Positive Behaviour Support – Don’t Just Train and Hope!

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Training for staff is an essential part of getting the right PBS practices in place and there are a range of options for this. However, too often knowledge based training alone is seen as THE solution. Training is simply commissioned and then it’s ‘hoped’ that it will deliver ‘PBS’. But without supervised practice this is an approach that will rarely work! Some providers spend money on PBS training, only for senior staff to be frustrated when no real skills development and changes occur. This is not a criticism of any training course on PBS but does indicate that often people believe that training in PBS starts and finishes with a set of training days or a course which provides a qualification…not so!

What is the solution?

Training courses in PBS are mostly knowledge based, even those at diploma level with some element of work based assignments; this includes the training days we provide at Redstone.  They are a great starting point, but knowledge alone does not translate into practical skills. It’s like learning to drive – you can driving instructorread exactly how to drive a car and memorise the Highway Code, but it’s not until you get into a car and the instructor tells you how to use the pedals and change gear that you can start moving the car safely.  It’s not until you hit traffic that you start to really understand the rules …and the fact that some drivers are bending or ignoring them!

Supervised Practice

For PBS to be applied, knowledge needs to be combined with supervised practice. The majority of information and concepts in PBS are not difficult to understand. The challenge comes when we apply them with real people, in real settings. Support and guidance at this stage is what separates practitioners that know something from those who can reliably and consistently apply sound PBS practices.

The PBS Academy has outlined the competencies needed in practice. They have scoped out what staff at different levels need to know in terms of knowledge and what they need to be able to do in terms of practical skills.  Some PBS training days and courses have their contents mapped on to the competence framework, in terms of knowledge gained. This is good practice because currently there is no international or UK based accreditation system for PBS training or service provision.  There is a common misunderstanding here, as there is an accreditation system for physical intervention training, but this is not the same. At Redstone we are of mapping our supervised practice offer onto the skills areas of the competence framework.

Without supervised practice there are three key areas that people struggle with;

  1. Being clear about the function of behaviour (s) – As part of an assessment process lots of information is gathered and then needs to be put together for a staff team to understand the function of a behaviour or behaviours
  1. Developing a clear intervention plan – This should be based on the assessment and include all stakeholders.
  1. Being able to implement the plan – This requires skills beyond writing a plan, includes teaching new skills as an alternative to a behavioural challenge.  It includes trouble shooting implementation where there are real life obstacles, such as staff team disagreements, organisational issues or health factors for the focus person.

Supervised practice should be provided by someone at consultant level as identified by the PBS competency framework, who has both the knowledge and practical competency skills.

Defined Outcomes

In addition to supervised practice, an essential element to ensuring that you’re getting the right solution to your problem, is to map out exactly what change you are expecting to see. This should be in terms of observable behaviour change rather than more general terms such as ‘we will have a team of PBS practitioners in place’. Important questions to ask are, “what changes at the support level do we expect to see?”, “do we expect to see a reduction in behaviours that challenge?”, “will we see reductions in the use of restrictive interventions?” and “have we got systems in place to measure these outcomes?”

Redstone Tip

Don’t just train and hope – supervised practice and defining specific outcomes are critical!

  • Review your training strategy. Look at how you can ensure that supervised practice is a key element of it.
  • Set outcomes you would ideally like to see from staff training, in terms of concrete and observable changes.
  • Evaluate what you have in place, if it’s not resulting in the changes you want to see, review and make changes.

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© Redstone PBS 2018


Author

Kate StruttKate StruttDirector of Redstone PBS and Clinical Psychologist.  Kate has over 20 years’ experience of working with adults and children with intellectual disabilities and those who are autistic, both within statutory services and the independent sector. Kate is registered with the Health and Care Professions Council. Bsc Psychology, D.Clin Psyc, PG Certificate Applied Behaviour Analysis.

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