introducing the disability justice...

Disability Justice Project

Positive Behaviour Support and Disability Justice

Participant’s Handbook


Acknowledgements

DisclaimerNSW Department of Family and Community Services (FACS) as well as project partners and the course developer(s) do not give warranty nor accept any liability in relation to the content of this work.

Copyright NSW Department of Family and Community Services, 2016

Contact the Disability Justice Project:

Level 4, 699 George Street (Cnr. Ultimo Road) Sydney NSW 2000

Phone: (02) 9281 8822Email: [email protected]

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Introducing the Disability Justice Project:

The Disability Justice Project aims to:

“...build capacity across the NSW disability sector to support people with a cognitive disability who come into contact with the justice system, to be able to exercise their rights under the law.”

The Disability Justice Project is a two-year capacity building project for disability service providers, working with those who have intellectual or cognitive disabilities and may come into contact with the criminal justice system.

What does this project provide?

• Free face-to-face, webinar and online training

• ‘Leaders’ Forums’ breakfasts

• Detailed Framework document

• Communities of Practice

• Website with links to many other resources

• Monthly Newsletter

Who is delivering the project?

The project is being delivered by a consortium of three partner agencies:

• The Association of Children’s Welfare Agencies/Centre for Community Welfare Training (ACWA CCWT)

• The Intellectual Disability Rights Services (IDRS)

• Life without Barriers (LWB)

Go to this link http://disabilityjustice.edu.au/ to find out more about the project, and upcoming training and events in your area.

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http://disabilityjustice.edu.au/


Overview of the training:

Learning Outcomes:

• Understand that behaviour serves a legitimate function to the person

• The function of behaviour

• Culturally informed practice

• The interaction of behaviour, offending and cognitive impairment

• The benefits of PBS: why use it and who benefits

• Understanding behaviour through cultural lens

• Practices that enhance PBS

• Your role in PBS

• Where to get support in PBS

This one-day training will provide the learner with an introduction to what is positive behaviour support, how it connects directly to people with a cognitive impairment and the criminal justice system. It is intended as an overview and explores:

Understanding what is behaviour of concern Risk factors that contribute to behaviours of concern Understanding cultural needs and seeing behaviour through a cultural lens Understanding all behaviour serves a legitimate function to the person Where to get help and support when dealing with complex behaviours of concern

in your workplace

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Function of behaviour:

• All behaviour serves a legitimate function to the person exhibiting that behaviour:

o All behaviour occurs for a reason, it is a form of communication. Sometimes the reason will be clear, but at other times it may not be clear.

o What can be said with certainty is that a person is demonstrating a behaviour because it meets a specific need for him or her

4 Functions of Behaviour:

The Function of a person’s behaviour is never the concern, it’s the behaviour itself that could be positive or a concerning behaviour.

Behaviour Of concern Definition:

Behaviour which is of such severity that it presents a serious challenge to the person, family, carers, service providers and or the community in any of the following five areas:

• Home / school /day placement /work potential or actual placement breakdown• Person is at risk of harm or is being harmed or others are at risk of harm or are

being harmed

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• Person is at risk of being relocated to a more restrictive setting eg. jail, lock down facility

• Person’s development / learning / community involvement is seriously impacted • A persons wellbeing, quality of life or goals are being effected by their behaviour

Notes:________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

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Culturally Informed Practice:• Acknowledgement and respect of Aboriginal people and that they have been the

custodians of the land, waters and sea for over 60,000 years, with a strong and diverse culture across the country

• Acknowledgement and understanding of the contribution Aboriginal people make, and of the richness and beauty their culture brings

• Build cultural competence, in a very real and meaningful way. Learn and seek advice and support from culture leaders, understand the injustice, racism, inequality that continues in Australia

• Trans-generational and inter-generational trauma• White settlement of Australia and the impact this has had on Aboriginal people

today• Kinships, roles of elders, Uncles, Aunties, extended family• Cultural ceremony• Active and real discrimination occurring across the country• The importance of country, connection to country and cultural life, on their terms

and their way• All the work we do with Aboriginal people needs to ensure all of this practice, and

when working on behavioural change especially, we need to understand culturally appropriate behaviour as workers and support people - to express themselves freely

