In the fields of disability, mental health, and education, Positive Behaviour Support (PBS) has become a widely respected framework for understanding and responding to challenging behaviours. Rooted in the principles of applied behaviour analysis (ABA), PBS focuses on improving quality of life and reducing behaviours of concern through proactive, respectful, and person-centred strategies.
But what happens when those behaviours are shaped not just by environmental factors or developmental conditions—but by trauma?
To truly support individuals with complex behavioural needs, especially those with histories of abuse, neglect, or significant emotional distress, PBS must be implemented through a trauma-informed lens. This post explores how clinicians can integrate trauma-informed principles into their PBS practice to support healing, resilience, and meaningful behavioural change.
Table of Contents
What is Trauma-Informed Care?
Trauma-informed care (TIC) is an approach that recognizes the widespread impact of trauma and understands paths for recovery. Rather than asking, “What’s wrong with you?” trauma-informed care asks, “What happened to you?”
Key principles of trauma-informed care include:
- Safety: Physical, emotional, and psychological safety for clients and staff.
- Trustworthiness and transparency: Building and maintaining trust through clear expectations and consistent actions.
- Peer support and collaboration: Empowering individuals through supportive relationships.
- Empowerment and choice: Respecting autonomy and encouraging decision-making.
- Cultural humility and responsiveness: Acknowledging and honoring diverse cultural backgrounds.
In the context of PBS, these principles don’t replace traditional methods—they enhance them.
Why PBS Needs a Trauma-Informed Perspective
PBS is already rooted in values that align with trauma-informed care: dignity, respect, and a focus on proactive rather than punitive strategies. However, trauma-informed PBS takes this a step further by recognizing that behaviours of concern may be adaptive responses to trauma, rather than just learned behaviours.
For example:
- A child who lashes out during transitions may not just dislike change—they may associate unpredictability with past trauma.
- An adult with intellectual disability who refuses to attend a day program may not be defiant, but instead overwhelmed by sensory triggers that remind them of distressing past events.
Without a trauma-informed approach, even well-intended behaviour plans can inadvertently re-traumatize individuals by ignoring the root causes of behaviour.
Core Strategies for Trauma-Informed PBS
1. Understand the Function—Through a Trauma Lens
Functional Behaviour Assessment (FBA) is central to PBS, helping to determine why a behaviour is occurring. In trauma-informed PBS, clinicians expand this assessment to consider trauma histories and how behaviour might be serving a protective or coping function.
Ask:
- What past experiences could be influencing this behaviour?
- Is the person attempting to gain control, safety, or predictability?
- Could the behaviour be a flashback or dissociative response?
Use tools like trauma screeners, interviews with trusted caregivers, and careful observation to build a fuller picture.
2. Prioritize Relationships and Emotional Safety
Relationships are the foundation of trauma recovery. In trauma-informed PBS, clinicians must work to build trust and establish relational safety before attempting behavioural interventions.
This means:
- Being consistent, calm, and predictable.
- Validating emotions, even when the behaviour is challenging.
- Avoiding power struggles and using collaborative language.
3. Use Proactive Strategies That Promote Regulation
Many behaviours of concern stem from dysregulated nervous systems. Trauma-informed PBS emphasizes regulation before intervention.
Support emotional regulation through:
- Sensory strategies: Access to calming spaces, fidget tools, weighted items.
- Movement breaks: Especially for those with sensory processing difficulties.
- Mindfulness techniques: Breathing exercises, grounding tools.
- Predictable routines: Using visual schedules and social stories.
Incorporate these strategies into the individual’s daily environment, not just when behaviours escalate.
4. Avoid Punitive or Coercive Interventions
Punishment, exclusion, or restraint can be especially damaging for individuals with trauma histories. Trauma-informed PBS avoids these approaches in favour of gentle redirection, positive reinforcement, and skills teaching.
When teaching replacement behaviours:
- Ensure they meet the same need as the behaviour of concern.
- Teach them in calm moments, not just during crisis.
- Reinforce small steps toward change.
Importantly, give individuals the space to opt out or take breaks when they feel overwhelmed—respecting autonomy is a core trauma-informed principle.
5. Include the Person’s Voice in the Process
True trauma-informed care empowers individuals to participate in their own support plans. This aligns with PBS’s person-centred approach.
Involve the individual by:
- Asking what helps them feel safe.
- Collaborating on goals and strategies.
- Using accessible communication formats (e.g., visuals, AAC).
When people feel ownership over their plan, they’re more likely to engage and less likely to feel controlled.
A Trauma-Informed PBS Case Example
Let’s consider a teenager, Alex, with autism and a history of foster care placement. Alex often becomes aggressive when routines change and has a history of suspensions from school.
A traditional PBS plan might focus on reinforcing calm behaviour and giving warnings before transitions. These are useful, but in trauma-informed PBS, we’d also explore:
- Alex’s trauma history of sudden removals from caregivers.
- Triggers such as loud noises, unfamiliar people, or changes in routine that mimic past instability.
- Proactive regulation strategies like noise-cancelling headphones and a “calm-down card.”
- Trust-building with staff through daily check-ins and consistent, warm interactions.
- Opportunities for Alex to choose how to transition (e.g., walk with a peer, use a visual timer).
Over time, not only do behaviours reduce—Alex begins to feel safe and in control, leading to more meaningful participation at school.
Final Thoughts: Healing Through Support
When PBS and trauma-informed care work hand in hand, the result is a compassionate, effective model that supports not just behaviour change—but healing and empowerment.
Clinicians have a unique opportunity to be agents of safety and resilience. By recognizing the impact of trauma, listening deeply, and planning thoughtfully, we can help individuals move from survival to thriving—one relationship, one moment, and one strategy at a time.
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