Positive Behaviour Support Plans

Effective design and development

Objectives

• What is Positive Behaviour Support? • How can plans be made effective ?• Why might plans fail or not be as effective as

they could be?• What are effective formats for PBS plans?• My experiences of PBS planning.• How should plans be reviewed and maintained?

What is Positive Behaviour Support?

‘Positive behavior support (PBS) is an applied science that uses educational and systems change methods (environmental redesign) to enhance quality of life and minimize problem behaviors’

Carr et al (2002)

Sources of PBS (Carr et al 2002)

Applied Behaviour Analysis

Normalisation/ Inclusion Movement

Person Centre Values

Feature of PBS (Carr et al 2002)

• comprehensive lifestyle change• a lifespan perspective • ecological validity • stakeholder participation• social validity • systems change and multicomponent

intervention• emphasis on prevention,

Characteristics of PBS and PBS Planning

• Assessment based• Comprehensive• Proactive• Lifestyle enhancement/inclusion• Person Centred Values• Everyday application• Teaching of alternative skills Bambara and Knoster 1998

Principles underlying effective PBS plans

• Multiple interventions or support strategies

• Hypothesis based

• Person Centred

• Personalisation

Aspects that should be included in PBS plans to make them effective

• Antecedent and setting event modifications

• Teaching of alternative skills• Consequence interventions• Lifestyle Interventions

(Bambara and Knoster 2003)

Triadic Approach

• Consultant

• Mediators

• Focus person (Tharp and Wetzel 1969)

Contextual fit

Congruence between PBS plan and variables related to:

• Focus person

• People implementing the plan

• Environment and systems

Reasons why PBS plans may fail

• Not comprehensive enough

• Not technically sound

• Poor fit

• Poor implementation (Bro Morgannwg 2009)

Formats – 13 step model (PRT)

1. Behaviours of concern

2. Who is affected?

3. Setting conditions

4. Primary Prevention

5. Early Indicators

6. Secondary Prevention

13 steps continued (PRT)

7. Reactive strategies 8. Unresolved risks 9. Post Incident Support 10.How does the plan support community

living? 11.Data collection and review 12.Plan agreement 13 Review date

PBS plan (Bro Morgannwg format) 1

1. Identifiers

2. Pen portrait

3. Behavioural Summary

4. Health needs

PBS plan (Bro Morgannwg format) 2

5. Primary Prevention

6. Secondary Prevention

7. Reactive Strategies

8. Evaluation

What I have found helpful in practice

• Planning with teams• Matching support to individual teams• Attending to ongoing team needs• Ensuring grasp of theoretical principles• Adequate data gathering and analysis• Create momentum• Regular review• Facilitator knowledge• Clear, understandable language

Audit tools

• PBS checklist

• Goodness of Fit Survey

• Audit Tool for Best Practice