The Importance of Culturally informed practice

• The number of Aboriginal people in prison is continuing to rise, with 2016 a record-breaking year

• As of June 2015, 9,885 (27%) of people in Australian prisons that identified as Aboriginal

• 1 in 4 Aboriginal Men will end up in jail at some point in their lives• Aboriginal people are less likely than non-Aboriginal people to be referred to, or

complete pre-sentencing and court intervention programs• Aboriginal people are up to 5 times more likely to be sentenced to prison for the

same offence than non-Aboriginal people• The reoffending rate for Aboriginal young people is almost 3 times that for non-

Aboriginal young people• 90% of Aboriginal juvenile offenders reappear in adult court, same figure for non-

Aboriginal youth is 52%• The cost for these far higher rates of Aboriginal custody is significantly more than

for non-Aboriginal young people and adults• Aboriginal women experience higher rates of mental health disorders, cognitive

impairment, sexual violence, homelessness

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Exercise: Cultural Awareness List

What are you currently doing in your work practice?

1.

2.

3.

4.

Risk Factors

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Baldry, E., Dowse, L. and Clarence, M. (2011) People with mental and cognitive disabilities: pathways into prison School of Social Sciences and International Studies, P11

Where changes can be made, we need to address the risks and make positive changes.

Group Discussion:

Where there is a risk factor that cant be changed what do you think is the action that should be taken?

Some examples could include:

• Trauma informed practice• Building skills and resilience• Counseling

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Cognitive Impairment

Types of Cognitive impairments and their expression of behaviour can include:

• Acquired Brain Injury: can have poor impulse control due to frontal lobe damage

• Dementia: loss of memory

• Intellectual Disability

• Foetal Alcohol Syndrome: can have an inability to manage complexity

Exercise: What are some other examples?

________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

Based on these examples we then can conclude that we can’t separate cognitive impairment and possible behaviour of concern because the behaviour could be as a result of the impairment. This is why PBS is so important.

The Context of Behaviour:Behaviour is a response to the stimulus of the environment around the person. Behaviours of concern are a particular reaction to the stimulus in the environment that may cause harm to self or others.

The combination of the person’s impairment and the environmental factors such as:

Marginalisation Poverty Homelessness

This can mean that some people may not know right from wrong or good from bad

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Exercise: large group

As a large group using butcher paper, discuss and record how behaviour can manifest in the environment

o An example could be environment is noisy.

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Kerry’s StoryKerry is a 14-year-old Indigenous boy, who is the youngest of 5 brothers. Kerry lives part-time with his mum and part-time with his grandmother. The family struggles week-to-week with money and there is conflict between his mother and grandmother.

Kerry is a proud Indigenous young man and has good expressive and reception language skills and enjoys a range of sports being especially good at AFL. Kerry is inconsistent with school attendance but when he attends school he likes making objects out of timber. He loves watching high action movies, hanging out with his friends and riding his bike around town.

Kerry has an Intellectual disability and has been recently diagnosed with ADHD

Recently Kerry was arrested for shoplifting from the local food works. This was the eighth time he has been caught shoplifting in the past 12 months. At the previous hearing Kerry was placed on a good behaviour bond and was told next time it happened he would go to jail.

Kerry went to court and the outcome was he was sentenced 12 months jail in a juvenile correctional centre.

What is in this story that can change?

What can be changed What can’t be changedRisk Factors

EnvironmentalFactors

Behaviours

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Defining the BehaviourWhen describing behaviour we need to ensure the following:

• It is observable• Factual, without interpretation• Defines when the behaviour starts and stops

Example:Description of Jono’s behaviour when he is asked to do something he doesn't want to do:

Jono yells and screams and throws things at people when he doesn’t get his way.

Is this a good definition of behaviour?

Detailed description of the behaviour:Example of behavior when Jono asked to do something he doesn't want to do:

The behaviour starts when Jono goes red in the face and in a loud raised voice swears and screams, telling people to leave him alone. If he has anything in his hand, he will throw it at the person. Then looks for other objects in his immediate area to throw. The behaviour stops once Jono stops screaming and walks into his bedroom.

