Member of the PBSN steering group Positive Behaviour Support The Underpinning Values “Where have we have come from?” 18th April 2013 Robert Pardoe Senior Lecturer UWE Member of the PBSN steering group

Aims To revisit some of the early models that were prevalent in Learning Disabilities services that have “informed” our journey. To explore the values that underpin those perspectives. To explore personal values and beliefs. To compare and contrast and identify any points for learning. To identify the values and beliefs underpinning PBS.

Behaviourism and Behaviour Modification The 1930’s-80’s I Pavlov, John Watson, E Thorndike, BF Skinner, Behavioural approach applied “neat” or “undiluted” http://www.youtube.com/watch?v=VZJNS_hVR2w Informed and revolutionised care in the large institutions (Any personal stories?) What are the values or the value base associated with this approach?

Gentle Teaching 1980’s-90/s A philosophical approach to caring for people who challenge: John McGee & Dan Hobbs http://www.youtube.com/watch?v=wODKRQ21PeY&feature=relmfu http://gentleteaching.sharevision.ca/downloads/GTPrimerFinal7-08-07.pdf Based on responding to Service Users in a way that communicates Safety, encourages Engagement, lets them know they are valued and Loved and encourages them to return value and Love Phoebe Caldwell...Intensive Interaction What are the values and value base that underpin this approach?

Normalisation and SRV 1960’s-80’s Bengt Nirje (Sweden) “The normalization principle means making available to all people with disabilities patterns of life and conditions of everyday living which are as close as possible to the regular circumstances and ways of life or society Wolf Wolfensberger (Canada) Developed and coined the term SRV

Normalisation and SRV (cont) 1960’s-80’s Bank-Mikellsen:- “Normalization involves the acceptance of people with disabilities, with their disabilities, offering them the same conditions as are offered to other citizens. It involves an awareness of the normal rhythm of life – including the normal rhythm of a day, a week, a year, and the life-cycle itself. It involves the normal conditions of life – housing, schooling, employment, exercise, recreation and freedom of choice. This includes “the dignity of risk”, rather than an emphasis on “protection”.” Medical v Social Model of Disability What are the Values or the Value base associated with this approach?

5 Service Accomplishments 1980’s-90’s John O’Brien: Community Presence, Community Participation (Relationships), Dignity and Respect, Competence, Choices. http://www.socialinclusion.org.uk/publications/SNQFD.pdf What are the values and value base that underpin this approach?

VIA...Valuing People...now! 2000’s A Government White Paper What are the four stated goals for VP 2001? Rights, Independence, Choice, Inclusion... Problems to be resolved...Better life chances, more Choice and Control, Support for Carers, Improved Health Outcomes for PWLD, Housing/Fulfilling Lives/Employment, Quality Services What are the values and value base that underpin this approach?

Individualised Care 1980’s-present day Carl Rogers? IPP’s ELP’s Circles of Support PCP’s PATH MAP’s Formulation? What are the values and value base that underpin this approach?

Risk Management and Awareness 1990’s-present day Identifying Assessing & Measuring Managing Risk taking Risk Avoidance What are the values and value base that underpin this approach?

Values Exercise Identify any values that you think remain relevant from the 7 perspectives that we have looked at. Individually spend 10 minutes identifying and listing the beliefs and values that are key to your work with Service Users who challenge. Share within your group and see if you can identify those that are reasonably commonly shared. Prioritise the top 5 key value statements that best explain and underpin your group’s understanding of PBS?

Outcomes from group exercise These were the value/belief statements that came out of the group exercise...not in any priority order: We are working with humanity. The Golden Rule always applies: Do unto others as you would have them do to you. Understand the person as an individual. Respond to the person as an individual. Our aim is to teach those who challenge services alternative ways of expressing themselves. We should be looking for “new” and positive outcomes for the people in our care. Behaviour happens for a reason. Relationship building through UPR, empathy, genuineness, warmth (Rogerian principles) is at the core of our work. Reflection both formally and informally should inform our work. Team culture and leadership should be of paramount concern.