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  2. How we work
  3. Resolving distress

Resolving distress

You’ll be less frustrated

Imagine never being understood by anyone around you. Would you shout? Throw things? Run? Withdraw? At the very least you’d feel distressed.

24

people supported out of Assessment and Treatment Units (ATUs) or crisis situations in 2024

Positive Behaviour Support

Most behaviours described as challenging result from a failure to understand a person’s distress.

We’ll react quickly, understand and minimise any distress through clinical evaluation with Positive Behaviour Support (PBS.)

PBS is a person-centred, clinically-directed approach to understanding and reducing a person’s distress and so-called challenging behaviour.

Our professional Behaviour Support team helps create environments where this behaviour is simply not needed, and so help the people we support to lead full and ordinary lives.

We have also virtually eliminated the use of restraint – sometimes to the astonishment of previous support providers and those closest to the person.

This avoids more costly support (for example in long stay hospital following a section.)

Read Jack’s story

Why we choose PBS

We believe in providing support that improves the individual’s quality of life.

This means that we give equal footing to questions of respect, dignity and individual choice alongside other concerns like promoting good health, protecting safety and offering positive support in place of reactive care.

PBS reduces distressed behaviour by understanding the individual, delivering effective support, and changing their environment where necessary.

When do we choose PBS?

Whilst the principles of PBS filter through much of our support worker training, formal PBS plans are delivered by our clinical team in response to a person’s assessed need.

Involving Dimensions from the early outset of an individual’s service design allows us to create personalised PBS plans, including identified behaviour triggers and compassionate ways to understand and address those behaviours.

Success stories

Who is involved?

Three groups of experts work together to create our PBS plans which deliver safe support to those who need it:

A range of protocols, panels and strategies support our work in this area.

Positive Behaviour Support Assessments

Through the functional assessment process, we learn why an individual may be behaving in a distressed way. Understanding this underpins the effectiveness of everything else, so assessments are comprehensive and thorough.

We gather information by:

  • spending time with and observing the person
  • interviewing experts (e.g. parents, carers, professionals)
  • reviewing documents and analysing past incidents
  • analysing the person’s environment and support.

The Behaviour Support Team is trained to use a variety of nationally recognised and specialist assessments.

The assessment identifies needs and required outcomes for the individual, forming the basis of a detailed behaviour support plan.

Positive Behaviour Support Plans

The behaviour support plan aims to increase quality of life and minimise behaviours of distress by modifying the person’s experience of day-to-day living, and teaching them new skills.

Plans are agreed by all the key people in the person’s life and in line with the PBS competency framework. They include:

  • description of behaviours of distress
  • possible reasons and triggers for behaviours of distress
  • proactive strategies – to avoid behaviours of distress by meeting a person’s needs
  • active strategies – to prevent behaviours from escalating, focusing on de-escalation, redirection, and distraction
  • reactive strategies – guidance on managing a challenging situation to minimise the immediate risk and keep everyone safe.
  • recovery strategies – to support recovery following an incident.

Monitoring and Review

Goals identified as part of the behaviour support programme are set as outcomes with the person we support, in line with their overarching person-centred support plan.

We then review and monitor behaviour support plans for:

  • the frequency and severity of any behaviours of distress
  • quality of life, including learning new skills
  • the use of psychotropic medication (medication that changes behaviour or mood.)
  • use of physical intervention
  • how accurately the plan is being used.

Professional guidance

Our approach is built on years of experience and research into best practice in the field. We adhere to the PBS Competence Framework and NICE guidelines.

We work closely with local authorities and the NHS under numerous bits of legislation.

We have a clear view that modern PBS is very different from old-fashioned ABA (Applied Behaviour Analysis.) Issues of choice, dignity, and respect are of equal importance to safety, health promotion and positive support. Find out our full position below.

Our complex needs protocol

The single biggest factor in supporting you successfully is getting it right from the start.

To do that we use our ‘complex needs protocol.’ This is a document that summarises everything we’ve learned when things have gone right – and especially what we’ve learned when they’ve gone wrong.

It pinpoints all the things that must be in place before we take your support on – and a number of red lines that we won’t cross – because we know from experience that if we cross them, we may not support you well.

I am beyond happy, Jake is using more words, behaviours of distress have reduced drastically and I am perfectly happy Jake is living his best life ever.

Family Member *Not his real name or image