• Is this a good description of behaviour?

Exploring what is Positive behaviour and behaviour of concernExercise Group one:

Describe 2 different behaviours, which are positive with a person you work with. What do they look like? What are there meanings for the person doing the behaviour?

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Exercise Group two:

Describe two behaviours, which are negative with a person you work with. What do they look like? What do you think could be there meanings to the person exhibiting them?

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_______________________________________________________________________

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Positive Behaviour Support (PBS)Positive Behaviour support is focus on understanding the behaviour of concern, that is based on values and evidence based practice. It is an approach that develops an understanding of why the person engages in behaviour that impacts on their or other people’s lives, focusing on prevention, positive support and teaching new skills.

It offers a holistic approach and considers all factors that impact on a person. It can be used on all types of behaviours and is least restrictive. It is always Person Centred.

The Positive Behaviour Support Model operates within the general values framework articulated by John O’Brien. He identified the five accomplishments of human Services, serving disadvantaged individuals and their families.

John O’Brien’s Five Valued Experiences

What is Positive Behaviour support?

• Focus on long term outcomes for behaviour change• Non-aversive approach and strategies• Strong emphasis on the importance of understanding the function of the

person’s challenging behaviour• Pro-active focus• Empowerment for the person and their support, to have real impact over their

lives

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• Focus on building on a person’s strengths and interests

Positive Behaviour Support is NOT:

• A quick fix to an area of concern• A way to change someone behaviour because we don’t personally like it or

agree with it• Power and control over a person• Excluding the person, their families / friends or cultural practices and beliefs• About changing a person• About working in isolation• Picking one area to use and ignoring the rest• “Fixing people” or rescuing people

Punishment Vs PBS

• Punishment requires someone to be there to enforce it• Punishment doesn’t stop behaviour of concern, often the behaviour goes covert• Punishment has no learning for the person

Example:

• How many people have ever been speeding when driving?• What do you do when you see a police car on the side of the road?• What do you do when you don’t see the police car?• When the police are present people follow the speed limit, when they are not

people speed

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Positive Behaviour Support has a number of key underlying principles:

1. Lifestyle improvement: Positive Behaviour Support (PBS) is founded on a philosophy of respect for the individual and desire to help them achieve a more agreeable lifestyle that meets their personal aspirations and decisions.

2. Functional Assessment: Interventions are based on an understanding of the individual’s interactions with others and the environment, the functions the behaviour may serve and the communicative messages it may contain.

3. Strengths Based : Goals are focused to strengthen and build the individuals existing skills, rather than suppressing unwanted behaviour or focusing on correction and/or the teaching of things that the individual does least well.

4. Person Centred : Goals and strategies are centred on the person’s needs and aspirations and the least restrictive techniques possible are used. Skill development and choice making are built into interventions that lead to outcomes that are meaningful and purposeful for the person involved.

5. Empowerment: Interventions emphasise teaching and supporting replacement skills that are pro-social and empower the individual by performing the same functions for the person as the problem behaviours did.

6. Multiple components: Acknowledging the influences of health and medical needs, disability issues and the environmental context, PBS considers and incorporates all factors of a person’s life into a unique support plan in ways that combine evidence based information and strategies with social value.

7. Partnership : Unique plans and strategies are developed and adapted for the context through collaboration and partnerships between all significant stakeholders and support workers. Plans address the needs and abilities of staff and families as well as the person, and include strategies to strengthen partnerships for information, decision making implementation and mutual support.

8. Promote and Support: Interventions emphasise enabling strategies for families and staff to:

a. Promote and support positive behaviour.

b. Minimise the likelihood of problems occurring in the course of everyday activities

c. Support the individual through incidents that may arise with the aim of reducing impact and escalation of problems that do occur

9. Environmental Change: Strategies often include systems change. This is necessary if positive support is to be maintained for positive behaviour to endure over time. Such strategies may include environmental changes, staff changes, and activity changes.

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Why Positive Behaviour Support?

