Transcript the file - 2gether NHS Foundation Trust

Positive Practice
Positive Behaviour Management
/ Children & Young Person
Service (CYPS)
Family Training Programme
29th April 2013
Team Functions
CYPS LD: Trust based team providing professional
support and advice to families, carers and other
professionals who support Children and Young people
with complex needs, regarding a wide range of issues
including physical and mental health, communication and
behavioural problems
PBM: Trust based team providing evidence based training
and support to 2gft staff, other professionals, parents and
carers of adults and young people with learning
disabilities; and older adults with Dementia. Proactive
focus on the prevention and safe management of
“challenging behaviours”
Positive Practice
• Collaborative working between 2gft Positive Behaviour
Management (PBM) & CYPS Learning Disability teams
• Deliver effective, cost efficient extended programme of
training for families and carers
• Reduced risk to Young person and siblings
• Provide family and carers with strategies for the
prevention and safe management of challenging
behaviours that may include physical aggression and self
injurious behaviours
• Reduce likelihood of family breakdown
Rationale for Intervention
CYPS – Typical Reason for Referral
Rationale for Intervention
• High rate of referrals that involve presentation of
complex aggressive and Self Injurious Behaviours
• Reducing the CYPS waiting list time
• Limited appropriate training for family / carers available
– where available not person focused
• In the absence of training Families / carers report the
use of untrained and potentially unsafe physical
interventions to manage difficult behaviours, therefore
potential safeguarding concerns.
• Evidence based benefits of early behavioural
intervention............................
Enduring Nature of Challenging
Behaviour
“….. 29 people (mean age 28 years) identified by service
agencies as being the most challenging that had entered
some form of institutional care (with an average age of
9.5 years); admission was often for the same challenging
behaviours being displayed nearly two decades later”
(Emerson et al, 1988)
Programme Delivery
• Identify young people from CYPS caseload who may be
at most risk and whose families are struggling to
manage more complex problem behaviours
• Prevention (theory session)
 up to four families with similar needs are identified for half
day theory training session
 Review behaviour support plan if already in place
 Individual behaviour audit to inform any practical training

Practical training clinic
 Review Behavioural support plan
 Based on behavioural Audit - provide training in minimal
number PBM self defence and physical intervention
techniques
Typical Techniques
Most Prevalent
techniques:
•Assisted support
(guiding)
•Bites
•Punches
Outcomes to date
• Positive feedback regarding how training is structured –
found benefits from attending theory with other parents,
however did not feel overwhelmed by practical due to
limited and focused amount of appropriate techniques
provided
• Parents / Carers report feeling more confident in
preventing and safe management of problem
behaviours following the training
• Heightened awareness of trigger factors for problem
behaviours
• Often reported that there is a limited use of physical
interventions post training
Continuing Positive Practice
• On - going delivery of a programme of PBM training in
collaboration with CYPS LD nursing team to families of
young people with LD and ASC. This will incorporate
refresher sessions for families / carers
• Explore the development and the delivery of the
programme; where appropriate to families of young
people supported by the wider CYPS
• Plans to publish the delivery of the programme and
outcomes in Nursing Times in 2013