What is behaviour support and how does it work in a practical sense?

I hope I can provide you with some insight into how our clinical team provides behaviour support and what that would look like for your child or family member in supported care.

First of all, let’s start with:

Is behaviour support an effective intervention and why?

The short answer is YES and this is the reason why NDIS will fund it. After all the NDIS is an insurance scheme which means they support evidence-based practice. Behaviour support is funded with the goal for a clinician to provide a combination of skill development to the client and strategies to the staff or families supporting the client. This can be in the form of a behaviour support plan.

Behaviour support plans are extremely helpful in accommodation and day program settings as it allows the staff to better understand the client they are supporting, helps to reduce the risk of behaviours of concern and provides effective strategies for responding to these behaviours.

The main aim of behaviour support is to help reduce barriers that may place the client at risk of harm and get in the way of building capacity for activities of everyday living and enjoy fulfilling  social/interpersonal relationships. It helps to improve the client’s quality of life and support the people around the client to be the best support team they can be.

I’m sure that anyone who has raised kids will understand how a child’s behaviours can really negatively impact on relationships, family dynamics and engagement in everyday activities. This is particularly true when we are new to parenting and struggle to know exactly how to manage behaviours of concern we are being presented with. It can often lead to frustration, tiredness and even emotional burnout.

You can type in almost anything into google these days and find an answer for anything, but it does not necessarily mean its correct (I’m sure you have realised this when you google your medical symptoms and diagnose yourself with all sorts of diseases 🙂). The important point here is: there is not a one size fits all approach to behaviour managing. Some examples of what you might come across when looking for strategies may be using timeouts with children, reward charts, social stories, reflections sheets, avoiding certain foods and many many more.

Some medications can assist in behaviour management however, in this blog, we are just focusing on psychological/parenting strategies which some parents will trial before moving to medications or implement alongside a recommended medication regime. And whatever works for you as a parent or family member is okay as long as you are comfortable with it.

It is important to highlight that although some the behaviour intervention strategies you will read on google may be beneficial, it really comes down to trial and error which can problematic for several reasons:

• If it is not a carefully considered and planned out strategy with advice from allied health professionals, it may lead to an increase in behaviours
• Development of new behaviours
• Impact the attachment/quality of the relationship
• And one that we often hear from parents is “I tried the strategies from google and nothing has worked”. This is very problematic as it demotivates the parent/carer to try new strategies that have been specifically developed from a comprehensive case formulation.

So what does behaviour support look like in a practical sense at We Care NSW

As mentioned above behaviour support strategies are developed following a comprehensive case formulation. To develop a comprehensive case formulation, we first need to conduct a comprehensive functional assessment.

What is a functional assessment?

In simple language, it is using a number of different direct and indirect methods of collecting information/data to identify target behaviours (tip of the iceberg) and what factors are influencing or contributing to the behaviours identified (what is the under the iceberg).

To collect this data the client’s family and support networks may be asked to complete behaviour assessment forms and monitoring sheets, i.e writing down any direct observable data in relation to the behaviour. This can be extremely helpful in identifying patterns of behaviour, identifying triggers and ineffective responses.

Other methods may include the clinician observing the child or adult client across different environments e.g. home, school, day program etc.

The Behaviour Support Plan

Once we have collected the relevant information, we will then work in collaboration with the family and relevant stakeholders to develop a behaviour support plan. The behaviour support plan will be tailored to suit family or staff needs. E.g. if the strategies are implemented at home then the plan may be only 1 or two pages with key strategies to ensure parents do not feel overwhelmed. Clinicians can also visit the client’s home and assist parents/carers with implementation of strategies if required. We are flexible in our development of behaviour support plans as we do not believe in a one size fits all approach. We are guided by carers in what approach will work for them and how this will be achievable within the family unit and busy lifestyles. This is important as it increases the likelihood of behavioural interventions being more successful.

If the plan is being developed for staff then it can be up to 20 pages long depending on the complexity of behaviours and information required for staff to be aware of. It is important that these plans are comprehensive to ensure that any staff member who enters the client’s accommodation can read through the behaviour plan and get a good understanding of the client, their behaviours and appropriate ways of responding.

The plan may also include attachments such as visuals, worksheets etc that will be relevant to the strategies in the plan. We can also tailor plans for accommodation settings taking into consideration carer/staff recommendations about what will be useful and practical. E.g. developing a 1 to 2 page quick go-to document with the common behaviours that arise and strategies to assist so staff do not have to flick through the entire plan every time they need assistance with managing behaviours.

We may also make some recommendations for skill-building which means we can provide one on one skill development with the client to help teach coping or replacement strategies which can help to reduce behaviours of concern. E.g. assisting a client to learn new emotional regulation skills to help the client manage their anger more effectively.

If you have any questions regarding our behaviour support services, please do not hesitate to give our Allied Health team on 02 4013 6079 or if you would like to make a referral, download our referral form here.

Written by Yasmina Lees

Clinical Leader