Positive Behavioural Support in the UK – the next steps

It has been six months since my last confession blog. I have had things to say, but mainly I’ve had my head down working with colleagues on several projects and getting some grants submitted! In the meantime, I have made many of the measures/questionnaires we developed for research and practice available for free download on this blog. Check them out on the left hand menu if you’re interested.

A PBS Coalition

On to this new blog. Having, like many, experienced significant frustration with the (lack of) clear action on the post-Winterbourne agenda, like-minded colleagues have been beavering away on some practical resources. This group built on the informal connections between PBS folks across the UK who produced a special issue of the International Journal of PBS at the end of 2013.

In the IJPBS special issue, we produced what were designed as two key building blocks to inform challenging behaviour services/supports and PBS in particular. We started by describing an underlying framework (or model/theory?) that we think is a useful summary of why challenging behaviours may occur, especially in those with more severe intellectual disability. This is explained in an earlier blog:

http://profhastings.blogspot.co.uk/2014/02/what-use-is-theory-to-supporting-people.html

That framework paper makes it clear the breadth that is required from any interventions for challenging behaviour, and also shows why behavioural theory and intervention approaches need to be a part of PBS. With the theory stuff in mind, and drawing on international definitions of PBS, we also included a paper in the IJPBS special issue on defining PBS. This Gore et al. 10 point definition is now widely used in practice, and is informing resources that other people are producing. For example, BILD have a great new film explaining PBS for people with learning disability that incorporates this definition. You can take a look at the film here:

http://www.bild.org.uk/our-services/positive-behaviour-support/capbs/introduction-to-pbs/

The reference to the definition paper is:

Gore, N. J., McGill, P., Toogood, S., Allen, D., Hughes, J. C., Baker, P., Hastings, R. P., Noone, S. J., & Denne, L. (2013). Definition and scope of Positive Behavioural Support. International Journal of Positive Behavioural Support, 3 (2), 14-23.

[for a copy of this paper, find my email address at Warwick Uni; Nick, Peter M, Dave Allen, Peter B at the Tizard Centre; Carl Hughes at Bangor]

A third paper in the IJPBS special issue was a conceptual paper describing how one might go about clarifying what competencies people need to be able to deliver high quality PBS. This was not possible without an underlying clear “model” of challenging behaviour, and clarity on the definition of PBS. We hadn’t developed a competence framework at this point, but we knew that one was needed. More on the PBS competence framework below.

The collection of people involved with the IJPBS special issue also reached out to other PBS people and to campaigning and service provider organisations and developed some proposals for a PBS “Academy” for England.

http://profhastings.blogspot.co.uk/2014/08/do-we-need-positive-behaviour-support.html

This idea has not gone away, but it didn’t quite catch the imagination (!) of civil servants and others involved in responding to Winterbourne. So, as yet there is no PBS Academy. However, some of the ideas in our outline proposal we felt were needed desperately. In particular, some guide to the human resource and competence for delivering high quality PBS was needed. Even though we thought we had defined PBS in a way that made clear what it is and what it is not, this was not settling the argument when individuals or services said “we’re doing PBS” when this declaration was in question.

A detailed document called the PBS competence (or competencies?) framework (see below) was then born. The informal group of people who had been working together to this point thought that a name was needed for the group. For better or worse, we chose PBS Coalition. There is nothing secretive about the group, but we don’t have a formal organisational structure, governance arrangements, or funding. Instead, for the time-being the group works together to develop much-needed resources and seeks to make these available free for anyone to use. In the longer term, we are still committed to exploring the idea of an organisation something like the proposed PBS Academy or at least that the core functions we proposed for an Academy are available somewhere at a high level of quality. We’ll see. Rather than keep arguing for an idea, we have been working away to produce useful stuff. We have engaged in action.

Positive Behavioural Support Competence Framework

This document has been launched today and you can download a copy for free by following this link:

http://pbscoalition.blogspot.com/2015/05/positive-behavioural-support-competence.html

Please note that the framework is designed at present for use by professionals primarily. The competencies needed for three different roles/levels within PBS services are described in great detail. Both what you need to know, and what you need to be able to do, are described. The document is long, and the detail is deliberate. This is essentially an “all you need to know about” document. It can be used by individuals or services to say “what skills do we have, and where are the gaps”. Equally, any training provider’s offer could be checked against this framework – what is this trainer offering in terms of competencies as outcomes, what is missing, what else should we ask for, and from where else could we get the remainder? I am sure that you will be able to think of multiple other ways that the document can be used in practice.

Many people gave their time for free to get this framework written, and it was a process of consensus and editing to produce something that we think is pretty good and that is coherent. Revisions may be needed in future, but this is a good starting point.

You can also read on the PBS Coalition’s blog about Phase 2 of the PBS competence framework project. The idea is not to produce practical guides for various stakeholders based on/consistent with the underlying clarity of the detailed competence framework. These additional resources are unlikely to be as long as the first one! We plan to produce stuff for people with learning disability, family carers, support staff, service providers, and commissioners of services.

As a note of interest – the PBS competence framework has been released under a Creative Commons license. Anyone can download and pass on copies for free to anyone else. There is no restriction. If anyone uses the Framework to develop additional resources, the original document must be credited as a source but people must not suggest that the authors of the original framework endorse the derived materials/resources. Any derived resources/materials must also be made available for free to everyone to use and download/distribute as per the license for the original competence framework. We hope that this means no-one will be excluded from reading and using this work to make a difference to the lives of people with a learning disability, and their carers. The ideas might also be useful in developing resources for work with other groups, such as people with mental health problems, brain injury, or dementia.