• Offers the possibility for behaviour change, involving replacing one behaviour with a more attractive behaviour

• Provides strategies for people to understand and manage their emotions i.e. anger, stress, worry

• Provides a platform for understanding the interaction of the behaviour and the environment, and the role of the support worker in that interaction

• A holistic approach - therefore looks as the whole person not just the behaviour

For Positive Behaviour Support to be effective, safe and sustainable it requires:

• People to work from a strengths based approach• Commitment to the person and the plan• Constancy of all people involved• An understanding that all behaviour serves a legitimate function to the person,

therefore the behaviour has a purpose• Collaboration and strong team work• Monitoring and evaluation of strategies• Accurate data collection• Positive, encouraging support teams.

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Exercise: Self Reflection

Describe behaviour of yours that you have changed because it no longer serves a positive purpose:

• Describe the behaviour

• How did you change it?

• What was the outcome?

Then in pairs walk the other person through that experience?

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Why do PBS? People with impairments don’t often have the same cognitive capacity to

understand their own behaviour. Helps build insight and supports them in their quality of life

Behaviour is a universal human concept and people with cognitive impairments use behaviour to communicate

Constructs the behaviour as an interaction between the person and their environment

Supports environmental and cultural change

Provides a behaviour change model that is rights based and takes into account the whole of the person’s circumstances

What are some other reasons?

Exercise: Kerry Page 10:

What do you think could be a likely function of his behaviour?

What could possibly change in his environment to make things better?

What supports could be added?

What skill or skills could be taught to Kerry?

What could his supports do when the behaviour of concern is occurring to minimise the impact?

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Cost benefit to early intervention:Cost benefit analysis by Professor Eileen Baldry ACSO 2013

Findings:

• Young people with mental and/or cognitive impairment are at least 6 times more likely to be in custody than the general NSW population

• Adults with mental &/or cognitive impairment are 3-9 times more likely to be in prison than general NSW population

• Prison is significantly more likely for Indigenous Australians than non-Indigenous Australians

Some examples from the study included:

Roy• 30-year-old Aboriginal man with an intellectual disability & personality disorder • Early contact with CJS –JJ• Over 1,400 days in adult custody• Over 100 days in hospital for mental health and self harm • Over 5,000 days of methadone treatment. • $1,958,292 - incl 209 police, 362 JJ, 1468 custody days

Casey • Woman, early 20s; intellectual disability and a range of mental health disorders• ADHD, conduct disorders, adjustment disorders, PD & bipolar affective disorder• Early history with police and of self-harm, physical abuse and trauma • $5,515,293 - incl1169 OOHC, 356 police, 604 custody & 270 days in hospital

Who benefits from PBS?

• Person with cognitive impairment and behaviours of concern

• Family and friends

• People in the environment where behaviour occurs

• Systems / institutions / services who have to manage the impact of behaviour i.e. criminal justice costs

• Community

• Support services

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Ultimately the biggest benefit is to the person, who can grow and deepen their understanding of self in their environment, develop insight and space for more functional behaviour, stronger relationships and quality of life.

PBS through cultural lens:

All behaviour is seen through a variety of cultural lens - it frames how you understand the interaction of yourself and the world.

The cultural lens:

• Can be ethnic identity

• Can be a social and environmental identity

Think about:

The Ten Commandments list, we have a general understanding and acceptance of this list - let's look at one of the commandments

• Thou shall not steal. Thinking about Kerry’s story, his reference was different, thou should not steal wasn’t functional for him - from his cultural lens he was in poverty, hungry and had lack of opportunity

• His cultural lens did not have thou should no steal as he might not eat if he doesn't therefore this cultural understanding was not his

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• Kerry lives in poverty and has limited formal and informal supports around him, so he gets hungry and goes to the shop and shop lifts. In this context the behaviour makes sense but against the laws of the state it’s a criminal act

Amy’s story

Amy is a 63-year-old Aboriginal Women in a community group home, for people with a disability, in Moree. She shares with three other women. Amy was placed into this home four months ago because it was believed she was at significant risk to herself, as were others due to her fire-lighting behaviour

Amy was regularly lighting fires, which burned down objects including the bedroom in her last home. Many interventions were tried to stop this behaviour, with only varying degrees of success. Preventing access to fire-lighting devices was the main strategy.

