Systematic adoption of positive behavioural support across a service system was associated with reductions in physical interventions


We have posted previously about the use of physical interventions in services for people with learning disabilities and challenging behavioiur, with BILD estimating their use in around half of all people with learning disabilities and challenging behaviour. (BILD link).

The researchers in this organisational case study were interested in whether the adoption of organisation-wide positive behavioural approaches in services that support people with learning disabilities might bring about a reduction in the use of restrictive practices such as restraint, seclusion and the use of PRN or ‘as required’ medications.

Working with a specialist service for adults with learning disability in a locality, they introduced a series of initiatives which sought to establish positive behavioural support (PBS) as what they describe as the ‘primary clinical model

They collected data on a monthly basis on the use of physical intervention in eleven specialist services settings using PBS as the clinical model for a period of seven years.

They found there were reductions in the use of physical intervention in the period of study. The way in which physical intervention use changed over time was different in acute and long-stay settings, but reductions were found in both settings.

They conclude that the initial findings from this case study suggest that the

systematic adoption of PBS within a service system would appear to be associated with substantial reductions in the use of physical interventions.

The impact of a whole-organisation approach to positive behavioural support on the use of physical interventions, Allen D et al., in International Journal of Positive Behavioural Support, 2,  1, 26-30

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John Northfield

After qualifying as a social worker, John worked in community learning disability teams before getting involved in a number of long-stay hospital closure programmes, working to develop individual plans for people moving into their own homes. He worked for BILD, helping to develop the Quality Network and was editorial lead for the NHS electronic library learning disabilities specialist collection. This led him to found the Learning Disabilities Elf site with Andre Tomlin as a way of making the evidence accessible to practitioners in health and social care. Most recently he has worked as part of Mencap's national quality team and also been involved in a number of national website developments, including the General Medical Council's learning disabilities site.

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