What Does Effective Positive Behaviour Support Look Like?

Posted 13 Dec 19

Positive Behaviour Support

Positive Behaviour Support or PBS is a form of person centred support promoting dignity, human rights and respect and is aimed at providing a long term support for all those involved.  Instead of applying the rules of a more rigid approach to care, PBS puts the individual first every time, celebrating humanistic differences and using them to inform care plans. The approach recognises that there is more than one way to accurately understand how or why a person behaves the way they do, nor is there any one hard and fast method to alleviating the outcomes of such behaviours. As with any form of support there are always ways to build upon and improve on delivery, and lessons are continually being learned from case to case which can only mean techniques continue to reach higher standards. So what makes for ‘good’ positive behaviour support and what might that look like in practice? According to the BILD centre for the advancement of positive behaviour support, we should all be able to see ‘good’ PBS being delivered in 5 key ways. 

5 Key Elements Of Good Positive Behaviour Support

  1. Personalisation 

One of the key areas of positive behaviour support is to deliver a form of support that is entirely personalised; something that many other forms of therapy or support do not tend to focus on. It is this level of attention towards the ‘individual’ that helps to make PBS an entirely unique approach to care.  Recognising personalisation in a positive behaviour support plan would require the collection of evidence that would suggest care providers are taking actions to significantly enhance or improve the quality of life, and overall well being of an individual. However what we are particularly looking out for here is consistency, personalised care will not be as effective as it possibly could be unless it is delivered to a consistent standard and on a regular basis. The ‘personalisation’ aspect of PBS would be seen in the way of a list of actions to be taken by the individual, possibly even the carer of close family and friends which are eventually written into the positive behaviour support plan. In many cases, these actions will be decided upon as a result of working closely with the individual and immediate family or friends to find a level of support that fits with the needs and personality of the person involved. When looking for actions that are carefully tailored towards a ‘personalised’ approach, we should be seeing steps that need to be taken in order for the individual to take part in a number of activities that are meaningful to them. Instead of some generalised activities, these should be tailored towards helping the individual experience as normal a life as possible, and to truly feel like a valued member of their community. Something that really can be invaluable in building confidence, and ultimately helping them to feel able to manage their behaviours. 

  1. Scientific Approach 

Any form of positive behaviour support is entrenched with scientific understanding, which means that whilst this is certainly a very personalised approach to care, the information gained from speaking with and getting to know and individual is combined with a strong scientific knowledge. When these two approaches join forces it can make for an extremely effective approach to care, which could be why positive behaviour support is so well received. Within a PBS care plan, the care provider must demonstrate that they have a strong understanding of how that person learns, and also what the ‘behaviour of concern’ might mean to that individual. Looking at the term ‘behaviour of concern’ in this sense, it is intended to describe the particular behaviour/s that an individual may be exerting to express themselves. This may in many cases be upsetting or disruptive to others but is often thought by the individual to be the best way to get their needs met. In some PBS care plans this may be described slightly differently, such as ‘challenging behaviour’, ‘distressed or risky behaviour’ or ‘behaviours that challenge’.  To ensure good positive behaviour support is being delivered, it should be recognised that practitioners have used standardised assessment tools to gather information. These PBS tools can include questionnaires or other appropriate tools to very carefully measure different areas of an individuals’ living environment and day to day life. Using such standardised assessment tools helps to ensure consistency in the delivery of a PBS care plant, as they will have been tied and tested by other practitioners. Being confident that the tools being used are providing accurate results will help to ensure individuals are receiving ‘good’ positive behaviour support. 

Once data has been collected it can be used to inform function-based interventions that are then directly and very practically applied with the benefit of the individual at the very centre. When we talk about function-based interventions in relation to positive behaviour support, we mean and strategies or plans that have been developed with a detailed understanding of an individuals’ behaviours and the purpose these might serve in helping a person get what they need. When looking for a good PBS strategy or plan, it should detail the way in which a person can develop the skills to independently manage their distress inorder to get their needs met. 

