What is Positive Behaviour Support?

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Positive Behavioural Support (PBS) is recognised as an effective and ethical way of supporting people with learning disabilities who are at risk of behaviour that challenges. It and/or its components have been recommended in several policy documents and professional guidelines3 including the NICE guidelines for Challenging Behaviour; Ensuring Quality Services; Positive and Proactive Care: Reducing the need for Restrictive Interventions; A Positive and Proactive Workforce; and Supporting Staff who work with people who Challenge Services.


PBS is a framework for developing an understanding of behaviour that challenges, rather than a single therapeutic approach, treatment, or philosophy. It is based on the assessment of the broad social, physical and individual context in which the behaviour occurs, and uses this information to develop interventions. The overall goal is to improve the person’s quality of life and of those around them, thus reducing the likelihood of challenging behaviour in the first place.


The framework is made up of twelve core elements (Gore et al., 2021) each of which should be included and visible if a service is providing PBS. The elements relate to the rights and values that underpin PBS, the theory and evidence base that supports PBS interventions, and the process and strategy, i.e. the methods used to implement PBS. (See Box 1, below).


When a person receives PBS, it is unlikely to come from just one individual, one professional group or one service. Families, carers, professionals, service providers and commissioners need to work together and each play their part in supporting that person.

The Core Elements of Positive Behaviour support (PBS)

Rights and Values

A focus on rights and good lives for people with learning disabilities and those who care for them

  1. Person centred foundation

  2. Constructive approaches and empowerment

  3. Partnership working and stakeholder involvement

  4. Elimination of aversive, restrictive and abusive practices

Theory and Evidence Base:

Understanding Behaviour, needs and experience

  1. A biopsychosocial model of behaviours that challenge

  2. Behavioural approaches to promote learning, doing and interacting

  3. Multi-profession and cross discipline approaches

Process and Strategy:

A systematic approach to ensuring high quality support

  1. Evidence informed decisions

  2. High quality care and support environments

  3. Functional assessment

  4. Multi-component PBS support plans

  5. Implementation, monitoring and evaluation

 

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