What is Positive Behaviour Support (PBS)?
Positive Behaviour Support (PBS) is a proactive and person-centred approach to understanding and addressing behaviours of concern. Originating in the 1980s from Applied Behaviour Analysis (ABA), PBS has evolved to have a stronger emphasis on being person or family-centred, distinguishing it from ABA, which is more rooted in learning theory. It involves identifying the underlying reasons or functions of these behaviours and developing strategies to teach alternative, more desirable behaviours. PBS aims to improve the quality of life for individuals by focusing on their strengths and preferences, promoting their independence, and enhancing their social inclusion. It supports individuals living with developmental disabilities, autism, and other differences that may lead to a specific challenging behaviour.
One key aspect of Positive Behaviour Support is its focus on proactive strategies. Instead of waiting for the behaviours of concern to occur and then reacting to them, Positive Behaviour Support encourages PBS specialists and clinicians to anticipate and prevent them by creating supportive environments and teaching alternative skills. This proactive approach helps minimise reactive strategies, such as restrictive interventions, which result in negative consequences and prioritises Positive Behaviour Support strategies.
Leaf Complex Care has a therapy team of in-house specialists in PBS, occupational, and speech and language therapists who provide cost-free services for the individuals we serve. Our PBS practitioners’ primary focus is on helping each person achieve the best possible outcomes by working proactively with the individual.
It’s about providing the people they serve with options and choices when it comes to meeting their preferences and health needs. Our team ensures that the person’s needs are met by always using a support model and personalised positive behaviour strategies tailored to the person’s needs.
What are the Behaviours of Concern?
Behaviours of concern are actions or escalated behaviours that pose risks or challenges to individuals or those around them, impacting their physical and mental well-being. It can include a range of behaviours such as intense, self-harming, destructive behaviour, wandering, or behaviours that interfere with daily activities or social interactions.
These behaviours can be a form of communication, often indicating unmet needs, discomfort, or challenges in understanding and navigating the environment. When a specific behaviour of concern is met with empathy and understanding, seeking to understand the underlying reasons or triggers for these behaviours, positive outcomes and desired behaviours begin to arise.
Positive Behaviour Support focuses on prevention, teaching alternative skills, and creating supportive environments to reduce the occurrence of these behaviours and improve the individual’s quality of life.
Key Principles of PBS
At its core, Positive Behaviour Support is built on fundamental principles, including a person-centred approach in care, positive reinforcement, assessment-based intervention, preventive strategies, and an outcome-based approach.
These principles form the foundation of PBS, emphasising the importance of understanding the individual’s unique needs, reinforcing positive behaviours, collaborating with stakeholders, conducting thorough assessments, implementing proactive strategies, and focusing on outcomes that will enhance the person’s independence and community living.
This way, PBS enables the creation of supportive environments that allow individuals to thrive and achieve their goals.
Person-Centred Care
Each individual has their own experiences, desires, and capabilities. Person-centred care involves actively involving the individual in decisions about their support and designing interventions tailored to their specific needs and goals.
For individuals living with a learning disability or autism, person-centred care is especially crucial since it involves recognising that challenging behaviours often stem from unmet needs or difficulties in communication. This may include developing behaviour support plans that focus on teaching alternative skills and providing the right support aids to ensure a person can live a fulfilling life. The person-centred approach in care also involves collaboration with the individual’s family to ensure the support is consistent and aligned with the individual’s needs.
Positive Reinforcement
Learning theory explains that how people behave in a certain situation depends on their previous experiences with similar moments. Positive reinforcement, one of the key principles of Positive Behaviour Support practices, focuses on helping individuals learn new ways to behave.
Therefore, our PBS specialists use positive reinforcement to create positive outcomes in:
Behavioural improvement which is a part of improving and shaping behaviours. By rewarding desired behaviours, individuals are motivated to repeat those behaviours, leading to consistently positive outcomes.
Enhanced self-efficacy that boosts individuals’ confidence and belief in their ability to succeed. When they receive praise or rewards for their efforts, they are more likely to feel capable of achieving their goals, leading to increased self-esteem and motivation.
Stronger relationships between individuals and their caregivers or peers. Trust and rapport are built by focusing on positive behaviours and using encouragement and rewards, creating a supportive and nurturing environment.
Assessment-Based Interventions
When it comes to conducting assessment-based interventions, our PBS specialist’s process begins with a functional assessment, the first step in understanding the underlying causes of the behaviour of concern. The evaluation focuses on identifying the function or purpose of the behaviour, such as escaping a task. By conducting a functional assessment, our PBS specialists can develop interventions tailored to address the specific triggers and functions of the behaviour, leading to more effective outcomes.
The assessment-based interventions our PBS team uses are developed to promote the person’s unique needs, strengths and challenges, and they include:
Person-centred approach considering people’s health needs, privacy, dignity and human rights.
Targeted strategies based on the outcomes of the assessment.
Data-driven decision-making allows the specialists to track progress, adjust interventions as needed, and ensure that the strategies bring positive outcomes over time.
