Positive behaviour support (PBS) is a training approach that is widely and successfully used to support participants who may present behaviours of concern to themselves and those who care for them.

PBS is built upon the belief that such behaviours will reduce if the right conditions and opportunities are created for participants to learn positive and safe ways of communicating and meeting their needs. This, in turn, can help to reduce restrictions on them and improve their quality of life. 

What are behaviours of concern? 

Behaviours of concern can take many forms. They may involve hurting one’s self, hurting other people, or being in crisis. 

What you may regard as a behaviour of concern is often used to help a person cope in a situation that they find difficult or stressful. If the behaviour has been successful in the past, then the person will continue to use the behaviour if they don’t have any other way of making their feelings known, or if they believe it is the most effective way of meeting their needs. This is why it is important to address the reason for the behaviour of concern. 

What does a PBS approach involve? 

PBS aims to develop an understanding of the behaviour of a participant. The approach involves collating lots of information about a person through an evidence-based functional assessment in order to develop an understanding of their behaviours. 

The analysis includes a functional assessment of their physical and social environments, such as where they are and who they are with when they present those behaviours. The assessment also includes the views of the individual and everyone that is involved with their care and support in order to develop a detailed understanding.

Imagine a three-month-old baby crying in its cot. Crying is the behaviour. The function of their behaviour is to get the parents attention, however, crying will have multiple different meanings for the child at that age. 

It can’t communicate yet, so it cries to let you know that something is wrong. The parent/ carer then goes through a process of elimination – are they tired, hungry, do they need a nappy change? Have they got a tummy ache? Do they just want a cuddle? Through this process, they are finding out the function of the behaviour. 

In this respect, a functional assessment is looking at a behaviour and saying what does that behaviour mean? What are the outcomes and function? What is it trying to achieve? 

Once you are able to identify a function or reason for a behaviour, you can then help to develop behaviours that work just as well, or better, in achieving what that person wants so that they do not use the behaviour of concern to communicate their needs. 

What is a PBS plan? 

Once an assessment has been undertaken the information helps to develop a PBS plan, which as well as including information on how to manage risk behaviours, will be proactive with a long-term focus on teaching new skills. 

The plan is then monitored and developed over time. 

What does “improving quality of life” really mean?

Quality of life improvements can include:

• Developing skills to take place in meaningful activities with or without support, such as communication skills, coping strategies, life skills
• Being able to exercise choice
• Being empowered
• Gaining life experience
• Developing and maintaining relationships
• Being valued

A PBS approach will often look for help from other professionals who can draw on their knowledge and expertise to help improve understanding of the person. This could include occupational therapists, speech and language therapy, psychotherapy or cognitive behavioural therapy. 

When a person’s quality of life improves, behaviours of concern, reduce.