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Reducing self-harm through Positive Behaviour Support

Paul would violently self-harm when we first started supporting him. Through Positive Behaviour Support, he’s much happier.

Paul is a young man who came to Dimensions straight from school. With a complex mix of challenging behaviours, we saw opportunities to use Positive Behaviour Support techniques that have vastly improved his well-being, life and relationships.

Paul could only deal with a very limited amount of stimulation and would become very agitated if any of his belongings were moved.

Sadly, he also became agitated by his parents. This meant he could only visit them for a few minutes before getting upset and having to leave.

These triggers caused not only his challenging behaviour but also his self-harm. When he was unhappy, he’d often hit his head against hard walls, damaging property as well as his own well-being.

Our specialist team of Behaviour Analysts worked with him, his family and his support team on a number of approaches to reduce his self-harm, aggression and triggers.

He is now much happier, gets on well with his parents and his self-harm has reduced significantly.

Our analysis below outlines the approaches and outcomes achieved for Paul and his family.

Identifying triggers

  • Any unexpected noise and movements
  • Family visits
  • Small change in routine
  • Any perceived threat to his belongings

Techniques and approaches

  • Matched to calm and observant Support Worker
  • Trained support team to understand needs and preferences
  • Improved and personalised communication
  • Identified and tackled triggers gradually
  • Change taken at a pace comfortable to Paul

Before and after comparison


  • Self-harmed
  • Damaged property
  • Reclusive
  • Severely limited personal care
  • Restricted diet
  • Prone to anxiety and anger
  • Used self-harm as coping mechanism
  • Cautious of Support Workers


  • Confident and outgoing
  • Trusts support team
  • Allows support with personal care
  • Improved, healthy diet
  • Understands triggers
  • Significantly reduced self-harming
  • Trusts Support Workers

Key outcomes

  • Responds well to new Support Worker
  • Motivated and confident
  • Improved communication
  • More control over his life
  • Improved family relationships
  • Paul is much happier

Key data

  • Significantly less self-harming behaviour
  • Significantly less property damage
  • Very little risk of harm to others