Positive Behaviour Support NDIS

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Ever since the National Disability Insurance Scheme (NDIS), thousands of disabled people all over Australia have received supports to enhance the quality of their lives. Through the services provided by the NDIS, people with disabilities have gained access to information and interventions that can improve the different aspects of their living, including their home situation, work environment, and social needs.

One of the services offered by the NDIS is Positive Behaviour Support, which is a programme aimed to assist people who face challenges in their cognitive or intellectual ability. NDIS understands that while challenging behaviours are seen as difficult situations, the proper environment and treatment can reduce, and eventually stop, such practices. The Positive Behaviour Support plan of NDIS is dedicated to working closely with the participants to address their needs without taking away their freedom of choice and independence. In this article, you will find a more comprehensive explanation of how the Positive Behaviour Support works.

What is the Positive Behaviour Support of NDIS?

There are essentially three support budgets that can be funded under your NDIS plan. These are Core Support budgets, Capital Supports budgets, and Capacity Building Supports budget. The Positive Behaviour Support is found under Improved Relationships, which is a subcategory of Capacity Building Supports budget. What does this mean? Well, Capacity Building Supports are mainly targeted at building the patient’s skills to help them become more independent as they reach their long-term goals. Improved Relationships can be included in the NDIS plan to aid in developing positive behaviour, social interactions, and a strong support system for the patient.

One of the programmes to address these goals is Positive Behaviour Support, which is a plan meant to improve the lives of individuals whose challenging behaviours stem from their cognitive or intellectual disability. Under this framework, the support makes sure that the use of restrictive practices will only be for necessary circumstances that will protect the patient from harm.

The Positive Behaviour support aims to understand the causes of a person’s challenging behaviours through consultation with the patient, their carers, families, and other support systems. After this consultation, a document will be prepared that will serve as a guide for the patient’s plan. This will contain strategies based on evidence that can fully address the needs of the patient to improve the quality of their life.

How are Challenging Behaviours regulated?

Challenging behaviours are defined as unpredictable, complex behaviours that significantly impacts the individual’s learning, development, safety, and relationships. Some of the manifestations of these behaviours are damaging property, physical and verbal aggression, impulsive or disinhibited practices, and inflicting self-injury. While challenging behaviours are usually misunderstood, fostering a safe environment where the patient can receive ample support will reduce the severity of their situation. The Positive Behaviour Support plan is structured according to evidence-based research so that the treatment can focus on where the patient needs it the most.

Such needs can be addressed through these types of services:

  • Building the Positive Behaviour Plan

  • Assessment and intervention of the patient to understand the triggers and causes of challenging behaviours

  • Development of a person-centred plan to recognise the patient’s goals

  • Including others- such as family, caretakers, professionals, and support providers- to contribute to the planning

  • Building skills such as communication and interaction without resorting to challenging behaviours

  • Developing the staff of caretakers and providers by understanding the techniques to perform the support strategies that are necessary to the programme

  • Performing environmental changes to enhance the living conditions and eliminate possible sources of negative behaviour

  • Reducing restrictive practices that may limit the patient’s freedom for their safety. Throughout the treatment, the aim is for the person to do without such restrictions.

Understanding Restrictive Practice

While it is the goal of the Positive Behaviour Support to eliminate the use of restrictive means, there are few circumstances wherein certain regulated, restrictive practices are required to ensure the safety of the patient. It is necessary to note, however, that the NDIS gives utmost priority and importance to upholding the rights of the patient. This means that the restrictive measures that will be performed are still based on strategies that are based on evidence of the person’s situation. It is stated in the NDIS (Restrictive Practices and Behaviour Support) Rules of 2018 that restrictive practices can only be used:

  1. As a last resort; a necessary response to the risk that the patient may harm themselves or other people

  2. Will be used in the shortest possible time and is equivalent to the risk of harm

  3. Is authorised within the territory legislation or within its policy requirement

Since restrictive practices do temporarily restrict the movement and freedom of an individual, it is a vital part that they are reported to the NDIS Commission. When the use of restrictive measures is part of the Positive Behaviour Support Plan, the NDIS providers must see to it that a regular report is given about the patient. In cases wherein the Behaviour Support plan does not include the use of the regulated restrictive practice, it is no longer necessary for the NDIS provider to lodge with NDIS commission.

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Regulated restrictive practices can be classified into five categories. These are:

1. Physical restraint

Manual method of using controlled force (e.g. guiding with holding elbows) will be used to restrict, subdue, and prevent the movement of the patient in order to influence their behaviour. This type of restraint does not include using equipment for non-behavioural matters or therapeutic purposes.

2. Mechanical restraint

Caretakers use devices that can restrict, subdue, and prevent the patient’s movement in order to influence their behaviour. This category does not include using the devices for non-behavioural matters or therapeutic purposes.

3. Chemical restraint

Chemical substances and medication will be used to influence the behaviour of the patient. This type of restraint does not include the use of prescribed medicine authorised by a professional for the treatment of any physical or mental condition.

4. Environmental (access) restraint

A patient will be restricted to some areas or areas of their living environment, while still having freedom to access all parts of their home.

5. Seclusion

The patient will be placed in a solitary room or space that they cannot voluntarily leave. This may be done at any hour of the day if deemed safe and necessary. The patient may only leave if permitted or is facilitated by a person of authority.

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