Jan 17, 2021
CCFP Key Topic 11 - Behavioural Problems
Written By: Chris Cochrane
Reviewed By: Kajsa Heyes
Objective One:
In all patients, when
working up a behavioural problem:
a) Ensure a thorough
assessment of medical and mental health conditions and psychosocial
factors before offering a diagnosis or definitive
advice
b) Use a validated assessment tool if
available
c) Use multiple sources of
information (e.g., workplace, family, school) with
consent
d) Explore the patient’s own
perspective, not just that of the caregiver
Objective Two:
In assessing
behavioural problems in adolescents specifically look for substance
use, peer issues, abuse, and other stressors.
Objective Three:
While assessing
behavioural problems in a patient,
a) Evaluate the impact of the behaviour
b) Explore any underlying emotional distress with the patient
c) Destigmatize embarrassing behaviours
Objective Four:
When making a
diagnosis of a behavioural problem in a patient,
a) Avoid premature labelling of a behaviour as a disorder
b) Follow up with support and regular visits until the situation is clearer and any therapeutic requirements are more evident
Objective Five:
When managing
behavioural problems:
a) Assess and address immediate risk for the patient and others
b) Do not limit treatment to medication; address other dimensions (e.g., do not just use amphetamines to treat ADD, but add social skills teaching, time management, etc.) and match to available community resources
Objective Six:
When there is a
challenging relationship with a patient with behavioural problems
maintain a continuous, therapeutic, and non-judgmental relationship
with the patient and family.