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Responding to Unwanted Behaviors & Motivating Clients in Therapy

presented by Rob Winningham, Ph.D.

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Disclosure Statement:

Financial: Rob Winningham has a financial relationship with Scientific Advisor for Linked Senior, Speaker/Teacher for Activity Connection, Speaker and content developer for Masterpiece Living, and Partner with Northwest Rehab & Wellness who products and services are mentioned in this course. Rob Winningham receives compensation from MedBridge for this course. There is no financial interest beyond the production of this course.

Non-Financial: Rob Winningham has no competing non-financial interests or relationships with regard to the content presented in this course.

Satisfactory completion requirements: All disciplines must complete learning assessments to be awarded credit, no minimum score required unless otherwise specified within the course.

MedBridge is committed to accessibility for all of our subscribers. If you are in need of a disability-related accommodation, please contact [email protected]. We will process requests for reasonable accommodation and will provide reasonable accommodations where appropriate, in a prompt and efficient manner.

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Motivation is possibly the best predictor of therapeutic success among older adults with or without cognitive impairment. However, most therapists and practitioners have very little training in the psychology of motivation and how to maximize it. In this course, we will explore factors that affect motivation, including depression. Theories of motivation that can be used to design many interventions to maximize patient motivation for and engagement in the therapeutic process are discussed. Caregivers and medical professionals need as many tools as possible when it comes to reducing unwanted behaviors commonly seen in people who have dementia. We will discuss how memory ability and behavior affect the level of care needed and how to manage behavioral challenges to maximize independence and safety. Using the knowledge of these cognitive and behavioral changes, many techniques will be offered for preventing and responding to emotional outbursts and behavioral problems (e.g., redirection, knowing the person, music therapy and other more). This course is the fifth of a five-part series.

Meet Your Instructor

Rob Winningham, Ph.D.

Dr. Rob Winningham has 25 years of experience researching human memory and has largely focused on older adults and ways to enhance their mental functioning and quality of life. He creates brain stimulation activities for over 10,000 retirement communities and rehabilitation facilities as a part of Dr. Rob's Cranium Crunches on activityconnection.com and helps create…

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Chapters & Learning Objectives

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1. Depression in Older Adulthood

It is a myth that all older adults are at increased risk of depression. Risk factors for geriatric depression and common treatment options are explored in this chapter, along with the effects of depression on cognitive abilities.

2. Bandura’s Motivational Theory

Motivation is highly correlated with ultimate therapeutic outcomes. We will explore one of the most useful theories of motivation and introduce how therapists and other professionals can use it to develop short-term motivation strategies that help to improve clients’ beliefs that they can do the necessary work. The idea that clients need to be aware of the benefits of doing specific therapeutic exercises is introduced. One of the best predictors of a client’s success is their self-efficacy, or their belief that they can do something and attain a desired outcome. We will discuss the concept of self-efficacy and ways to improve a client’s self-efficacy for therapy.

3. Outcome Expectations (What’s in it for Me)

Whether or not someone is willing to do some behavior is, in part, determined by their knowledge of the benefits of doing that behavior. We will discuss how to connect the therapy exercises to functional goals and outcomes that the client wants. Strategies for how therapists and other professionals can better explain why exercises are being prescribed are provided. There are other tools that professionals can use to maximize motivation. They can point out the consequences for not engaging in therapy. Practitioners can also benefit from asking clients to report the frequency and duration of home exercises. Caregivers can also be used to maximize motivation and therapeutic outcomes.

4. Behavioral Management Strategies: Executive Functioning Enhancement

Unfortunately, people with dementia and traumatic brain injuries often engage in behaviors that can negatively affect their quality of life. Caregivers and staff members are often unsure how to handle unwanted and challenging behaviors. In this chapter, we will look at how executive functioning mediates behavior and use that to develop intervention strategies so people can better inhibit unwanted behavior.

5. Behavioral Management Strategies: Retrogenesis and Redirecting

Often times people with more advanced cognitive impairment will be living in the past and have even lost more recent memories. We will discuss these phenomena and how this process usually abides by the principles of retrogenesis. We will then discuss interventions designed to redirect attention by taking advantage of what the person remembers and comprehends. The goal will be to reduce unwanted behavior and the need for pharmaceutical interventions.

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