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Behaviours that challenge: How positive behaviour support significantly lessens the need for restraint

A new film highlights the driving force that has built up behind positive behaviour support – and how one regularly restrained client’s life was transformed by the approach, as Ben Higgins reveals 

A new film highlights the driving force that has built up behind positive behaviour support – and how one regularly restrained client’s life was transformed by the approach, as Ben Higgins reveals

‘If you go angry and you’re really not well, they restrain you and they might have to give you PRN medication [as needed] to calm you down, but the strong dose can knock you out… Now if I get angry when I am out in public, I just sit down, act like an adult and talk it through with a member of staff’.

Ashley Richardson’s story is featured in the film Positive Behaviour Support:
Changing Practice, Changing Culture and Changing Lives

Ashley Richardson’s life has been transformed by positive behaviour support (PBS). He experienced restraint regularly during his time in an assessment unit and his life was tightly monitored and controlled.

In control

Now, supported by a PBS approach, he is in control of his life and has found new ways to manage the challenges he encounters.

Ashley’s story is featured in a new film, made by the British Institute of Learning Disabilities (BILD), Health Education England and the Department of Health, which shows how the use of PBS makes differences to people with learning disabilities, autism or both.


Watch: Positive Behaviour Support: Changing practice, changing culture, changing lives


The film, Positive Behaviour Support: Changing Practice, Changing Culture and Changing Lives, highlights the huge momentum that has built up behind PBS.

‘We are supporting the development of a new culture and skills – and knowledge in PBS needs to be practised, checked and encouraged in the workplace’

In our experience, the organisations we have worked with have seen significant improvements by adopting a PBS approach. The Witherslack Group reported reducing their use of prone restraint by 72%, and the charity MacIntyre reported a reduction in physical intervention by 30%.

We now find ourselves delivering our 100th Centre for the Advancement of Positive Behaviour Support coaches programme and, after seeing an increased number of schools interested in working with us to adopt PBS, we have also launched a specialised coaches programme designed for schools.

For us, the challenge now is to ensure PBS is sustainable within organisations rather than a one-off training course. We are supporting the development of a new culture and skills, and knowledge in PBS needs to be practised, checked and encouraged in the workplace.

Several factors are integral to its success:

  • It needs skilled empathic people to deliver direct support.
  • Access to appropriate levels of behavioural expertise.
  • Organisational structures that support implementation.
  • Practice leaders.

Practice leaders are people in the workplace who understand, and are enthusiastic about PBS and can guide others who may not be so confident. They can highlight good practice examples and, through consistent working, the service can improve and make a difference to the quality of life of the people they support.

PBS Alliance

Delivering evidence-based high-quality support to people with learning disabilities and/or autism – including those with mental health conditions or behaviours that challenge services – is a specialised activity.

The PBS Alliance is a collaboration of academics and practitioners that aims to deliver the vision outlined in the Mansell report (2007) of widespread competent, community-based support for children and adults in education, health and social care.

‘Delivering evidence-based high-quality support to people with learning disabilities and/or autism is a specialised activity’

The National Institute for Health and Care Excellence draft guidance recommends that services ‘ensure that staff providing direct support to people with a learning disability and behaviour that challenges have the ‘direct contact’ level competencies of the PBS competency framework’.

BILD believes each organisation should support from a PBS specialist who can advise on the development of staff and the organisation to embed PBS.

The challenge for organisations is not becoming over-reliant on external consultants and complementing this with investing in their staff who provide direct support, so they have skills to provide the best possible support.


References

About the author

Ben Higgins is chief executive of the British Institute of Learning Disabilities, Edgbaston, Birmingham

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