Building brighter futures with Positive Behaviour Support in Wales
By David O’Brien, Senior Improvement Manager
I recently spent a week at Summer School. Not one where we eat marshmallows by an open camp side fire, but one that I was able to enjoy with fellow leaders across public services to explore our shared purpose to achieve a better quality of life for us all.
Taking part in Academi Wales’ 20th Summer School was an incredibly immersive experience. My time in the beautiful Lampeter gave great conversations with my colleagues. It challenged me, presented different perspectives, and afforded me the headspace to think about what I’ve done and what I do moving forwards.
Those who work in health and wellbeing for people with a learning disability feel an extra responsibility to make sure some of the most vulnerable people in our society aren’t excluded or restricted. I know I’m not alone in this. They deserve to feel the same sense of connection and community that invigorated me, but that’s not the case for many.
It has prompted me to think again about the influence of Positive Behaviour Support (PBS), especially the resource we published last year to upskill and empower families along with the British Institute of Learning Disabilities (BILD) and the All Wales Forum.
Why is PBS important?
In Wales, we believe that everyone deserves the opportunity to thrive, feel safe, and be supported in ways that respect their individuality. PBS is a key approach in supporting people with a learning disability across Wales because it provides a framework enabling them to live a life that is meaningful and of value to them.
PBS is especially helpful when used to support people with learning disabilities who are at risk of being excluded or restricted. At the heart of PBS is the understanding that all behaviour has meaning. When someone is engaging in behaviours of concern, they are communicating in the most effective way they have that something is not right for them.
So, PBS is more than just a strategy or intervention. It’s a compassionate, evidence-based way of understanding behaviour and improving quality of life. By focusing on what a person needs, values, and enjoys, PBS helps reduce behaviours of concern by promoting positive alternatives and meaningful engagement.
What makes PBS so impactful?
There’s lots of reasons to implement PBS, but here are some of my main reasons for championing its use:
- It uses functional assessment to understand behaviour.
- It’s person-centred and proactive.
- It’s rooted in dignity, respect, and inclusion.
- It reduces the use of restrictive practices by reducing harmful behaviour.
Underpinned by evidence
PBS is a holistic approach to improve the overall quality of life for individuals with a learning disability and those who support them. There’s lots of anecdotal corroboration, but we can be reassured in knowing that PBS is also underpinned by solid evidence.
There is an ever-growing body of evidence to support its effective use. Positive Behavioural Support in the UK: A State of the Nation Report1 reflects on developments in PBS across the UK since 2013. The reasons why I hold the report in such regard is because it’s co-produced, trauma-informed, and looks to bridge the gap between being evidence-based and practically applicable.
The report is an overview of current and significant research. It gives a clear narrative about the evidence base in favour of PBS, including what the research tells us about how “not to do” PBS and it gives a guide for future research and practice. The National Institute for Health and Care Excellence (NICE) also supports the use of Positive Behavioural Support (PBS) as a key intervention for people with a learning disability who have behaviours of concern.2
Staying informed
As PBS becomes more widely known, it’s important to stay informed with the latest thinking, evidence and debate. We know that some believe that PBS is similar to Applied Behaviour Analysis (ABA). We share the view of many organisations and academics that PBS and ABA are not the same thing. PBS doesn’t try to change people; it helps improve environments and quality of life by understanding the function of behaviours, using this information to shape personalised care and support.
We must also recognise that not all advice or content labelled as PBS reflects the true values or evidence-based practices behind it. Identifying what good PBS looks like is key to the good commissioning and delivery of care and support.3
That’s why we encourage everyone including families, professionals, and communities to seek trusted sources, ask questions, and stay connected. If you would like to share knowledge, develop good practice and even influence policy, you can join the All Wales Community of Practice for Behaviours of Concern. Please come along! I’m always thrilled to welcome new members.
Together, I truly believe we can use PBS to improve Wales as a place where people with a learning disability enjoy the same benefits of connection and community that we can all enjoy.
References
- Gore etal ( 2022) Positive Behavioural Support in the UK: A State of the Nation Report ↩︎
- Legg, Gill & Thomson, Megan 2017 Positive behaviour support with children and families ↩︎
- PBS Alliance What does good PBS look like now? ↩︎