Key Components of PBS

Positive Behavioural Support (PBS) has become widely recognised as the preferred approach for supporting individuals whose behaviour challenges services.

Several definitions and frameworks for PBS have been developed over the years (Allen et al., 2005; Carr et al., 2002; Horner et al., 1990, 2000; LaVigna & Willis, 2005). However, a recent re-definition by Gore et al., (2022) has aimed to consolidate the core elements of PBS to provide a clear, evidence-based framework for use across services in the UK.

This framework is designed to inform service delivery, policy development, and research in the field of PBS. It highlights that PBS is not a single therapy or intervention, but rather a multi-component framework for understanding behaviour that challenges and providing effective, person-centred support. The framework is based on a thorough assessment of the social and physical context in which behaviour occurs and aims to enhance the quality of life for individuals, and their carers.

The framework consists of 12 components grouped under three overarching categories. Each component is essential to ensure a high standard of care and a reduction in restrictive practices.

Key Components of PBS

(Source: Positive Behavioural Support (PBS) in the UK: A State of the Nation Report, 2022)

Rights and Values:
A focus on rights and good lives

1.  Person-centred foundation

2.  Constructional approaches and self-determination

3.  Partnership working and support for key people

4.  Elimination of aversive, restrictive and abusive practices 

Theory and Evidence Base:
Ways to understand behaviour, needs, and experience

5.  A biopsychosocial model of behaviours that challenge

6.  Behavioural approaches to learning, experience and interaction

7.  Multi-professional and cross-disciplinary approaches 

Rights and Values:
A focus on rights and good lives

8.  Evidence-informed decisions

9.  High-quality care and support environments

10.  Bespoke assessment

11.  Multi-component, personalised support plans

12.  Implementation, monitoring, and evaluation 

NAPPI Approach to PBS Values

At NAPPI UK, we are committed to promoting Positive Behavioural Support that leads to improved quality of life for individuals. Our approach focuses on:

• Increased feelings of Belonging, Productivity, and Relaxation: Identifying high-quality, meaningful activities tailored to the preferences of the individual. This reduces the need for restrictive physical interventions.
• Consistent and meaningful engagement: Ensuring that Team Members build positive relationships with individuals and provide engaging activities based on known likes and preferences.

NAPPI Modules that promote PBS Values:

• Amber Awareness
• SMART Principles
• Green Behaviour Scale

The involvement of the wider team is critical to achieving successful PBS outcomes. We encourage collaborative planning to build skills and reduce restrictive practices.

NAPPI Modules that promote Wider Team Involvement:

• Care Team Response
• Green Behaviour Scale

NAPPI Approach to PBS Theory and Evidence Base

Understanding the underlying causes of behaviour that challenges is essential in delivering effective support. The NAPPI approach ensures that all team members have the following competencies:

• Functional Awareness: All team members should understand Functional Assessment and Functional Analysis, contributing to consistent and informed support.
• Clinical Support: Skilled PBS Consultants work alongside the team to provide guidance and ensure evidence-based practices are embedded.

NAPPI Modules that promote Functional Awareness:

• Care Team Response
• Amber Awareness – Stress Factors
• Red, Amber & Green (Lalemand) Behaviour Scales

Supervision and Continuous Improvement: Registered Managers are supported to promote the use of NAPPI SMART Principles in staff supervision, ensuring continuous improvement in PBS delivery.

NAPPI Approach to Process and Strategy

NAPPI UK champions the delivery of high-quality, multi-component support plans. This approach is grounded in:

• Collaborative Planning: All interventions are planned with the involvement of the service user, family members, and the wider multi-disciplinary team.
• Ethical and Evidence-Based Practices: The use of PBS Plans, including any restrictive interventions, is managed in line with legal and best practice frameworks.

Clinical Oversight: PBS Consultants work alongside Registered Managers to ensure clinical excellence and adherence to best practice standards, ensuring safe, high-quality care is consistently provided.