What Are Harmful Behaviours or Behaviours of Concern?
As humans, we have learned that certain behaviours are good and effective ways of communicating and expressing our needs. Sometimes, people living with disabilities may have learned behaviours which carry high levels of risk, or are unsafe ways to express themselves and their needs, or they may need to learn different skills or need different resources to communicate their needs in a safe and effective way.
Unsafe actions, or Behaviours of Concern (BoC) may include:
- property damage and or intentionally breaking or throwing things,
- verbal or physical aggression towards people or animals,
- self-harm (causing injury or illness to themselves intentionally or unintentionally)
- socially inappropriate behaviours towards themselves or others,
- running away from support, or wandering and putting themselves in danger due to lack of safety awareness,
- unsafe eating behaviours such as refusal to eat, binge eating, eating non-food items, etc.
These behaviours can:
- cause distress and harm to the client using the behaviour,
- lead to the use of a restrictive practice to minimise safety concerns,
- place their support networks at risk of harm, or cause direct harm, and potentially lead to a breakdown in the caring relationship,
- impact the quality of life and quality of care of the client, and their support networks.
What is involved in Positive Behaviour Support?
First, your Novita Positive Behaviour Support practitioner will assess the behaviours that are happening, and the circumstances of the client involved. These circumstances may include:
- background information or personal history that might set the scene for BoCs.
- the client’s health needs, such as medication they may take, or their general health
- their daily routine, such as their level of independence, their sleeping patterns, their activities, etc,
- their daily activities, such as their schooling, and how they transition between essential activities,
- their sensory profile – assessing if they have a particular sensitivity to stimuli such as sound, light, etc.
- their communication needs and abilities
The practitioner will also gather information through interviewing members of the client’s support network and observing the behaviours in action. This is not a judgement on lifestyles or current support actions – it allows your practitioner to begin to develop a tailored plan that is specifically designed to support the client’s needs. This tailored plan may cover strategies to build on the client’s existing strengths, and reinforce useful and safe behaviours, strategies to reduce the severity and frequency of BoCs, and identify safer ways the client can communicate their needs, or independently meet their own needs.
We will also support you and your network to implement the strategies throughout your plan. Depending on your needs, this can happen in a variety of ways, such as:
- face to face coaching and mentoring with your support network,
- recorded training that can be viewed at a time that suits best,
- fortnightly or monthly catch ups to troubleshoot any issues that may arise and check everyone’s understanding of the behaviour support plan,
- one to one support to teach the client new life skills,
- referral to other allied health professionals such as speech pathologists or occupational therapists for learning further communication or sensory skills or psychology services for mental health support.
Ongoing monitoring and learning new skills (by everyone involved), their effective use, and their effect on reducing BoCs and reducing restrictive practices is a big part of making sure our positive behaviour support is evidence-based and client-centred. Our practitioners can also assist support networks in using reflective practice to improve their skills and plan for future incidents of BoCs.
What is the role of the support network in Positive Behaviour Support?
Positive Behaviour Support works best when everyone is on the same page – from the client themselves to their surrounding support network to the practitioner. It’s a long term effort that requires commitment from everyone involved to create a sustainable positive change in behaviour. Your Novita Positive Behaviour Support Practitioner will be able to provide strategies and advice – but they will only work if they are implemented in the client’s everyday life.
What can Positive Behaviour Support provide?
When you undertake Positive Behaviour Support with Novita, we will work with you, and your support network to develop a plan to address BoCs. This plan will be carefully tailored to each client, and will explain strategies to reduce these BoCs and improve quality of life, while minimising practices which restrict your loved one from choosing how they want to behave or engage with the world, often referred to as restrictive practices.
Your Positive Behaviour Support plan can assist you in areas such as:
- environmental changes to better suit the client’s needs,
- tips and resources for meeting sensory needs and energy regulation,
- developing Functional Equivalent Replacement Behaviours (FERBs) that are safer, building on existing strengths,
- safe methods of responding to unsafe Behaviours of Concern to aid in reducing the severity and duration,
- supporting functional communication where this contributes to BoCs
- setting goals to measure the success of strategies in your Positive Behaviour Support plan.
Who would benefit from Positive Behaviour Support?
Positive Behaviour Support can support any client who displays BoCs. At Novita, we specialise in providing Positive Behaviour Support to both children and adults with intellectual disabilities, and dual diagnosis of intellectual disability and neurodivergence.
Positive Behaviour Support can also be required in circumstances where restrictive practices are being implemented, even if these practices are only being used by the family involved in their own home.
Positive Behaviour Support can also be used alongside other forms of therapy. In most cases it is encouraged that you continue working with other allied health services, and our practitioners will work collaboratively with existing service providers in the development of your behaviour support plan.
However, there are limits to the ways Positive Behaviour Support can support a person with disability. Some of the situations work best alongside other services include treating mental health concerns, family therapy and guidance, and addressing medical and health concerns. Positive Behaviour Support can not take the place of crisis services.
Funding for PBS
For NDIS participants, Positive Behaviour Support must be funded in your NDIS plan – through the Capacity Building – Improved Relationships funding lines.
There are 2 plans typically associated with Positive Behaviour Support – Interim plans and comprehensive plans. Both types of Positive Behaviour Support plans are centred on the needs of the client – they will always be individualised and tailored to each client, however the interim plan acts as an initial risk management plan and will not contain all the relevant information, strategies and goals that the comprehensive plan will have. The comprehensive plan must also be reviewed annually, or if there is a significant change in circumstances, such as the occurrence of new BoCs, or new restrictive practices.
Interim plans are completed within 1 month of your initial consultation, and is only completed if the client already has restrictive practices (such as medication) in place. Clients will usually only get 1 interim plan completed while undertaking Positive Behaviour Support – however if they have big life changes (such as moving house) another one may be undertaken if necessary.
Your comprehensive plan can take up to 6 months after your initial consultation. To develop your comprehensive plan, your practitioner will undertake a Functional Behavioural Assessment to ensure that your goals, strategies and responses are all evidence-based and relevant to you, the client, and the purpose of your behaviours. Your comprehensive plan will include strategies for responding to, and reducing the occurrence of BoCs, skill building in the de-escalation of BoCs, and strategies for minimising the use restrictive practices. If restrictive practices must be used by supports, your comprehensive plan will feature protocols on how to safely use them, and a plan to phase them out (which could be over the short term or long term). These plans last for a year – they need to be reviewed annually by your Positive Behaviour Support practitioner.
How can I access Positive Behaviour Support at Novita?
If you’d like to book an appointment with a Positive Behaviour Support practitioner, you can speak with someone in our friendly team on 1300 668 482 or visit our Contact Us page for more ways to get in touch.
You can access Positive Behaviour Support services across metropolitan, regional, and rural areas.