What is a reactive strategy for, and what should it be judged by?
This article asks what a reactive strategy is for and what it should be judged by. It separates what the published sources state from professional reasoning and Beyond Thrive’s practice. Shaded panels mark the practice view.
“You are just rewarding the behaviour”
This is a familiar objection when a support plan includes a planned response to a crisis. The person is distressed, staff give them what they are asking for, and the behaviour appears to have been paid for.
The concern is reasonable. What happens after behaviour may affect what happens the next time. If a person gains access to something important only after behaviour has become more intense, that sequence may become part of the pattern. No support plan should create a situation in which distress has to intensify before the person is heard.
The objection nevertheless tends to combine two questions.
The first is immediate: what should staff do when a person is already distressed and the situation is escalating?
The second is longer-term: what support will help this person communicate, cope and participate over time?
A reactive strategy is an answer to the first question. It is not intended to replace the second.
What is a reactive strategy is for?
A reactive strategy is a response, planned in advance, for when a behaviour of concern is already occurring or developing. Planning in advance matters because the moment of crisis is the least favourable time to improvise.
LaVigna and Willis, who developed the framework discussed here, are explicit about its limits. They state that “the only role of a reactive strategy is the minimisation of episodic severity”, and that “all responsibility for the future is assigned to the proactive strategies” (LaVigna and Willis, 2016, p.12).
Episodic severity refers to how serious a single incident is: “a quantified measure of the gravity of a behavioural episode” (LaVigna and Willis, 2016, p.4). The authors describe the aim as rapid, safe control of the episode, resolved at the lowest level of episodic severity possible (p.12). In plain terms, the purpose is to help the person and those around them through the episode safely.
In this framework, teaching new skills and addressing the reasons behaviour occurs belong to the proactive plan rather than to the reactive strategy itself. National guidance expects the two to operate together. NICE advises that reactive strategies be used “together with” proactive interventions (NICE NG11, recommendation 1.9.1). The Department of Health (2014) expects a behaviour support plan to detail how staff will respond when a person starts to become anxious, aroused or distressed, although it describes those responses as preventative rather than reactive strategies (paragraph 34).
What should a reactive strategy be judged by?
LaVigna and Willis argue that the effectiveness of situational management should be measured primarily by its effect on episodic severity (2016, p.4). That is the originating position. No independent test of it appears in the sources used.
NICE asks for regular review of the “safety, efficacy, frequency of use, duration and continued need” for reactive strategies (recommendation 1.9.6). It does not address episodic severity as such, so it gives the wider view partial support only.
A response that ends an episode quickly is not necessarily a helpful one. The fact that behaviour stopped does not, by itself, show that the response was appropriate. In the practice view taken here, teams also need to ask whether the person recovered, whether dignity was preserved and whether the same pattern keeps recurring. This is professional reasoning, not a research finding.
Least restrictive responses first
When action is required in the moment, the order in which options are considered matters.
LaVigna and Willis state that restrictive methods should be recommended only as a “literal ‘last resort’”, with “first resort” methods used first wherever possible (2016a, p.10). NICE advises “a graded approach that considers the least restrictive alternatives first” (recommendation 1.9.2).
This is a standard for planning and practice, not evidence about what happens when services apply it.
Redirection
The first is redirection, which the 2002 chapter calls diversion. LaVigna and Willis describe it as “diversion to a powerfully reinforcing or compelling event or activity”, used when the person is starting to act up, with “the most powerful reinforcing or compelling activity or event you can identify” (LaVigna and Willis, 2002, p.98).
The authors identify the risk themselves. They refer to a “counter-therapeutic effect”, which they define as the reinforcement and strengthening of the target behaviour (p.101). Their answer is to pair the strategy with safeguards in the proactive plan.
They illustrate this with a single case that they report. A pupil who screamed and scratched her own face was handed a magazine as the tantrum began. She could also ask for a magazine using a communication board: “Therefore, having a tantrum was not the only way to get access to a magazine”. A stack of magazines was also available in the play area, “with which she could do anything she wanted” (pp.99–100). The authors call such arrangements “safety valves”, and state that they allow diversion “without producing a counter-therapeutic effect” (p.100). They report that tantrums fell and had stopped by the end of the school year (p.100).
Two cautions apply. The account is one case, reported by its own authors. And the safeguard comes with a trade-off that the authors raise themselves: free access to an item “could reduce the distracting qualities of the event as a reactive strategy” (p.100). They offer this as a possibility, and propose a middle position between satiation and deprivation as clinically useful. No data are given for it.
The authors also state that they “have not seen the counter-therapeutic effect”, although they use diversion frequently. They add that most of their work is with people who have a very good quality of life, with rich access to reinforcement (p.100). This is a practice observation. It is not outcome evidence, and it should not be read as showing that diversion is safe or that it reduces incidents or restraint.
Strategic capitulation
Strategic capitulation is the more provocative term, and it requires precise description.