Prevention Instead of Reaction
When it comes to conducting assessment-based interventions, our PBS specialist’s process begins with a functional assessment, the first step in understanding the underlying causes of the behaviour of concern. The evaluation focuses on identifying the function or purpose of the behaviour, such as escaping a task. By conducting a functional assessment, our PBS specialists can develop interventions tailored to address the specific triggers and functions of the behaviour, leading to more effective outcomes.
The assessment-based interventions our PBS team uses are developed to promote the person’s unique needs, strengths and challenges, and they include:
Person-centred approach considering people’s health needs, privacy, dignity and human rights.
Targeted strategies based on the outcomes of the assessment.
Data-driven decision-making allows the specialists to track progress, adjust interventions as needed, and ensure that the strategies bring positive outcomes over time.
Outcome-Based Approach
As a healthcare provider involved in people’s care journeys and helping them to live life on their own terms with greater independence and smiles on their faces, we invest in our care teams. We provide free training so the individuals we support and their families feel safe and treated with the humanised care they deserve.
We have implemented Positive Behaviour Support Plans that focus on the capabilities of the individuals we serve. Richard’s care journey with Leaf Complex Care is based on trust and a genuine commitment to building Richard’s strengths together. We created a safe environment that supports him through his challenges and build strategies to support positive behaviours.
Please hear what Richard’s parents have to say about our journey together.
What is a Positive Behaviour Support Plan?
A Positive Behaviour Support Plan (PBSP) is a structured and individualised plan designed to address challenging behaviours experienced by individuals living with autism, learning disabilities, dementia, or developmental delays.
Positive Behaviour Support Planning
The process of developing a Positive Behaviour Support Plan can begin after behaviour hypothesis statements are made. The behaviour support plan is the result of the assessment process, which is typically developed along with person-centred planning. It serves as the team’s strategy document, detailing the specific actions to enhance the person’s engagement and achievement in daily activities. Behaviour support strategies should be carefully prepared and properly explained in simple language for optimal effectiveness. They should reflect the family’s and support team’s values, outline any necessary resources and training for implementation, and feature user-friendly and individual components.
The components that one Positive Behaviour Support plan should consist of are the following:
- Behaviour Hypothesis Statements
- Prevention Strategies
- Consequence Strategies
- Replacement Skills
- Long-term Strategies
Positive Behaviour Support Stages
The Positive Behaviour Support model offers a structured approach to creating behaviour support plans. It focuses on enhancing participation, quality of life, independence, and development in various areas.
This model consists of three key stages: Assess, Manage, and Prevent.
Assessment Stage
The assessment stage has three aims that need to be identified:
The individual’s strengths, important life aspects, and their support systems.
The individual’s needs and preferences.
The triggers lead to the challenging behaviour and the reason behind the occurrence.
Gathering information about the person’s profile allows the care team to get a complete picture of their health needs and capabilities. Additionally, this phase reviews the measurable details of behavioural data and conducts Functional Behaviour Analysis (FBA) to understand better, describe, and illustrate the consequences of the behaviour of concern. The final step is to determine the function or purpose the behaviour served.
Manage Stage
The manage stage describes how to respond effectively to behaviours that occur before and after challenging behaviour. Properly responding enables you to safely prevent, redirect, and de-escalate the behavioural challenge with minimal challenge.
The manage stage follows:
The Escalation Stage
The Escalation Profile
The Deescalation Plan
Prevention Stage
This stage focuses on preventing challenging behaviours by minimising or avoiding the causing triggers, creating a supportive environment tailored to the individual’s needs, teaching alternative behaviours, and enhancing their overall quality of life.
The plan outlines strategies to reduce or prevent triggers that lead to challenging behaviours by offering the individual:
A supportive and safe environment by tailoring environmental factors to minimise the risk of trigger points
Activities that support people’s abilities
Supportive communication and interaction
A positive way of teaching how to manage the person’s emotions and behaviours
Leaf Complex Care Applies PBS in Its Practice
Creating a positive change in the health and social care sector is about recognising the inherent dignity and worth of every individual and ensuring they receive the care and support they deserve.
Our PBS specialists follow a structured process through functional assessment, identifying triggers, developing support strategies and monitoring and adjusting care plans to gather information and develop an intervention plan for behaviours of concern.
Richard's Care Journey
Richard is one of the individuals we support by implementing proactive, Positive Behaviour Support strategies in his daily routines. To meet Richard’s needs, our PBS specialists conducted a thorough functional assessment to understand the triggers entirely and why they occur. They then developed a person-centred care plan for social skills training, and sensory strategies focused on his abilities and preferences.
We are delighted when the families of the people we support share that our care respects their loved one’s human rights and the right to privacy and dignity.
”Leaf came along, and this was the first time someone actually asked what we needed, which was refreshing and gave me a new hope. Leaf did the assessment, and the people they sent they turned out to be more experienced. He’s now walking about a two-mile walk easy, without problems, and that’s amazing. He’s happy to go on it, and admittedly, we did start by going to the cafe first, that’s Richard. He loves to walk around the woods and enjoys that walking gives him that stimulation required.” – Richard’s father.
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