If we view this behaviour through a white Anglo cultural lens we would most likely view the behaviour Amy was engaging in as mental illness. And it was this reason that then resulted in Amy having to leave her family land and live in a group home in the town area.

One day, an Aboriginal Elder explained to Amy’s workers at the group home that Aboriginal women would often guide their children home at the end of the day using fire. Amy would have experienced this with her mother and Aunties in her early years, and as a mother she also used this practice.

Staff found out that all of Amy’s children had been placed into foster care and apparently she never recovered from this and was in deep grief and trauma, and what they guessed was she was lighting fires to guide the children home.

Amy was mentally unwell and likely suffered from depression, however when the staff understood the cultural reason for why she lit the fires and responded to the behaviour in a more culturally informed way the behaviour went away by putting candles in the window.

The principles of positive behaviour support are culturally relevant across all cultures, its important that the application of these principles is adapted to the cultural specifics of the person.

Exercise: What are we learning from this story?_______________________________________________________________________

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Disability Justice Project 23


Exercise: Cultural Lens

Think about a person you are working with:

What is the behaviour they are engaging in?

Think about what could be the function of the behaviour?

Think about this behaviour and function from their cultural Lens, does this behaviour make sense based on their lens?

Lets go a step further:

What could you change in their environment to make it better for the person?

What do you think the person needs to learn to change the behaviour?

What could you offer the person to change (what’s in it for them to change)?

What can you and other staff do to better support the behaviour change?

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Rights of People with a Disability

Exercise: Watch this Video

Rights Under the Convention of the Rights with People with Disabilities

https://youtu.be/PgQnLXazdSg

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Exercise: DiscussionThink about your work place. What stories can we tell of where the Bill of Rights is and isn’t happening? How could this be affecting people’s behaviour?

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Person centred practice and PBS

What is Person Centred Planning?

‘Person Centred planning’ may be defined as a way of discovering:

How a person wants to live their life and

What is required to make that possible?

The overall aim of person centred planning is “good planning leading to positive changes in people’s lives and services” (Ritchie et al, 2003).

Person centred planning is not so much a new technique for planning, as a new approach to - or new type of - planning that is underpinned by a very exacting set of values and beliefs that is very different to the current norm. It is planning that takes as its primary focus a person - as opposed to a disability or a service or some other particular issue. It is ‘whole person’ oriented as opposed to disability-management focused. It is about citizenship, inclusion in family, community and the mainstream of life and self-determination and can, therefore, require some very fundamental changes in thinking and the established balances of power, the implications of which are potentially enormous and far reaching.

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Before undertaking positive behaviour support we have to get to know someone - who they are as a person, not just what their concerning behaviour is:

• What are their interests• What are their skills and passions• What is important to them and for them• Their daily needs, including medication, health and well being• How they communicate• Importance of syndrome characteristics• Cultural needs, practice and identify• Relationships• Sexuality• What else should we know?

We need to know who a person is so that we support them, respect them and incorporate who they are into all the work we do with positive behaviour support.

We are not about fixing people, changing who a person is or taking away from their choices.

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Restrictive and Prohibited Practices (NSW)What are Restrictive Practices?

Sometimes people behave in ways that might hurt themselves, hurt other people or break things. These ways of behaving are called “challenging behaviours”. Service providers sometimes try to stop or help challenging behaviour by touching the person or changing what happens around them.

This kind of support might be hurtful, harmful or does not respect the rights of the person. The kind of support that might be hurtful or harmful is called restrictive practices.

Service providers need to look at other ways to help the person. Using restrictive practices might show that a service provider does not really understand why a behaviour is happening.

Rights of people with a Disability:

• People with disability have the same rights as all people - to be free from discrimination

• Service providers need to include people with disability in decisions and choices about the services provided to them

• Service providers need to know when restrictive practices are being used and have a plan to try and stop restrictive practices that are being used

• People with disability can talk to service providers and other people about their choices and decisions

• Service providers will include the person’s family, friends, carers or advocates in discussions about services for the person. Together, they can talk about choices and decisions that are respectful and helpful

• Service providers will be respectful of the culture of the person with disability and try to provide support that is about their individual needs

What are Restrictive Practices?