  1. Active Implementation 

Good positive behaviour support can be seen in many ways, one important thing to look out for is that practitioners are delivering care in a very well planned way in which PBS is implemented in the best way possible and regularly monitored. Delivering PBS well often takes a team of individuals to work closely together, rather than any one person conducting all of the work alone. When looking at a care plan, every individual involved should have a very clear role and their responsibilities clearly laid out, agreed and understood. As with any form of care and support, good positive behaviour support should be backed by evidence of strong and effective leadership at both the service and organisational level. Working together and outstanding communication can often be the key to delivering the very best PBS to any individual, and is certainly something to look out for in practitioners. A key thing to make note of is any evidence to suggest that support is both progressive and developmental for not only the individual, but any others involved which would help to suggest a joint-up approach to PBS. In some cases, it could be deemed necessary that some restrictions are put in place to help the development of the individual, and in these cases a PBS care plan should show that regular reviews are in place around this. It may well be that over time, and as the individual progresses with their positive behaviour support that any restrictions can be limited, and in any case it should be evidenced that the least restrictive action possible be taken. 

  1. Evidence Based

As discussed earlier, positive behaviour support is intertwined with a great deal of scientific knowledge, understanding and evidence in order to help individuals in the best way possible and also continue to be incredibly effective. The popularity of PBS over recent years has certainly grown, partly due to it’s uniquely personalised approach and also thanks to its strong evidence base in support of its outcomes. When looking at a positive behaviour support care plan it should be clearly seen that the support provided has been based upon a range of different types of data. This could be from a range of sources and investigating a number of different areas of an individual, but what is important is that this data is analysed at all levels in the system.  Within the development of a positive behaviour support plan, there should be a combination of hard and soft data informing the course of action to be implemented for the individual. Within PBS, hard data will generally include any facts and figures around a behaviour or an individual such as ‘how often’ or ‘how many’ in many areas of life, which can then be used to build up a more numerical data set. Soft data on the other hand would involve a far more descriptive interpretation of an individuals’ behaviours or lifestyle, usually derived from asking about sometimes personal perspectives, experiences or particular feelings about things. Combining these types of hard and soft data can help to make for a very effective approach to positive behaviour support, and should be evidenced by any practitioner. This data can be used to inform any assessments, as well as helping to regularly evaluate interventions to help maintain a high level quality of care. Not only can hard and soft data help inform the PBS care plan directly, but it can also play its part in improving the overall quality of the individuals life, as well as others directly involved. 

  1. Multicomponent Interventions 

One of the most important characteristics of ‘good’ positive behaviour support is evidence to show that the support offered is implemented at different levels and in a number of different ways. Where looking at behaviours of concern, practitioners should be putting proactive strategies in place to help reduce and maybe even prevent the triggers or events that may be causing it in the first place. When we talk about proactive strategies, many PBS practitioners will choose to implement developmental support, which helps the individual develop new skills to get what they need or else develop their own coping strategies. What makes proactive strategies particularly effective in positive behaviour support, is that they are put in place before the behaviour in question occurs. This can be a far more effective way of delivering PBS than essentially being a response when the behaviour is in action. Allowing people to develop coping strategies would certainly be prioritised in the delivery of ‘good’ positive behaviour support. A good practitioner should be able to clearly evidence that the environment has been altered in some way  to ensure it was the best it can possibly be for the individual. Good PBS should still have some reactive strategies in place, especially in the realm of challenging behaviour as they could help to keep people safe if they needed. You should expect any support offered to be based on an individuals’ assessed need, and could well utilise a number of evidence-based procedures. 

Positive Behavior Support At Time For U Limited

Thanks to positive behavioural support our specialist team of care workers have many years of experience in delivering the highest quality care services. We are able to help describe, predict and change challenging behaviour in individuals with a range of different needs, and we take great satisfaction in seeing lives change for the better.   For us here at Time 4 U Limited we believe all forms of personal behaviour support should be seen as a long term solution, to help those with complex care needs, learning disabilities or struggling with mental illness. We want to help prevent old habits from reappearing, to ensure that our person centred support services are working the very best way they can for every individual in need. If you or someone you know is interested in our positive behaviour support services or maybe you need to talk to a member of the team, please contact us today and we would be happy to help.