The PBS approach is to understand the function of a person’s behaviour (both positive and challenging behaviours) – and upskill their supports and environments to meet their needs.
‘Behaviours of concern’ or ‘challenging behaviours’ can look like:
- Hitting, head-butting or biting themselves
- Physical aggression towards others, including spitting, hitting or kicking
- Verbal aggression, including shouting, threats and abusive language
- Harmful sexualised behaviours, including non-consensual sexual interactions with others or touching/exposing themselves in public
- Property damage, such as throwing items, stealing or becoming physically aggressive towards property
When to refer to PBS?
You know it’s time to access PBS when the person:
- Is a risk to themselves or to others
- Is excluded from activities due to their behaviour
- Engages in concerning behaviours often, or for a while
- Displays behaviours outside their age or development stage
- Cannot learn a new skill because of their behaviour
- Has restrictive access to their body and/or environment due to their behaviour (‘restricted practice’)
- Empowers their support network to thrive under challenging circumstances
What are restrictive practices?
Restrictive practices are types of interventions that restrict a person’s rights and freedom of movement. Regulated restrictive practices are only used to reduce the risk of harm to oneself – or to others.
A primary focus of PBS is to reduce restrictive practices, as they can have a severe negative impact on a person’s quality of life.
The five types of regulated restricted practices under the NDIS Quality and Safeguards Commission are:
- Chemical: A medication or chemical substance used to influence a person’s behaviour that is outside the treatment of a mental health condition, physical illness or physical condition.
- Physical: Using physical force to prevent, restrict or subdue a person’s movement. This does not include using devices for therapeutic or non-behavioural purposes.
- Mechanical: Using a device to prevent, restrict or subdue a person’s movement. This does not include using devices for therapeutic or non-behavioural purposes.
- Seclusion: Confining a person in a room or space where voluntary exit is prevented – or it’s implied that exit is not permitted.
- Environmental: Restricting a person’s access to any part of their environment, including items or activities.
A regulated restrictive practice must be:
- Authorised by the Senior Practitioner with a Behaviour Support Plan
- The least restrictive option
- Only used as a last resort
- Aimed at reducing the harm of the behaviour
- Proportionate to the potential negative impact of the behaviour
- Used for the shortest time – and a fade-out plan must be identified
If you have any further questions about restrictive practices, please contact us or refer to the NDIS Quality and Safeguards Commission website.
Our PBS Process
- We get to know the whole person – This includes understanding their likes, dislikes, motivations, family supports and environments. We also unpack how they want to improve their quality of life.
- We assess and analyse – We conduct an environmental assessment and an initial Functional Behaviour Analysis.
- We keep getting to know the person and their supports – We also complete ongoing assessments and establish priorities.
- We unpack if, when and why restrictive practices are being used – Then we develop a vision to reduce them, over time.
- We develop an Interim Behaviour Support Plan – We share this plan with the care team to discuss the strategies and secure approval and consent. Where required, we then notify the NDIS Quality and Safeguards Commission.
- We implement strategies and environmental changes – This helps the person improve their quality of life. We also monitor any behavioural changes.
- We finalise a Comprehensive Behaviour Support Plan – This plan is based on monitoring the strategies and the person’s response over five months. In the plan, we identify the function of the challenging behaviour and functionally equivalent behaviours. Where required, we then notify the NDIS Quality and Safeguards Commission.
- We continue to support, train, report and monitor – We keep working with the person and their supports to implement the plan through training, support and incident management (including debrief support). We monitor and report monthly to ensure the plan is as effective as can be. We also make appropriate changes with consent from the person and their family.
- We formally review the behaviour support plan at nine months – This includes changes in restrictive practices, as well as the frequency, intensity and duration of behaviours. This is also a good time to celebrate improvements in the person’s quality of life – and the reduction of their challenging behaviours and restrictive practices. We make any changes to the plan to promote ongoing improvements. Finally, we inform the NDIS Quality and Safeguards Commission of the revised plan.
Make a referral
If you would like support to influence positive behaviour change and you have improved relationships funding in your NDIS plan, see our NDIS referral form.NDIS REFERRAL