Making a Positive Behaviour Support Plan

A Positive Behaviour Support Plan is a plan to support a person and includes assessment and planning and implementation of strategies to meet the person’s needs, improve their capability and quality of life, and reduce the occurrence of the behaviour that causes harm.

• What a Positive Behaviour Support Plan does
• Basic strategies
• Some of the most commonly used and successful approaches
• Example of a Positive Behaviour Support Plan
• A Summary Checklist

How do you actually go about setting up a Positive Behaviour Support Plan?

It’s best to start with what a Positive Behaviour Support Plan does. The aim is to:

• Observe and measure the behaviour
• Identify what causes or contributes to the behaviour
• Develop realistic expectations about change and how to measure the results
• Choose possible approaches and strategies for change
• Develop, implement and regularly review the plan.

Triggers for behaviour are avoided or minimised, or the person is encouraged to identify triggers, advise when they occur, and use coping strategies to hopefully avoid the behaviour occurring. Basic strategies here include:

• Modify the environment or routine.
• Change expectations and demands.

When the challenging behaviour occurs, there are many different approaches and strategies available. Some of the most commonly used and successful approaches are:

• Giving feedback about the behaviour
• Motivating the person to change
• Teaching the person new skills and behaviours
• Changing how people around the person react
• Psychological support
• Medication.

A consistent approach is crucial for all carers and family members involved in the plan. The expectations of behavioural change also need to be clearly defined and realistic. It may not be possible to change all behaviours at once, or in all situations.

Here is a brief example of a Positive Behaviour Support Plan:

WHY THE BEHAVIOUR OCCURS: Ian has a brain injury. His ability to process some information is impaired, and he may become disinhibited. Ian talks excessively about the desire to have sex.
RESPONSE 1: family members are to gently remind Ian that this behaviour is not appropriate. Tell Ian “Please do not talk about this with me”. Responses should be consistent, respectful and timely. If Ian does not stop, use the second response.
RESPONSE 2: If Ian continues to talk about his desire to have sex, advise him again that you do not wish for him to talk like this with you and that you are going to leave the room.
REMEMBER: Not to take Ian’s behaviour personally. It is important that all team members are consistent and patient in their responses. Redirection could be useful (e.g. “Ian can you help me to . . .?”).
SUPPORT & ASSIST: Once the behaviour has stopped, return and advise Ian that the behaviour was not appropriate. Ask him if he would like to talk to someone about it.
REINFORCE: When Ian is not discussing sex, reinforce his appropriate communication (e.g. “I’ve really enjoyed our conversations today, Ian”).

A summary checklist

• What are the different behaviours displayed?
• Which behaviours will be focussed upon first?
• Why is the behaviour a problem?
• What pattern has been observed for each target behaviour?
• What are the specific target behaviours within this category?
• What seems to cause or contribute to the behaviour?
• How will change be measured?
• What are the possible approaches and strategies for change?
• What level of control and participation is possible for the person with the brain injury?
• Could this plan be relevant to other behaviours?
• Have the person’s rights been fully protected within the plan?