Positive behaviour support (PBS) is an evidence-based person-centred approach aimed at improving a person’s quality of life and reducing their behaviours of concern. It’s an approach that is practiced with consideration of and respect for the needs, preferences, rights and goals of every person receiving support.
And while this approach has been widely embraced by positive behaviour support practitioners, it bears little resemblance to the behaviour therapy practices prior to the 1980s.
The history of PBS
Positive behaviour support (PBS) emerged in the US in the 1980s in response to the disability rights movement and increasing concern over the use of inappropriate and abusive treatment of people with developmental and intellectual disabilities.
Australia adopted PBS around the same time as the US and UK, and practitioners started to replace practices that used punishment to modify behaviours with a holistic approach that prioritised the health, wellbeing and rights of the people they were supporting.
Despite this welcome change in behaviour support practice, prior to the launch of the NDIS in 2016, PBS services varied significantly across the country, with inconsistent practices and limited access to resources. Participants also had no or little choice or control over their behaviour support.
With the NDIS now in place, participants are empowered with greater choice and control over their positive behaviour support provider and the scheme’s goals to improve quality of life for people living with disability and reduce and eliminate of restrictive practices have created greater awareness of PBS practices and improved consistency in their delivery.
The purpose and importance of PBS
The role of positive behaviour support is to enhance the quality of life for people living with disabilities by using a person-centred, evidence-based approach.
PBS can also reduce or eliminate a person’s behaviours of concern, also called inappropriate, challenging, or disruptive behaviours. These behaviours are often an expression of feeling anxious, frustrated, unsupported, nervous, stressed, and vulnerable and can include damaging and throwing items, and self-harming actions.
Behaviours of concern can impact a person’s quality of life in many ways, from affecting their health and straining their relationships to limiting their participation in activities and putting their safety and that of others at risk.
By understanding a person’s needs, individual situation, preferences, and goals, PBS practitioners can develop strategies that improve their quality of life while respecting their rights and dignity.
The benefits of positive behaviour support can include:
- Improve quality of life for participants.
- Helping participants to reduce or eliminate behaviours of concern.
- Reduced use of restrictive practices. Through personalised support, PBS aims to minimise the use of restrictive practices and promote alternatives that respect the rights and dignity of participants.
PBS at Better Rehab
Our positive behaviour support practitioners provide person-centred, evidence-based support, which involves recognising the unique needs, preferences and goals of each participant and working closely with their support network to develop tailored interventions.
The creation of every PBS program involves
- A Quality of Life assessment.
- A Functional Behaviour Assessment (FBA), to understand the underlying function of an individual’s challenging behaviours. This involves systematically analysing the environment, triggers, and consequences of their behaviours to identify patterns and develop targeted interventions.
- The creation of a tailored Behaviour Support Plan (BSP) which outlines the evidence-informed strategies and interventions designed to first improve the participant’s quality of life and, secondly, address behaviours of concern. These can include teaching others about the participant’s interaction and communication preferences, daily activities and interests, providing strategies to improve emotional regulation and new positive behaviours and making changes to the participant’s daily/weekly routine, home and other places they spend time to reduce or remove triggers. The BSP is developed collaboratively with each participant, their support team and other people involved in their care and education, taking into account their unique needs and preferences.
- The review of any Restrictive practices and creation of plans to fade them out and eliminate them. There is a wide variety of restrictive practices to reduce behaviours of concern that can affect their quality of life and the safety and welling of others.
The PBS team at Better Rehab comprises clinicians with a variety of backgrounds, qualifications and experiences that enables us to match the right clinician to each participant. Regardless of whether they are ABA-trained, have a background in aged care, disability support or social work, they all provide evidence-based person-centred therapy and are passionate about achieving the best outcomes for participants.
One of the many ways the PBS team at Better Rehab go the extra mile with participants is their creation of The Good Life Booklet. This interactive booklet has been designed to help participants feel ‘front and centre’ in their PBS plan and remind them that PBS is about their needs, choices, and goals and how it can help them enjoy a good life.
The multidisciplinary approach to PBS at Better Rehab
Our PBS practitioners often work in multidisciplinary teams (MDTs) comprising clinicians from two or more allied health disciplines. These teams bring together a variety of skills, knowledge, and expertise to develop comprehensive, holistic and coordinated programs of interventions.
So, in addition to one of our experienced PBS practitioners, a participant might also receive tailored person-centred support from other Better Rehab clinicians such as a speech pathologist, physiotherapist, occupational therapist, and/or exercise physiologist, depending on their needs and goals.
Referring PBS: reasons to seek support
It can be difficult to know whether you or a loved one could benefit from positive behaviour support. Some signs a person needs PBS include:
- Poor or low-quality of life: This can include exclusion from social activities due to challenging behaviours. Our PBS Practitioners can assess quality of life to identify whether support is needed.
- Behaviours of concern. These can be both present and emerging behaviours that have a negative impact on
- the safety of the person or others;
- access to services;
- community engagement;
- securing and retaining carers and supports;
- ability to complete daily living tasks;
- achievement of personal goals;
- quality of life.
- A lack of or limited community engagement and social connections
- Supports, such as family, carers, and support workers, not being aligned with the care and support needs of the participant, such as not understanding their interaction, environmental and/or support preferences. Supports can receive guidance and/or training in supporting the participant from a PBS practitioner.
- The presence of restrictive practices.
- A need for the assessment of restrictive practices and/or supports considering introducing restrictive practices, which can only be carried out after they have received endorsement from PBS.
- A transition from hospital or prison into the community.
PBS: support across the participant’s lifespan
As positive behaviour support works across a person’s lifespan and with any disability, our PBS practitioners work holistically and collaboratively with each participant’s family, caregivers, and wider support network to optimise outcomes.
Our PBS practitioners also provide comprehensive recommendations for other professionals in a participant’s life, such as support workers and teachers, and ensure everyone involved in their care and support are compliant with the relevant NDIS Practice Alerts (Practice Alerts provide information on best practice, safe and quality service delivery to people with disability).
If you would like to find out more about our positive behaviour support services, or would like to arrange an assessment, please fill out our referral form.
