Once agreed goals have been achieved, the focus shifts to maintenance of change. Planning for the end of the intervention commences as part of the initial engagement and assessment process and should be reflected in the behaviour support plan. Throughout the practice pathway the BSS practitioner should be preparing the person, their family, carers and significant others for the eventual cessation of service. After the is completed an it is agreed that the exit criteria as reflected in the behaviour support plan has been met, the referral is closed and the service ends. This does not preclude re-referral at a later stage should the person’s circumstances change.
BSS practitioners as scientists Practitioners should function as scientists and adhere to basic . Practitioners should gather data regarding efficacy. Positive behaviour support applies a approach using systematic data collection to evaluate and guide intervention and support, in determining efficacy in maximising quality of life (Goal 1) and minimising behaviours of concern (Goal 2). These data include . BSS practitioners determine whether is achieved.
Standards matrix Standards matrix One DHS standards 1. Empowerment: People’s rights are promoted and upheld 2. Access and engagement: People’s rights to access transparent, equitable and integrated services is promoted and upheld 3.Wellbeing: People’s right to wellbeing and safety is promoted and upheld 4. Participation: People’s rights to choice, decision making and to actively participate as a valued member of their chosen community is promoted and upheld Disability Industry Standards 1. Service access – fair and equitable practices that are consistent with funding obligations, applicable legislation and the purpose of the service are applied when managing and allocating resources 13.2. Manage referrals (allocate referrals) 2. Individual needs – planning and support is tailored, flexible, responsive and appropriate to the individual 13.3. Referral: assess risk (undertake a risk assessment) 14. Behavioural assessment (provide a BSS assessment report) 15. Contemporary interventions (deliver contemporary intervention strategies) 16. Inclusive Support (deliver support that is inclusive) 3. Decision making and choice – support options are planned, developed, implemented and reviewed in a manner that is responsive to the decisions, choices and aspirations of individuals 17. Review and exit (undertake review and exit planning) 13.1 Engage the person 15. Contemporary interventions (deliver contemporary intervention strategies) 16. Inclusive support (deliver support that is inclusive) 4. Privacy, dignity and confidentiality – are respected and maintained 5. Participation and integration – support options are planned, developed, implemented and reviewed in a manner that builds opportunities for individuals to participate in the life of the community 17. Review and exit (undertake review and exit planning)
Mitchell, G and Hastings, RP 1998, ‘Learning disability care staff emotional reactions to aggressive challenging behaviours: Development of a measurement tool’, British Journal of Clinical Psychology, 37, 441–449. Emotional Reactions to Behaviours of Concern Scale Instructions: Below is a list of emotions that caregivers have said they experience when they have to work with people who display behaviours of concern. We want to know how you typically feel in this situation when working with [INSERT NAME]. Think of your own recent experiences of behaviours of concern displayed by [INSERT NAME]. Consider each of the emotional reactions and select the responses next to each item that best describes how you feel when working with [INSERT NAME]. For each time, tick the box that is most relevant for you. For example, if there have only been a few occasions when you have felt ‘shocked’ by [INSERT NAME] behaviour then tick the ‘yes, but infrequently’ box. No, never Yes, but infrequently Yes, frequently Yes, very frequently 1. Shocked 0 1 2 3 2. Confident 0 1 2 3 3. Guilty 0 1 2 3 4. Hopeless 0 1 2 3 5. Comfortable 0 1 2 3 6. Afraid 0 1 2 3 7. Angry 0 1 2 3 8. Invigorated 0 1 2 3 9. Incompetent 0 1 2 3 10. Happy 0 1 2 3 11. Frustrated 0 1 2 3 12. Helpless 0 1 2 3 13. Self-assured 0 1 2 3 14. Disgusted 0 1 2 3 15. Relaxed 0 1 2 3 16. Resigned 0 1 2 3 17. Frightened 0 1 2 3 18. Cheerful 0 1 2 3 19. Humiliated 0 1 2 3 20. Betrayed 0 1 2 3 21. Sad 0 1 2 3 22. Excited 0 1 2 3 23. Nervous 0 1 2 3 Adapted from: Special Projects Team: Directorate of Learning Disability Services, Bro Morgannwg NHS Trust 2010, A hitchhiker’s guide for the specialist behaviour team (operational guidance), GIG CYRMU, .