What Is Positive Behaviour Support (PBS)?
Positive Behaviour Support (PBS) is a person-centred and multi-element practice that uses functional, evidence-based strategies to reduce behaviours of concern in autistic people and people with a learning disability safely. The outcomes it provides significantly improve people’s lives by valuing their human rights.
When neurodivergent people experience excessive rules, restrictions, and punishments, stress rises and behaviours of concern become more likely. The same holds for neurotypical people as pressure, limitations, and controls increase, behaviour can deteriorate, and overall well-being declines in both groups. Positive Behaviour Support takes an approach that enables people to live more freely in ways that reflect their preferences, relationships and interests.
Our Positive Behaviour Support team takes time to understand what’s behind someone’s behaviour and how changes in their surroundings might affect them. With a person-centred approach at the heart of what we do, we also help the people we support learn and develop everyday life skills.
“Elliot (an autistic person we serve) doesn’t ask for the impossible. He just wants to live his life. And our role is to make that possible — not with control, but with curiosity and care.” – Darren Moyle, UCS’s PBS Practitioner.
History: From Behaviour Management to Positive Support
Positive Behaviour Support has evolved and made a substantial shift through the eras. Here’s a clear historical overview of how Positive Behaviour Support (PBS) evolved:
The early behaviour-management era (1950s-1970s):
- Relied on Applied Behaviour Analysis (ABA) focusing on reducing or suppressing the “challenging” behaviour often through aversive or punitive methods (electric shocks, time-out rooms, mechanical restraints). It was a period that one would hope no person ever had to endure, raising serious ethical concerns about people’s rights, dignity and harm.
The shift to normalisation & rights (1970s–1980s):
- The normalisation principle (Bengt Nirje, Wolf Wolfensberger) and the civil rights/disability rights movement began in the 1970s, challenging institutional care and coercive practices.
- UK, US and Europe policies promoted community living and person-centred planning. At the same time, behaviour analysts were refining functional assessment and teaching alternative skills rather than only punishing.
Birth of Positive Behaviour Support (late 1980s–1990s):
- The focus shifted from “What do we do to stop this?” to “Why is this happening, and how can we make life better?”
- Researchers like Hieneman, Horner and Carr coined “Positive Behaviour Support” to describe a values-driven, multi-element approach that blended Functional Behaviour Assessment, Positive teaching strategies, Environmental redesign, Person-centred planning, and Team and family involvement.
Systemic/Organisational PBS (2000s–present):
- PBS expanded beyond individual plans to whole-school, agency-wide and national frameworks: UK PBS competence frameworks, NHS guidance, NICE guidelines (2015 onwards) and School-wide PBIS in the US.
- Emphasis on reducing restrictive practices (restraint/seclusion) and improving quality of life became central policy goals.
- Growing integration of multidisciplinary teams (PBS practitioners, speech therapists, OTs, mental health, family carers) for people who need complex care.
- Research shifted from “does it reduce behaviour?” to “does it improve wellbeing, participation, and staff practice sustainably?”
The current Positive Support ethos prioritises: Co-production with the person and the family, integration of trauma-informed care and safeguarding, and sees behaviour as communication of unmet needs rather than a problem to eliminate.
Principles of PBS
The principles of PBS are about quality of life rather than control. Fewer incidents measure progress, richer participation in the community, stronger relationships, and greater independence. Collaboration, consistent staff practice and organisational support all help embed these values so that positive approaches become part of everyday life.
Positive behavioural support is built on the idea that everyone has the right to live a meaningful life and be supported in ways that respect their dignity. Teaching new skills, particularly for those with a learning disability, is at the heart of PBS. People are supported to learn practical alternatives to behaviours of concern, such as different communication methods, coping skills and daily living skills, to get their needs met. Plans are co-produced with the person, their family and professionals, combining environmental adjustments, skill teaching, positive reinforcement and, where necessary, agreed least-restrictive responses.
For a detailed approach to the PBS principles, you can read here.
Benefits of PBS
Positive Behaviour Support (PBS) has a strong evidence base demonstrating meaningful benefits for people who need complex care. Multiple studies and systematic reviews consistently show that when PBS is implemented with the right support and fidelity, it significantly:
- Reduces behaviours of concern (frequency/severity of aggressive, self-injurious and other behavioural challenges)
- Improved quality of life and skill development (PBS emphasises teaching alternative communication, coping and daily-living skills, which improves meaningful engagement and wellbeing)
- Fewer restrictive practices and safer environments (guidelines (e.g., NICE) and evaluations recommend PBS as part of strategies to reduce use of restraint, seclusion and emergency medication)
- Stronger, more consistent staff practice (training and organisational implementation of PBS improves staff knowledge, confidence and reduces reactive/punitive responses. Training alone is not enough since implementation systems matter.)
Quality of Care with PBS
Delivering high-quality support for people with learning disabilities, autistic people, and those with multiple needs is a challenge and a responsibility for healthcare professionals. Through training and implementation, PBS equips professionals with the tools to anticipate needs, reduce risk, and create positive outcomes.
“You’ve got to be confident, a great listener, compassionate, and to be able to give everything what you can to a role of supporting.” – Paula, UCS’s support worker.
The Impact of PBS Trained Healthcare Professionals
PBS-trained professionals can anticipate potential triggers and reduce the frequency and severity of challenging behaviours. Research shows that when staff apply PBS with fidelity, incidents of aggression, self-injury, and distress significantly decrease, creating safer and more supportive care environments.
Beyond managing behaviour, PBS training enhances staff confidence and competence, enabling them to teach alternative communication, coping strategies, and daily living skills. This strengthens relationships with the people they support, inspires trust, and encourages meaningful relationships.
See what happens when care professionals’ focus is on building trust rather than control.
Importance of PBS Training
The importance of PBS (Positive Behaviour Support) training and a proper plan cannot be overstated, especially when working with people with multiple needs in complex situations. Proper training ensures that staff and organisations deliver ethical and person-centred interventions. Here’s a detailed breakdown:
Ensures Understanding of PBS Principles
- Staff learn the core values: person-centred planning, dignity, rights, and quality of life.
- Training helps teams move away from punitive or reactive approaches toward proactive, supportive strategies.
Enhances Skills in Functional Assessment
- Staff learn to understand behaviour: antecedents, triggers, and functions systematically.
- Training covers collecting, interpreting, and using data to design tailored interventions.
Reduces Use of Restrictive Practices
- PBS-trained staff are less likely to rely on restraints, seclusion, or punitive measures.
- Training equips staff with alternative strategies for managing behaviour safely and positively.
- This aligns with legal, ethical, and safeguarding frameworks.
Improves Quality of Life for People Supported
- Evidence shows that PBS training directly correlates with well-being, engagement, and independence improvements.
- Reduces stress and trauma for the person, and improves the safety and satisfaction of staff.
Unique Community Services Provides PBS-Trained Support Workers
Unique Community Services is committed to delivering person-centred care by integrating Positive Behaviour Support (PBS) into its support model.
Our in-house PBS teams provide tailored support to individuals with complex needs and their families. Besides PBS, all care teams within the organisation are trained in PRO-ACT SCIPr, a training program focusing on understanding the underlying causes of challenging behaviours and implementing strategies to address them proactively. The training emphasises compassion, respect, and individualised support, aligning with the principles of PBS.
Our clinical care teams and support workers are equipped with the skills to:
- Understand behaviours
- Develop individualised plans
- Implement proactive strategies
- Promote positive outcomes
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