The potential role of nurses in leading positive behaviour support
Positive behaviour support (PBS) has become the preferred intervention in the management of challenging behaviour in learning disability and mental health services. However, there is an absence of literature on nurses' views and experience of PBS. Nurses are passive in PBS plan development while other professionals, such as clinical psychologists, often take the lead. While nurses see clinical psychologists as experts in PBS, they feel this could create a barrier that hinders its full potential and a more multidisciplinary approach would be beneficial. Nurses could take a pivotal role in delivering PBS plans if they were able to take a leading role, and this would benefit service users as nurses work far more closely with them than other professionals.
Following the Winterbourne View incident in 2011, positive behaviour support (PBS) gained more attention in the care of people with challenging behaviour (Care Quality Commission, 2018). PBS is a framework that provides a structured approach to care where the dignity, human rights and values of vulnerable service users are safeguarded.
Baker and Allen (2012) discussed PBS being an evidence-based intervention. In essence, they distinguished between PBS and applied behaviour analysis (ABA); this separation is important for the future practice of PBS (Baker and Allen, 2012). PBS is a model that ensures and maintains the human rights and values of individuals, whereas ABA offers treatment interventions that can be specific to circumstances (Smith and Nethell, 2014).
A wealth of evidence supports PBS and confirms it is an extensively used model that is value based, bearing all the hallmarks that improve individuals' quality of lives (Hanley et al, 2003; LaVigna et al, 2005; LaVigna and Willis 2012; Hassiotis et al, 2014). The person-focused, individualised approach of PBS makes it favoured over other interventions (Weiss and Konster, 2008). In addition, a number of studies have validated PBS as a scientific model in the management of challenging behaviour (LaVigna and Willis, 2012; Gore et al, 2013; MacDonald and McGill, 2013; McClean and Grey, 2016). Similarly, a recent study has shown wide approval of PBS by parents, who have described the practice as a positive, collaborative approach to address behaviours of concern in children with complex needs (Botterill et al, 2019).
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