The emphasis is on preventive work and good practice – not on physical intervention.
Rose Trustam - Chief Executive, Integrate
Restraint Reduction
Around half of people with a learning disability and challenging behaviour are subject to physical intervention. (BILD) Many behaviour management training programmes emphasise training in physical intervention with little consideration given to the prevention of difficult behaviour. Whilst behaviour management strategies are a critical component of effective support plans for people who challenge, they have restricted objectives and consequently limited effects: · Their goal is to achieve safe, rapid and ethical control over serious risk behaviours · They provide temporary control over difficult behaviour · They are not constructive as they are not concerned with helping services and users change challenging behaviour in the longer term. (Allen 2003a) When physical interventions do have to be used, it is vital that they are performed safely and effectively. Organisations must however also ensure that reducing the use of restrictive practices is a central service objective. This notion is fully supported within by the 3rd edition of the BILD Code of Practice for the use of restrictive physical interventions which places greater emphasis on the requirement of training organisations and commissioners to provide evidence that restraint reduction plans are being implemented. This will require whole organisational commitment and a move away from the delivery of purely reactive strategies to a system of Positive Behavioural Support (PBS). This in turn will help support a reduction in the use of restraint and other reactive procedures. A key component of PBS is applied behaviour analysis which operates on the understanding that all behaviour is functional for the individual. By determining the function (or purpose) of an undesirable behavior, PBS allows staff to teach the person new skills and to redirect the behaviour in a more appropriate way whilst still fulfilling its original function. With its strong value base, data-led practice, emphasis on ecological and antecedent interventions and focus on improved quality of life outcomes, PBS actively promotes the reduction of restrictive practices. Positive Response offers person-centred advice, training and consultancy that clearly focuses on the needs and living circumstances of individual service users who are presenting behavioural challenges. In some cases this may include training in the use of safe, and in some cases bespoke, physical interventions as a short term reactive measure. However, to achieve change that will be maintained a whole service approach is required. Our approach utilises and builds on the six core strategies for restraint reduction described by Huckshorn (2004; 2005): Leadership · Organisational commitment at a senior level · Reduction goal clearly enshrined in mission statements and policy documents Using Data to Inform Practice · Data driven functional analysis · Collection of data on the use of reactive procedures · Guidance on data analysis · Programmatic evolution as a result of data collection Workforce Development · Competency based carer / staff training programmes Use of Specific Restraint Reduction Tools · PBS model · Emphasis on prevention · Risk assessment Service User Involvement · Involving service users as partners in initiaves to reduce restrictive practices Debriefing Strategies- · Post incident support for service users and staff / carers · Proactive stress management for service users and staff / carers The Consultancy section provides more information about how we can help.
For more details download our information sheet or contact the Positive Response office.
"The emphasis is on preventative work and good practice - not on physical intervention." Rose Trustam - Chief Executive, Integrate
