RAID (in mental health)

RAID (Reinforce Appropriate, Implode Disruptive) is a positive psychology least restrictive practice approach for working with people who exhibit challenging behaviour. The RAID approach is written by Dr William Davies and is published and distributed by the Association for Psychological Therapies. Over 20,000 professionals working in Mental Health and related areas are trained in the RAID approach, mainly in the UK and Ireland. It is now in its 11th edition.[1]

## The RAID Model

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The RAID model advocates a philosophy of care where professionals “play down disruptive behaviours as far as safety allows, and concentrate on recognising and reinforcing appropriate behaviour, so that it gradually displaces the disruptive behaviour”.[2] It emphasises how the most extreme behaviours can be addressed through proactive encouragement of positive qualities and behaviours shown by an individual and clearly focuses on providing individuals with rewarding opportunities for progress.[3]

The aim is for the professional to focus on ‘green’ (positive) behaviours and reduce opportunities for ‘red’ (challenging or less positive) behaviour thereby developing a therapeutic milieu.[4] The process involves rewarding positive or ‘green’ behaviours in ways that help patients recognise their achievements; whilst ‘red’ (negative) behaviours are safely played down through the use of strategies such as distraction techniques.[5]

As a proactive approach, the RAID Model contrasts with approaches such as extinction and punishment (as used in Operant Conditioning) in that the RAID Model allows you to act in the absence of extreme behaviour, whereas punishment and extinction only allow you to act when the extreme behaviour occurs (and to have approaches to extreme behaviour that relies upon the extreme behaviour happening is viewed by many as undesirable). The RAID model is usually viewed as an example of the Constructional Approach in Behaviour Modification and as such attempts to solve problems by building positive behaviors which displace the negative ones. This contrasts with the eliminative approach which focuses on the problem behavior (with the aim of eliminating it).

## History

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The RAID Approach was written in 1990 by Dr William Davies, and established itself as a standard for setting and reinforcing positive behaviours in the UK.[6] It was originally written as a positive approach to working with disturbed adolescents in secure conditions, but was quickly applied to people showing difficult and aggressive behaviour at any age, especially if they were in secure or residential facilities. Originally the approach described 13 relevant strategies for constructive working with such behaviour; the RAID acronym came later (1992), as a memory-aid for the general theme that underpins the strategies.[7]

The acronym RAID (standing for Reinforce Appropriate, Implode Disruptive) was registered as a UK trademark in 1992.[8] In January 2019, in the first case ever to be heard by the Intellectual Property Enterprise Court (IPEC) outside of London, the High Court judge, HH Melissa Clarke found that an NHS Foundation Trust had infringed the RAID trademark by using it to stand for Rapid Assessment Intervention and Discharge and they had to stop using it.[9][10][11][12][13][14][15][16][17][18]

## Evidence

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The RAID model has been measured through the Overt Aggression Scale - Modified for Neurorehabilitation (OAS-MNR) - and shown a decrease in aggressive behaviours by over 80% across a two year period.[19] Research also shown that the RAID model significantly reduced the number of incidents of challenging behaviour on a medium secure LD ward,[20] and a paper conducted by Dr Cheryl Knowles shown that that there was as significant increase in staff members’ confidence towards challenging behaviour - this was observed immediately post training, and maintained 4-months following the training.[21]

## Training

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Training in the RAID approach is delivered by the Association for Psychological Therapies and has been attended by over 20,000 professionals working for the UK's National Health Service (including Rampton Secure Hospital[22]) and independent healthcare providers (including: St Andrew's Healthcare,[23] The Priory Group,[24] Cygnet Health Care,[25] and Elysium Healthcare).[26]

