Challenging behaviour training · Dementia care
Challenging Behaviour Training for Dementia Care Teams
Help your staff understand what distressed behaviour is communicating, respond to the cause and reduce restrictive practice. Built on Pat Hobson's Behaviours that Challenge™ model, first presented at the International Conference in Dementia in 2008.
Enquire for your team
Free live masterclass: Behaviours that Challenge Model case study with Pat Hobson, Monday 2 November 2026, 5:00–6:00 PM GMT, online.
Claim a free seatChallenging behaviour is communication that hasn't been understood
When someone living with dementia expresses distress through agitation, withdrawal, repetition, resistance to care or a physical response, services often call it challenging behaviour. The response then follows the label: manage, contain, redirect, medicate.
PMH's training starts from a different premise: behaviour is information. It may be communicating an unmet need, pain, fear, frustration, confusion or a response to the environment. Staff learn to find the cause and respond to it with compassion, evidence and respect.
“There is no behaviour that challenges that does not have a meaning; it is our inability to understand the significance of that behaviour that is the issue.”
Signs your team needs this
Does your service recognise these patterns?
- Behaviour labelled as 'challenging' rather than understood as communication
- Staff trained in de-escalation techniques without understanding why behaviour occurs
- Restrictive practices used before less restrictive approaches have been explored
- Environmental triggers such as noise, unfamiliar spaces and rushed care going unrecognised
- Care plans that record how often behaviour happens without interpreting its meaning
What staff learn
The five stages of the Behaviours that Challenge™ model
- 1
Observation before assumption
Staff observe and record what is happening before deciding why. When a person becomes agitated, the cause may be pain, the environment, an unmet need or rushed care, not the dementia itself.
- 2
Understanding the person
Behaviour is interpreted through the person's life history, personality, preferences and communication style, so responses are individual rather than generic.
- 3
Recognising triggers
Teams look first at what is within their control: noise, lighting, unfamiliar staff, rushed personal care, institutional mealtimes, isolation and lack of meaningful activity.
- 4
Responding compassionately
Responses are proportionate and person-led, exploring the least restrictive option first, as the Mental Capacity Act 2005 requires. Sometimes the right response is to change the environment, not the person.
- 5
Reviewing outcomes
Every response is reviewed for whether the person's wellbeing improved, not only whether the behaviour stopped. What is learned feeds back into observation.
PMH Academy programmes
Challenging behaviour and restrictive practice training
Understanding Distressed Behaviour in Dementia Care
A specialist programme teaching practitioners to observe, interpret and respond to behavioural expressions using the Behaviours that Challenge™ methodology.
Reducing Restrictive Practice
Teaching organisations to systematically reduce restrictive interventions through structured behavioural understanding, environmental adaptation and rights-based practice.
The model was originally developed for people living with dementia and has been extended to people with complex mental health needs, learning disabilities and autism. For organisation-wide change, PMH also embeds the approach through dementia care consultancy, alongside the Unique Life, Unique World Unique Environment™ framework.
Reviewed by PMH Consultancy and Education, October 2026.
Challenging behaviour training
Challenging behaviour training: frequently asked questions
Talk to PMH about challenging behaviour training
Tell us about your service, your team and the behaviours you are seeing. A senior consultant will contact you to discuss training or support.
Original methodology developed through decades of practice
Evidence-based frameworks that deliver measurable outcomes
Senior consultants who created the models they implement