Behavioural treatments

The communication barrier formed by mental retardation has led to an emphasis on the observable rather than on reports of subjective emotions or perceptions. Behavioural approaches are frequently resorted to as a first unthinking response; the function of a behaviour in a given context is open to misinterpretation. At the same time, increasingly sophisticated and more solidly research-based than other forms of psychiatric treatment, behavioural approaches can produce profound and rapid change.(!> Behavioural treatments are broadly divided into two areas.

1. Teaching appropriate habits and skills. These can include basic skills such as dressing, continence, communication, and establishing a normal pattern of sleep; or, at a more sophisticated level, training in social skills, dating skills, and assertiveness.

2. The unlearning of other maladaptive forms of behaviour.

These two areas are complementary—it is more effective to replace an undesirable behaviour than simply to remove it. Operant, incentive programmes dominate much institutional and offender work. Punishment techniques are effective and in certain situations may be justified. Nevertheless, their use must be governed by ethical issues as well as concern about their effect both on the patient and on the trainer. (2)

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