This informal CPD article ‘Positive Behaviour Support (PBS): Promoting Person-Centred Practice and Reducing Restrictive Interventions’, was provided by Rachel Webb of Phoenix-Kaw Care Consultancy, a health and social care training and consultancy organisation dedicated to improving standards of care across the sector.
Positive Behaviour Support (PBS) is an evidence-based framework designed to improve quality of life and reduce behaviours that challenge by understanding the reasons behind them (1). Rather than focusing on control or punishment, PBS emphasises compassion, respect, and proactive planning. It seeks to identify the function of behaviour what a person is trying to communicate or achieve and uses this understanding to develop positive, person-centred strategies.
Understanding PBS
At its core, PBS aligns with the principles of human rights and person-centred care (2). Every individual has the right to dignity, choice, and participation in decisions that affect their life. This approach recognises that behaviour is a form of communication; it often reflects unmet needs, environmental stressors, or a lack of appropriate coping skills (3). By addressing these underlying causes, staff can reduce the likelihood of distress and improve wellbeing.
Implementing PBS
Implementing PBS involves several key stages. First, professionals gather information through functional behavioural assessment (FBA) observing when, where, and why a behaviour occurs (4). This helps identify triggers and consequences that may reinforce the behaviour. Next, support plans are developed collaboratively with the person, their family, and the multidisciplinary team. These plans outline proactive strategies, teaching of new skills, and environmental adjustments to support positive outcomes (5).
A strong emphasis is placed on proactive rather than reactive strategies. Instead of waiting for behaviour to escalate, staff are encouraged to adapt the environment, adjust communication styles, and use early intervention techniques. Examples include providing structure and predictability, using visual supports, and offering choices to increase autonomy (6). These strategies reduce anxiety and promote independence, helping the individual feel safe and valued.
Training and reflective practice are vital to embedding PBS within services. Staff must understand their role in modelling calm, respectful interactions and using consistent responses. Regular supervision allows teams to discuss challenges, share learning, and ensure interventions remain ethical and proportionate (7). Effective PBS practice depends on leadership support, ongoing learning, and a culture that promotes respect and empathy.
Final thoughts
The approach is closely linked to the Restraint Reduction Network (RRN) and the Human Rights Act 1998, which highlight the need to minimise restrictive practices such as restraint, seclusion, or medication used to control behaviour (8). When restrictive interventions are unavoidable to keep someone safe, they must be the least restrictive option, used only as a last resort, and reviewed immediately afterward to learn and prevent recurrence (9).
PBS also promotes quality-of-life outcomes such as improved relationships, community participation, and skill development. When people feel understood and supported, challenging behaviour often decreases naturally (10). By focusing on wellbeing and empowerment, PBS transforms care from a reactive model to one that fosters growth, inclusion, and lasting change.
Ultimately, PBS is not a quick-fix method; it is a long-term, person-centred commitment to supporting individuals with compassion and understanding. Embedding PBS across teams helps create safer, happier environments where people are respected, valued, and enabled to live fulfilling lives.
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References
(1) Gore NJ et al. (2013). Definition and scope for Positive Behaviour Support. International Journal of Positive Behavioural Support.
(2) Department of Health and Social Care (2022). Positive and Proactive Care: reducing the need for restrictive interventions. London: DHSC.
(3) NICE (2015). Challenging behaviour and learning disabilities: prevention and interventions for people with learning disabilities whose behaviour challenges. NICE Guideline NG11.
(4) British Institute of Learning Disabilities (BILD, 2021). Understanding Functional Behavioural Assessment. Birmingham: BILD.
(5) NHS England (2023). Positive Behavioural Support Competence Framework. London: NHS England.
(6) SCIE (2021). Positive Behaviour Support (PBS): Key principles and practice guidance. London: Social Care Institute for Excellence.
(7) Skills for Care (2020). Developing a Positive Behaviour Support workforce. Leeds: Skills for Care.
(8) Restraint Reduction Network (2021). Standards for Reducing Restrictive Practices. London: RRN.
(9) Care Quality Commission (2023). Guidance on restrictive practices and the Human Rights Act. London: CQC.
(10) Mansell J & Beadle-Brown J. (2012). Active Support: enabling and empowering people with intellectual disabilities. BILD Publications.
