Positive a Behaviour Supports and Low Arousal Approaches: The Studio3 perspective
The training low arousal based courses focus on reactive approaches to manage behaviours. Reactive approaches are necessary but completely sufficient to effect change. Our goal is to apply scientific principles to day to day behaviour management which we call low arousal approaches.
There are four key components considered central to low arousal approaches, and those include both cognitive and behavioural elements:
1. Decreasing staff demands and requests to reduce potential points of conflict around an individual
2. Avoiding potentially arousing triggers, such as direct eye contact, touch, and removal of spectators to the incident
3. Avoidance of non-verbal behaviours that may lead to conflict, such as aggressive postures and stances
4. Challenging staff beliefs about the short-term management of challenging behaviours
Wider changes can be achieved when we combine good behaviour management with Positive Behaviour Suppports.
What are Positive Behaviour Supports?
Positive Behaviour Support (PBS) is an approach mostly used to support people with learning disabilities whose behaviours challenge others, or lead to restrictions for them. It has a strong empirical evidence base and is consistent with the human rights of people with Learning Disabilities (Chan, French, & Webber 2011). PBS uses non-aversive applied behaviour analysis techniques in combination with person centered approaches to achieve the values of learning disability support. Generally, PBS refers to strategies and methods which aim to assist an individual to reduce challenging behaviour and increase their quality of life by teaching new skills and adjusting their environment to promote positive behaviour changes.
PBS recognises that behaviour serves a function with the aim of supporting the individual to learn a new behaviour which serves the same function but is considered less ‘challenging’. PBS interventions have a strong emphasis on prevention.
When PBS is being used you should see that:
Challenging behaviour is seen as functional. The behaviour helps that person to gain or avoid something.
The focus of a PBS plan is teaching new ways of achieving this function, not reducing the challenging behaviour. These reduce as a naturally occurring side effect.
Plans do not use punishment interventions. They are based on increasing functional behaviours, not reducing behaviours.
Learning for people with a learning disability needs to happen at their pace. A slow and steady approach is often required. It is important to make data recordings to show how people grow skills over time.
Our own PBS practitioners in Studio3 provide a number of programmes that focuses on proactive and reactive approaches within an evidenced based framework. Teaching will focus on functional analysis, functional assessment, constructional non aversive approaches. Participants are encouraged to focus on real life experiences. Our focus is slightly different from traditional PBS approaches as a wellbeing framework is used, We focus on the PERMA wellbeing framework (Seligman, 2011) which has been applied to a number of different populations including autism (McDonnell and Gayson, 2014). This model focuses on key elements of wellbeing (positive emotion, engagement, relationships, meaning, achievements). We also strongly emphasise the role of stress as a mediator variable.
We adopt a model where participants receive two days training. They then apply these principles to a service user and then return for a follow up day at 3 months. A key outcome involves the production of good quality Behaviour support plans.
IMPLEMENTATION IS THE KEY
Good quality plans are only effective if they are consistently implemented by staff teams. This is often overlooked in organisations. Resistance to plans varies from organisation to organisation and it is a complicated process. Understanding these resistances can help with the implementation of more effective plans. A good subjective measure is to ask your staff anonymously their opinion about the implementation of plans.
There are a variety of reasons why behaviour support plans may not be implemented, which includes:
The plan is too difficult to understand. In this case, the organisation should consider rewriting the plans and it may also be useful to use reading age readability formulas available within word processing programmes.
Staff do not share the beliefs of the person who has written the support plan.
Staff do not agree with you, the managers, about the content of the plan.
Staff disagree with each other about the content of the plan and how they should implement it.
Plans are not reviewed regularly enough and so staff view them as out of date.
Once in place, behaviour support plans should be reviewed and triangulated – it should be asked “what direct evidence do we have that the plans are being implemented?” It is vital that there is ongoing documenting, discussion and analysis of all such evidence. The evaluation of outcomes should involve the person and family/carers where relevant. Outcome success should be judged on improvements in quality of life not just reduction in challenging behaviours.
We would strongly suggest that over the course of a year implementation audits should be conducted focussing on either specific plans or parts of the organisation which implements a number of plans.
STUDIO3 TRAINING VIEW
Studio3 routinely works with organisations that are developing PBS cultures. PBS primarily is strongly emphasized in our behaviour management training. Our emphasis is on good quality evidenced based on evidenced based reactive strategies. These strategies help to enhance the PBS Practitioner in their ability to manage behaviours of concern. In sum, to be proactive you need to be good at the reactive.
Contact Studio 3 to discuss how we can assist PBS Practitioners in their ability to manage behaviours of concern.