Restrictive Practice and Positive Behaviour Support (PBS) are terms commonly used in the context of supporting individuals with behaviours that may challenge. Let’s break down each term and understand how they relate to one another:
Table of Contents
1. Restrictive Practice
Restrictive practices refer to interventions or strategies that limit a person’s freedom of movement or access to certain rights, activities, or spaces, typically used when a person’s behaviour presents a risk to their own safety or the safety of others. These practices can include:
- Physical restraint: Using physical force to restrict a person’s movement.
- Seclusion: Isolating an individual in a room or space to prevent them from interacting with others.
- Chemical restraint: Using medication to control or sedate a person’s behaviour.
- Mechanical restraint: Using devices (like straps or belts) to restrict movement.
- Environmental Restraint: Lack of free access to all parts of a person’s environment is defined as an environmental restriction.
Restrictive practices are generally seen as a last resort and are considered harmful or undesirable if used unnecessarily or inappropriately. They often have negative emotional, psychological, and physical impacts on individuals.
2. Positive Behaviour Support (PBS)
PBS is a proactive, person-cantered approach to supporting individuals with challenging behaviours. It focuses on understanding the reasons behind the behaviour and using evidence-based strategies to address the underlying causes in a positive and respectful manner. The goal of PBS is to improve the quality of life for individuals while minimizing the need for restrictive practices.
Key principles of PBS include:
- Individualized Support: PBS is tailored to the unique needs, preferences, and goals of the individual.
- Proactive Strategies: Rather than focusing solely on managing behaviour after it happens, PBS involves identifying triggers and antecedents (the events or situations that lead to challenging behaviour) and teaching more appropriate behaviours.
- Positive Reinforcement: PBS emphasizes reinforcing desired behaviours (e.g., praise, rewards, or other incentives) rather than focusing only on punishing unwanted behaviours
- Collaboration: PBS involves working closely with the individual, their family, caregivers, and support team to create a comprehensive, coordinated plan.
- Building Skills: One of the central aims of PBS is to teach new skills that will enable the person to better cope with challenges and communicate their needs in more effective ways.
Relationship Between Restrictive Practices and PBS
While restrictive practices focus on controlling or limiting a person’s behaviour in response to challenging situations, PBS aims to reduce the need for restrictive practices by addressing the root causes of the behaviours and promoting positive alternatives.
Here’s how they are related:
- Reduction of Restrictive Practices: PBS seeks to reduce or eliminate the need for restrictive practices. By using proactive, individualized, and positive strategies, PBS helps individuals learn alternative behaviours that are safer and more effective.
- Focus on Prevention: Rather than reacting to behaviours, PBS emphasizes understanding the reasons behind challenging behaviours and developing strategies to prevent these behaviours from occurring in the first place.
- Rights and Dignity: PBS is committed to supporting individuals in a way that respects their rights and dignity, avoiding practices that could cause harm or trauma, such as restrictive interventions.
- Legal and Ethical Standards: In many places, the use of restrictive practices is tightly regulated. The goal of PBS is to meet these legal and ethical standards by reducing reliance on restrictive practices and promoting alternative, less intrusive ways of supporting individuals.
Example of PBS Reducing Restrictive Practices
Imagine an individual with autism who engages in aggressive behaviour when they feel overwhelmed in social situations. A PBS approach would involve:
- Assessing the underlying reasons for the behaviour, such as difficulty with social communication or sensory sensitivities.
- Developing a support plan that includes teaching the individual alternative communication skills (e.g., using a communication board or sign language) to express their needs.
- Modifying the environment to reduce sensory overload (e.g., providing quiet spaces or noise-cancelling headphones).
- Providing consistent positive reinforcement for calm behaviour and rewarding the individual for using communication strategies.
By implementing such a plan, the individual may become less likely to engage in aggressive behaviours, reducing the need for restrictive practices such as physical restraint or seclusion.
Summary
Restrictive practices should be used sparingly, with a focus on safety, and only when absolutely necessary. Positive Behaviour Support (PBS) is a proactive and holistic approach that emphasizes understanding and addressing the underlying causes of challenging behaviour, with the aim of reducing reliance on restrictive practices and promoting positive, meaningful change in individuals’ lives. Through PBS, individuals are empowered to learn more adaptive skills, and their dignity and autonomy are respected.
Transform Life is a NDIS registered organisation that provide support for your autistic child, as well as support to you as a parent to best navigate the challenges your child and family face on a daily basis.
Book your consult with an experienced Therapist at Transform Life to explore how OT, PBS and Speech Therapy can support you and your family.
