The safe management of physical aggression using multi-element positive practices in community settings.

Background: Behavioral strategies often are used with people with acquired brain injury. Most involve the application of contingent reinforcement and punishment for selected behaviors or teaching important skills to overcome the challenging behaviors. However, consequential intervention and other strategies that depend on new learning may be precluded when working with individuals with significant short-term memory impairment.

Main Outcome Measures: The present case study reports the results of non-consequential strategies based on a positive, multi-element model to address physical aggression and other related problems for such an individual.

Results: Support did not involve the use of aversive consequences for challenging behaviors nor the use of physical management/restraint. The identified problems were effectively and safely addressed and community living in close proximity to his family was maintained.

Conclusions: The implications of this approach for the support of people who face similar challenges are discussed, including the ability to address serious problems such as physical aggression without resorting to aversive procedures.