Trauma occurs when there is an event or experience that causes an actual or perceived threat to a person’s physical or mental well-being. Trauma can result in the person not being able to cope even when the situation is no longer present. This can be through psychological events such as ‘flashbacks’, intrusive thoughts, and nightmares or may, be more general feelings of anxiety, depression, poor sleep and poor appetite. Generally, trauma leads to the person not feeling safe and this can lead to behaviours that help the person to feel safe but have an impact on their quality of life over the longer term. People with learning disabilities are more vulnerable to bullying and being neglected and abused. These are two key factors that can result in trauma.
What to Look For
We might see people being more guarded, not trusting others easily, they may not want to engage in new activities or even activities that they have enjoyed in the past. They may act very defensively to other people’s behaviour, which they may see as a threat to them. This might result in them presenting with behaviours that challenge.
Trauma and PBS
The aim of positive behaviour support is to improve quality of life. In PBS we use behavioural approaches to understand behaviour and ensure that people’s needs are met through the team that supports them. PBS is not just one approach and other evidence-based approaches can also be used. So, while PBS uses a primarily values-based and behavioural approach, this does not mean the people’s life history and feelings are not taken into account. They are an essential element of getting the support right for the person.
Talking Therapies
Where it is relevant, a talking approach can be used to help the person process and the trauma of what has happened to them and look at helpful coping strategies. However, the person must consent to this and they must be able to use a talking therapy approach.
Behavioural Approach
Where a person cannot use a talking therapy approach or tell others about how they are feeling we can use PBS to make sure that the support approach is supportive, non-threatening and comfortable for the person. There are a few strategies and approaches that are helpful.
Making few demands- for many people lots of requests to do things they find unpleasant or scary can result in them refusing to do anything for fear of being ushed too far out of their comfort zone. Making only essential requests can help to build up trust. Once this is achieved you can gradually add more requests and activities.
Regularly providing preferred activities – alongside fewer requests, having familiar and favourite things to do can help a person to feel comfortable and happy and also begin to trust that the team around them are nice to be with.
Taking a soft and gentle approach to communication – style of communication is always important and getting it right for each person and their individual differences is essential. For people who are traumatized a soft and gentle communication approach can help. Often people who are traumatised are easily startled and may find loud and excitable people threatening.
This short blog aims to raise the issue of trauma in people supported through PBS. Where there are significant concerns, additional support should be sought from a qualified professional.
For further training
PBS Toolkit for Service Managers & Team Leaders
We have a PBS Toolkit e-learning, specifically for service managers and team leaders. It includes further support and resources. This e-learning course is sold via an organisational licence based on number of users. You can get a sneak peak of the content here.
PBS Coaching in Practice Programme
This programme includes the PBS Toolkit discussed above, plus 4 days training focussed on developing additional PBS knowledge and assessment skills. On completion of the programme. You can find more details here.
Get in touch with us at info@redstonepbs.co.uk or call 0161 864 2160 if you would like to explore either of these options further.
Author
Kate Strutt – Director 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, MSc Applied Behaviour Analysis.
