Introduction
“One day, the Wind and the Sun were arguing about who was stronger. The Wind thought, with its show of force, that it was strongest, while the Sun believed that there was more power in gentleness and compassion. Despite their argument going back and forward they could not agree. As luck would have it a traveller came along wrapped up in his finest, warmest cloak. Seeing the traveller the Wind and the Sun agreed to have a competition to see who could remove the travellers cloak as their show of strength.
The Wind going first, tried to force the traveller to take his cloak off, and blew and blew. However, the more the Wind blew the tighter the traveller wrapped his cloak around him. After much time had passed, the wind collapsed in despair, having only made the traveller hold on tighter. The Sun went next, and shone gloriously upon the traveller, until the traveller realised he could take off his cloak'
Adapted from Aesop's Fable, 'The North Wind and the Sun'
This help sheet will explain some of the principles of Positive Behavioural Support, and how we can better support individuals who experience behaviours that challenge.
What is Positive Behavioural Support (PBS)?
Positive behavioural support is an approach to behaviours that challenge that allows us to more effectively support those we care for, and about, in managing challenging environments and behaviour. While PBS has underpinnings in learning theory (behaviour modification, ABC, etc.), philosophically it has moved to a position of trying to understand individuals within their social and physical environments. Instead of focusing on reactive consequences and sanctions to try and force change, perhaps a bit like the Wind, we try and 'proactively' create the conditions that allow individuals to change in a way that is meaningful for them, a bit like the Sun.
What is behaviours that challenge? How we make sense of behaviour isn't absolute and depends on a number of things, such as the location, the person 'behaving', and the context within which behaviour occurs. If I wear swimming trunks in the middle of my local ASDA, for example, I may get some very funny looks indeed, but let me engage in this same behaviour at the beach or in a swimming pool, I'll go unnoticed.
For our purposes here, however, a working definition of behaviours that challenge can be:
- Behaviour that, while perhaps making sense to those we care for, is difficult for us to understand and/or manage.
- Behaviour that presents a risk to those we care for, or those around them.
- Behaviour that is not seen as appropriate for a given context.
- Behaviour that is not seen as appropriate for an individual's developmental or chronological abilities.
Why use Positive Behavioural Support?
“Prevention is better than cure!” - I wonder how often we have heard this phrase, and as true as it is for health related fields, it is equally true for behaviours that challenge. On a practical level, why would we want to wait for those we care for to be distressed and overwhelmed, often resulting in carers being distressed and overwhelmed in equal measure, if we could prevent this? On a humanitarian level, PBS helps us support those we care for to enjoy their individuality, dignity and human rights within their environment in a way which promotes least restrictive practices and quality of life.
What Positive Behavioural Support Strategies can we use?
“I don't believe we have all the answers, but the questions are certainly worth thinking about” - (Arthur C. Clarke). While we try and make sense of what leads to behaviours that challenge, the fact is we are all complex individuals and our behaviour, whether challenging or not, is often influenced by a variety of factors. The following brief list aims to give you some ideas of general areas where proactive strategies may be found.
Improving Health
We are all the worse for feeling under the weather, and how much worse would we be if we couldn't understand or communicate this to others. When we're tired, hungry, feeling unwell or in pain, for example, we all have lower tolerances for the challenges that our environments present us.
Improving Communication
How many of us have been abroad and found it difficult to understand what is being said to us, or even what is going on around us and what we should be doing? How frustrated can we become, and at times how anxious and insecure in a place and time where we are struggling to make our needs or wishes understood, or to understand the demands of others in a strange and seemingly unpredictable environment.
Improving Personal and Environmental Fit
When we have control over our lives we can select environments where we feel we function best, and avoid others which are more difficult. Perhaps for some of us we would choose a stimulating environment, such as a hot and crowded night club, with loud, pulsing music and dark misty areas with bright flashing lights. Perhaps if we are drawn to this, the quiet and sedentary environment of a library or church would be difficult to tolerate, or vice versa of course. If we have associated difficulties, e.g. claustrophobia, agoraphobia, epilepsy, etc. we will of course be more restricted in the environments we may choose, and more sensitive to the anxiety we would experience in inappropriate environments for us. In addition to this, we can also choose who we spend time with, who we feel safe with, or just who we enjoy spending our free time with, and thus shape our social environment.
Improving Skills
I wonder how many of us have been in a position where we do not have the skills to carry out what is being demanded of us? How might we have felt to have been in such a position, where we have to do something, but don't know what or how? Might we feel confused, frustrated, anxious# ashamed at our limitations, humiliated by the perceived response of others? Whatever we may experience, all of us feel better when we can act from a position of skill and understanding.
Improving Choice and Access to Physical and Social Resources
Throughout our days, weeks, and indeed our whole lives, we make choices at every turn, and in doing so we retain a sense of being in control of ourselves and our lives. We can choose to eat the food we like, entertain ourselves at a time and in a way that suits us, live in a space which suits our needs, perhaps in terms of size, cleanliness, noise levels, etc. But what if we couldn't make our own choices? Would this impact upon our behaviour? Wouldn't we want our wishes, choices and needs to be heard? And if we couldn't express these directly, would we not want others to help us express ourselves, and have as much control over our lives as we could?
Conclusion
'Walk a mile in their shoes' - We hope that from this help sheet you will take away how in putting ourselves in the shoes of those we care for, and with empathy and compassion, we can create the conditions which will help those who depend upon us realise their potential in more positive ways.
At Options we use Positive Behaviour Support to help improve quality of life and reduce behaviours that challenge. If you would like more information on PBS as an approach to supporting those we care for, then there are lots of useful resources on the web to help. Take a look at The British Institute of Learning Disability website which offers some great resources and videos on the topic.