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• Positive Behaviour Management
• PBM Direct Care Staff Training
• PBM Train the Trainer Course
• Positive Behaviour Support
• Supplying an Extra Trainer

The emphasis is on preventive work and good practice – not on physical intervention.Rose Trustam - Chief Executive, Integrate

The PBM model supports our service's philosophy of 'least restrictive intervention for the shortest period of time necessary to manage the situation'.Andrew Stewart, Bury PCT

PBM is based on excellent values that promote an ethical and person centred approach. Dr David Wing, Community Therapeutic Services

The training programme is comprehensive, practically applied and can be tailored to all situations. Rose Trustam - Chief Executive, Integrate

Our physical intervention team have found the trainer instruction and accreditation process to be supportive, fair and constructive. Andrew Stewart, Bury PCT

PBM training is an integral part of our staff training, to ensure a positive, safe and holistic approach to our service users. Andrea Osborne, New Bridges

PBM is effective in preventing and managing violent and untoward situations within learning disability care settings. Andrew Stewart, Bury PCT

We have now been training our staff since last July and the feedback is very good. Orna Matz, St Christopher's School, Bristol

We have always experienced good support and enjoy working within the PBM community. Dr David Wing, Community Therapeutic Services

The training materials support all aspects of primary, secondary and tertiary intervention. Andrew Stewart, Bury PCT

The PBM theory can be used to support general staff skills and equips staff preventively. Rose Trustam - Chief Executive, Integrate

We have found the training system to be comprehensive for our needs. Dr David Wing, Community Therapeutic Services

PRT is a good company to work with and we have been very pleased with the support and the good level of organisation. Orna Matz, St Christopher's School, Bristol

The PBM training programme is a logical format to follow. Heather Hindmarch, Brothers of Charity

We use the PBM training package because it provides a comprehensive range of the training materials required to support staff. Andrew Stewart, Bury PCT

Staff are happy about the theory which is very thorough and there is a good inner thread between the units. Orna Matz, St Christopher's School, Bristol

We find the PBM training to be effective in providing staff with what they need to deal with difficult situations. Heather Hindmarch, Brothers of Charity

The practical exercises, perception etc link up well with the theory. Orna Matz, St Christopher's School, Bristol

We appreciate the ongoing review and updating and the fact that the practical training is delivered around individuals. Rose Trustam - Chief Executive, Integrate

The PBM teaching is evidence based and progressive. Dr David Wing, Community Therapeutic Services

Positive Behaviour Management

The Positive Behaviour Management training programme was developed by Professor David Allen and Tony Doyle while working with the Intensive Support Service of what is now Abertawe Bro Morgannwg University Health Board in Wales. The programme has subsequently been revised and updated many times in conjunction with Health Board staff, notably Neil Kaye and Wendy James.

Positive Behaviour Management training (PBM) is a non-aversive tried and tested alternative to other potentially harmful physical management techniques that are routinely taught. None of our procedures uses pain to achieve compliance.

The PBM training programme has been accredited by the British Institute of Learning Disabilities (BILD) since 2002. It is reaccredited every three years. The current accreditation is valid until June 2012.

PBM training focuses on the prevention of challenging behaviour incidents, proactively working towards reducing the use of restrictive interventions. Following a gradient of support the training package also offers a menu of robust techniques to safely manage difficult situations if they occur. These techniques consist of breakaway moves and a limited number of restraint procedures, should they be required, all supported by underpinning knowledge and values stemming from evidence-based practice and empirical research.

Positive Behaviour Management training is suitable for staff working with adults or children and, if referred through social services, we can also provide training for parents/family carers.

"PBM is based on excellent values that promote an ethical and person centred approach."

Dr David Wing, Consultant Clinical Psychologist, Community Therapeutic Services

A new approach

The Positive Behaviour Management (PBM) training programme was produced as an alternative approach which:

Emphasised proactive, preventative strategies for managing aggression

Featured a 'gradient of support' for reactive strategies in which least intrusive approaches (for example, defusion and distraction techniques) were employed before more intrusive procedures (for example, breakaways or minimal holding) were introduced

Stressed that the reactive techniques derived should be effective for the population served

Evidenced that the reactive techniques were acceptable for use in a wide variety of community settings

Evidenced that the reactive techniques could be performed by all carers, regardless of their size, strength or gender.

PBM training programme secured accreditation from the Royal College of Nurses (RCN) for the period Jan 2000 – Dec 2001 and has been assessed by the Royal Society for the Prevention of Accidents (ROSPA) for health and safety considerations. Every technique has been bio-mechanically risk assessed by physiotherapy and manual handling specialists.

The training programme was a significant influence on the successful British Institute for Learning Disabilities/National Autistic Society publication Physical Interventions: A Policy Framework and the BILD publications Ethical Approaches to Physical Interventions Volumes l & ll and the BILD Code of Practice for the Use of Physical Interventions.

Is the training effective?

Positive Behaviour Management is one of the few reactive strategy training approaches to have any accompanying research into its effectiveness, and a series of studies have now appeared in high-profile, peer review scientific journals.

Research into the training over a five year period indicated that the introduction of the training resulted in 25% fewer behavioural incidents, a 30% reduction in the use of restraint, a 50% decrease in the use of emergency medication, a 66% reduction in the risk of injury to service users, and a 75% reduction in the risk of injury to staff (Allen et al, 1997).

Allen & Tynan (2000) demonstrated that PBM produced significant changes in confidence and knowledge for participating staff. Kaye & Allen (2002) reported how the continuous auditing of techniques used in practice has enabled us to refine the content of the courses so as to optimise learning and retention of skills. Whether or not carers have had training in this approach has also been found to discriminate between community placements for people with challenging behaviour which are maintained and those which breakdown (Allen 2000). Hawkins et al. (2005) found that service users who had previously been exposed to prone restraint techniques viewed PBM more positively.

Whereas the bulk of PBM research has been conducted in the field of intellectual disability, Killick & Allen (2005) again found that PBM impacted positively upon staff confidence and that it was preferred to more intrusive models of training in Child & Adolescent Mental Health Services.