Restrictive practices are any type of support or practice that limits the rights or freedom of movement of a person with disability.

This might include:

Seclusion

This is when a person is put in a room or place and the person cannot leave when they want to. This can occur at any time of the day.

Chemical

This means the use of medicine to control a person’s behaviour. The medicine might make the person calmer or sleepy. The person might take the medicine every day or it

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might be given to them when a challenging behaviour is happening. It is only OK to use this kind of medicine if a doctor agrees.

Mechanical

This is when something is put on a person to stop or make it harder for the person to move or to control their behaviour.

Sometimes a device is put on a person to help them to move or to stay healthy. This is called a ‘Therapeutic Device’. This type of device is OK as it can help reduce pain, improve health or help the person do an activity. It is OK to use a therapeutic device when a health professional like a doctor or occupational therapist has approved it. The person with disability also needs to say it is OK.

Physical

This is when support people use their hands or body to stop or lessen the person’s ability to move when they are upset or when a challenging behaviour is happening.

Environmental

This is when a person’s daily life is restricted so they cannot get what they want, when they want it. This sometimes includes:

Locking cupboards and fridges Taking away things people like Stopping the person from going to places they enjoy

Psychosocial

This is when support people try to control what the person can do.

This sometimes includes:

Making a person stay somewhere until they are told they can leave Not talking to the person Yelling at the person or telling them they are bad in some way Taking away something as a punishment

What are the rules for Restrictive Practices?

Restrictive Practices can only be used:

When there is proof that everything else has been tried first.

Everything else has been tried and the behaviour might harm the person or others For the shortest time possible If the person has given permission to use the practice or if approval has been given

by the person’s guardian When service providers have thought about how it might affect the rights of the

person If the practice is written in a Behaviour Support Plan When a restrictive practice is being used, it must be written down and checked at

least every 12 months

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Service providers will plan to stop using restrictive practices once they have found better ways to support the person.

Emergency situations

Sometimes a restrictive practice might be necessary in an emergency. An emergency means trying to save a person’s life, trying to stop a person from being injured or trying to stop other people being injured.

A certain number of restrictive practices also have significant additional safeguards placed on their use.

These are termed restricted practices and include:

1. Exclusionary time out – forcibly removing a client from one setting to another for a set time

2. Physical restraint – the intentional restriction of a client’s voluntary movements or behaviour beyond that which is reasonably required to ensure safety

3. Psychotropic medication or PRN (pro re nata – as needed basis)4. Response cost– withholding positively valued items or activities from a client in

response to a particular behaviour or set of behaviours5. Restricted access – use of physical barriers such as locks or padlocks or the

imposition of enforceable limits or boundaries designed to limit a person’s access to items, activities or experiences

6. Seclusion/isolating and adult client on their own in a setting from which they are unable to leave until the crisis is over

7. Any restricted practice that does not have consent

The use of a restricted practice must be informed by strict guidelines, which provide clear conditions and limitations on their use. When a restricted practice is recommended for use as a component of a Behaviour Support Plan, prior to implementation, approval must be sought from an appropriately constituted Authorisation Panel set up by the service provider. Where to get full details of requirements working in NSW:

https://www.adhc.nsw.gov.au/__data/assets/file/0003/228360/341_Behaviour_Support_Policy_and_Practice_Manual_Part_1_web.pdf

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Exercise: Workplace ReflectionCan you think of any restrictive practice that is occurring in your workplace currently?

Is it approved practice as per the NSW Government policy?

If it isn’t, what are you going to do about it when you return to work?

