1. Specifying positive behaviour support, creating capable environments
Peter McGill

2. Overview
Tools for
The use of PBS with individuals
The organisational context within which PBS is used
Identifying and designing capable environments
Other tools include PBS competency framework and other resources developed by PBS Academy

3. What we know about challenging behaviour
Importance of understanding the immediate context
But broader context also important
Genetics
Health
Personal capacities

4. Components of PBS Personalised Systematic (functional) assessment
Identification of broader influences
Proactive supports
Reactive supports
Reduce challenging behaviour and improve quality of life
Avoid punishment and minimise restrictions

5. Why we should use PBS
Best evidenced approach (case studies, meta-analyses, RCTs)
Best supported approach (NICE, DH, Mansell report, BPS, RCPsych, RCSLT)
Internationally endorsed (Australia, USA)

6. What should the service specification say?
For individuals (Tool 1)
Written PBS plan
Based on assessment
Specifying why challenging behaviour displayed
Identifying how to prevent it
Identifying how to replace it
Identifying how to respond to it
With monitoring/review arrangements

7. But…
PBS cannot be implemented in a vacuum or a challenging organisational environment
So important to also specify those elements that need to be in place to support this kind of focussed, individualised approach

8. What should the service specification say?
For organisations (Tool 2)
Leadership/ownership
User/carer/family involvement
Person-centred culture
Acceptable physical environments
Active support of alternatives to challenging behaviour
Trained, well-deployed staff
Data-driven practice
Learning organisation

9. Challenging behaviour doesn’t belong to the individual…
Rather it occurs in contexts of
Immediate support and interactions
Classroom/group home/workplace setting, practices and culture
Organisational policies and procedures
These are all components of the environment that may be “challenging” or “capable”
A whole-system understanding and approach are necessary

10. What is a capable environment?
A social/physical context which supports capable behaviour and discourages challenging behaviour (Tool 3)
Based on
A sound understanding of the causes of challenging behaviour
Recognising challenging behaviour as a problem of the system not (just) the individual
The ability and opportunity to intervene across the system
With a focus on improving the quality of support, care and treatment

11. In practice…developing more capable social care environments
Structured model of social care (see next slide)
Agreeing goals or standards for the setting to achieve (cf. LaVigna et al, 1994)
Support, training, monitoring and feedback with staff
= Setting wide positive behaviour support

12. Communication/Social Interaction Activities and skill development
Health
Communication/Social Interaction
Activities and skill development
Relationships / Family and Others
Physical Environment
Service Management
Service Staff
Wider Organisation

13. Aberrant Behaviour Checklist scores

14. Additional information
More on the research project at
More on capable environments at
Mark Dornan has developed a visual representation of some of these ideas
Contact me at