The term is LaVigna and Willis’s. In the same chapter they describe it in these terms: “When you know what the person wants, it is obvious that the quickest way to get him to stop asking for it is to give it to him” (p.101). The term can sound like “giving in”, and some staff may hear it as a loss of consistency.
The authors attach conditions. Their guidance states that if capitulation is used it should be used early, “ideally… in response to precursor behaviour”, meaning the earliest signs that the person is struggling. What the person wants should be made freely available “simply for the asking”. And it should sit within “a fully developed proactive plan” (p.102).
The chapter is expert guidance, not an outcome study. None of the sources used for this article tests whether strategic capitulation reduces the severity of incidents or the use of restraint.
The same applies to the word “early”. What counts as early differs from person to person. In Beyond Thrive’s practice it is defined through assessment, written down, measured and reviewed. That is a practice approach, not an academically validated method.
Reinforcement risk, safeguards and review
The concern described at the outset is not misplaced. Research on delivering something a person values on a fixed timetable, regardless of what they are doing, recognises that this can accidentally strengthen whatever behaviour it follows. It also notes that what produces this effect is not yet fully understood, although there are ways to prevent it (Carr et al., 2000, p.385). That research concerns timed delivery, not crisis responses, and it cannot be treated as direct evidence for either strategy described above.
LaVigna and Willis make a related point about crisis responses. They state that the potential for a harmful effect “may be greater when there is very limited access to a variety of reinforcers and may be less when there is a high density of reinforcement in the person’s life” (2002, p.100). Put plainly, giving access to something valued in a crisis may carry more risk when the person has little of it otherwise. This is the authors’ reasoning, expressed cautiously, and no data are offered for it.
What the evidence can and cannot show
Most of what is cited above about reactive strategies derives from a single tradition: the work of LaVigna and Willis. The independent sources used are national guidance (NICE and the Department of Health) and one review of research on timed delivery of reinforcers (Carr et al., 2000).
Guidance indicates what should happen. It sets expectations for planned and less restrictive practice, but it does not show whether a given strategy works. NICE also uses the term “reactive strategies” more narrowly than this article does, to mean personal space, disengagement from holds, as-needed medication and more restrictive interventions.
None of the sources used shows, through independent testing, that redirection or strategic capitulation reduces the severity of incidents or the use of restraint. None shows that reactive strategies reduce restrictive practice.
Questions worth asking of a plan
The following prompts are Beyond Thrive’s own. They are not a validated checklist.
What is the reactive strategy intended to achieve, and when is it used?
What is the person communicating, and how confident is the team in that interpretation?
If redirection is used, is what is offered genuinely compelling for this person?
Does the person have access to it at other times?
Is there a proactive plan behind the response, and is it being delivered?
Are less restrictive responses considered first, and is that recorded?
Was the response delivered as planned, and if not, what prevented it?
How often, for how long and how severely are incidents occurring?
Is anyone reviewing whether the response may be maintaining the pattern?
Returning to the objection
Are staff rewarding the behaviour?
Sometimes a response may contribute to a pattern. A sound plan acknowledges that possibility rather than dismissing it.
The more useful question is whether the response is planned, proportionate and reviewed, and whether it sits within support that is addressing the longer-term picture.
Redirection and strategic capitulation are not substitutes for understanding the person. They are ways of responding to a difficult moment while keeping the person’s safety, dignity and longer-term support in view.
A reactive strategy is not judged by whether it looks firm or whether it avoids giving the person what they want. It is judged by whether it helps the person through the episode safely, remains connected to proactive support, and can be reviewed honestly afterwards.
References
Carr, J. E., Coriaty, S., Wilder, D. A., Gaunt, B. T., Dozier, C. L., Britton, L. N., Avina, C., & Reed, C. L. (2000). A review of “noncontingent” reinforcement as treatment for the aberrant behavior of individuals with developmental disabilities. Research in Developmental Disabilities, 21(5), 377–391.
Department of Health (2014). Positive and proactive care: reducing the need for restrictive interventions. London: Department of Health.
LaVigna, G. W., & Willis, T. J. (2002). Counter-intuitive strategies for crisis management within a non-aversive framework. In D. Allen (Ed.), Ethical approaches to physical interventions: Responding to challenging behaviour in people with intellectual disabilities (pp. 89–103). British Institute of Learning Disabilities.
LaVigna, G. W., & Willis, T. J. (2016a). The alignment fallacy and how to avoid it. International Journal of Positive Behavioural Support, 6(1), 6–16.
LaVigna, G. W., & Willis, T. J. (2016b). Opening editorial: Special issue on reactive strategies for situational management. International Journal of Positive Behavioural Support, 6(1), 4–5.
National Institute for Health and Care Excellence (2015). Challenging behaviour and learning disabilities: prevention and interventions for people with learning disabilities whose behaviour challenges (NICE guideline NG11). Available at: https://www.nice.org.uk/guidance/ng11
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