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Restrictive Practice Quiz

Practice Restrictive Practice

Not Restrictive practice

Sam is a heavy smoker and because of this is given a smoke every two hours by staff between 7am -7pm. Staff decided to take this practice on to ensure Sam has enough smokes for the week.Mary puts in $150 per week for food contribution to the household. Some food is stored in the staff room (snacks, biscuits and chips), so it doesn’t all get eaten quickly as it needs to last the week.Max uses a wheelchair for his mobility. Sometimes staff put his brakes on so he can’t move freely around the house, especially when there are other people in the room. There have been incidences where Max has accidently run over peoples’ feet with his chair.Lilly lives with two other friends and has drop-in support from staff. Lilly can’t access the kitchen without staff support as she had an incident once using the kettle. The kitchen door has a key pad code so other residents can access the kitchen as they need to, Lilly has not been given the code number.Donna lives in a house with 24 hour staffing. Sometimes Donna can become annoyed, and staff have had to block the doorway to prevent her from running out of the house.Brian uses a wheelchair and due to concerns about his involuntary hand movement, his hands are strapped to the wheelchair as a safety issue. There are times when his hands can get in the way of getting through a door way and he has been hurt in the past.John has behaviours that can result in physical aggression to others, when he exhibits these behaviours he is escorted by two staff into his room to relax and calm down.Claire is locked into her bedroom at night due to sleepwalking and entering other peoples’ bedrooms at night, that don’t want her there.Kelly is on PRN medication that calms her down when she starts to get anxious and or angry towards others

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Your role in PBS• Our role is to participate positively in understanding the functionality of behaviour

in the people they support. What does this mean?

Example:

• Working with a person who isn’t using the soap when they have a shower, you don’t need a complex behaviour plan, you need to look at the soap, is there body lotion that could be used, is it the smell, do they prefer a bath etc. You can do this work yourself, this is positive behaviour support

When these are more complex and risk of harm to self or others, behaviours of concern are present

Example: person who is physically assaulting someone then your role is to:

• Refer them to specialist behaviour support• Participate in collecting data and information required for assessment • Assist with supporting the person to participate in creating an individualised,

strengths based behaviour plan • Be trained and support implement the behaviour plan created

Other areas for staff and organisations to consider:Depending on the severity of the concerning behaviour, staff and organisations should determine if the work can be achieved successfully within the organisation, where ever possible engaging behaviour specialists to assist.

When behaviour has the potential to put people at serious risk, professionals should be sourced to ensure a more comprehensive process is undertaken.

Staff:

No staff are responsible for someone else’s behaviour If you do not feel safe working with a person because of the risks involved then

you have a right to inform your supervisor for support to manage this situation All positive behaviour work should include a risk assessment, staff should use

their organisational process and follow policy and procedures relating to the work they are undertaking

When engaging in positive behaviour support staff should ensure they are supported by their management team, staff should never take on this work alone

Access to briefing and debriefing support Stress management Wellbeing Access to training and information in positive behaviour support Be actively involved in the assessment process

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Organisations:

Have clear policy and procedures relating to positive behaviour support in the work place

Ensure clear risk management practice Ensure staff are trained in this area and supported to update their skills Ensure cultural awareness training and practice is followed and implemented with

all positive behaviour change Defined professional integrity expectations Client focused work culture Supporting collaboration relationships and partnerships, shared power

Referrals pathways• The NSW government up until recently was a referral pathway to access a PB

practitioner. With the coming of the NDIS and the finalising of the closure of ADHC, this is no longer available. However, their website has numerous resources and policies and templates that can be used

www.adhc.nsw.gov.au

Search behaviour support

• We are in a period of change with NDIS, planning and funding for peoples’ needs including behaviour support, will be purchased as part of their funding.

Below is the NDIS provider list where you can find qualified behaviour practitioners in your local area.

https://www.ndis.gov.au/document/finding-and-engaging-providers/find-registered-service- providers

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https://www.ndis.gov.au/document/finding-and-engaging-providers/find-registered-service-providers



http://www.adhc.nsw.gov.au/


Reference List:Ageing, Disability and Home Care Family and Community Services NSW (September 2008) Person Centred Planning; A Review of the Literature

https://www.adhc.nsw.gov.au/__data/assets/file/0004/227956/LiteratureReviewpersoncentredplanningfinal.pdf

Allen D, 2008,’Positive behavioural support as a services system for people with challenging behaviour’, Psychiatry, vol 8 (10), pp 408–412.

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http://www.adhc.nsw.gov.au/

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