## Notes

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1. ^ "The RAID Approach". APT. The Association for Psychological Therapies. Retrieved 12 June 2019.
2. ^ Sarah Lee and Rachel West. "Cognitive Approaches to Intervention". Neupsy Key. Retrieved 12 June 2019.
3. ^ "Implementing Positive Behavioural Support within a Forensic Mental Health Medium Secure Unit". ResearchGate. The Royal College of Psychiatrists. Retrieved 12 June 2019.
4. ^ Shelton, Lyn (26 March 2019). Case Studies in Forensic Psychology (1 ed.). Routledge. p. 85\. ISBN 978-1138584822.
5. ^ "Recovery Journeys" (PDF). NHS. St Andrew's Healthcare. p. 13. Retrieved 12 June 2019.
6. ^ "RAID Training". Compare the Course. Archived from the original on 24 June 2021. Retrieved 12 June 2019.
7. ^ "Trade Mark Number". Intellectual Property Office. Retrieved 12 June 2019.
8. ^ "Trade Mark Number". Intellectual Property Office. Retrieved 12 June 2019.
9. ^ Carding, Nick. "Trust in £100,000 court battle over alleged trademark breach". HSJ. HSJ. Retrieved 12 June 2019.
10. ^ "APT Training & Consultancy Ltd & Anor v Birmingham & Solihull Mental Health NHS Trust [2019]". OPUS IP. Retrieved 12 June 2019.
11. ^ Mark Smulian, “NHS trust infringed trade mark owned by consultancy, court rules“, ‘’Local Government Lawyer’’, 15 January 2019
12. ^ Nick Carding, “Trust in £100,000 court battle over alleged trademark breach“, ‘’HSJ’’, 16 January 2019
13. ^ Mark Smulian, “NHS trust infringed trade mark owned by consultancy, court rules“, ‘’Public Law Today’’, 15 January 2019
14. ^ Practical Law IP&IT, “Use of RAID mark by NHS foundation trust was in the course of trade (IPEC)“, ‘’Thomson Reuters Practical Law’’, 16 January 2019
15. ^ Intellectual Property Enterprise Court, “Trust in £100,000 court battle over alleged trademark breach“, ‘’HSJ’’, 9 January 2019
16. ^ Counsel Magazine, “APT Training & Consultancy Ltd and another v Birmingham and Solihull Mental Health NHS Foundation Trust“, ‘’Counsel Magazine’’, Retrieved 28 February 2019
17. ^ Lambert, Jane. "Trade Marks: APT Training and Consultancy Ltd. and another v Birmingham & Solihull Mental Health NHS Trust". NIPC Law. NIPC Law. Retrieved 12 June 2019.
18. ^ Howes Percival, “Howes Percival successfully acts in NHS Trust trademark case“, ‘’Northamptonshire Chamber’’, 21 January 2019
19. ^ "Recovery Journeys" (PDF). NHS. St Andrew's Healthcare. p. 13. Retrieved 12 June 2019.
20. ^ Shelton, Lyn (26 March 2019). Case Studies in Forensic Psychology (1 ed.). Routledge. p. 85\. ISBN 978-1138584822.
21. ^ "Changes in staff confidence, emotional responses, and attributions for challenging behaviour immediately following staff attending RAID training at Guild Lodge" (PDF). APT. Dr Cheryl Knowles. p. 1. Retrieved 30 October 2020.
22. ^ Sheldon, Kerry (6 October 2011). Research in Practice for Forensic Professionals (1 ed.). Routledge. p. 256\. ISBN 978-0415672726.
23. ^ "An insight into neuropsychiatric services at the country's largest mental health facility". NR Times. St Andrew’s Healthcare. Retrieved 12 June 2019.
24. ^ "Hazelwood House, Secure mental health services" (PDF). Priory Group. Priory Group. p. 4. Retrieved 12 June 2019.
25. ^ "Cygnet Hospital Bierley launches RAID". Cygnet Healthcare. Cygnet Healthcare. Retrieved 12 June 2019.
26. ^ "National Learning Disability Awards". Elysium Healthcare. Elysium Healthcare. Retrieved 12 June 2019.