Getting “unstuck” in PBS: What to do when you don’t know what to do..
There have been many times in my professional life as a practitioner where I have felt
unsure of what to do next. The inertia of uncertainty can feel overwhelming – so afraid of
taking a wrong step that we take no steps at all. We second-guess our strategies,
question our direction, and quietly hope that clarity will arrive on its own.
It rarely does.
The truth is, uncertainty isn’t a sign that you’re doing something wrong. It’s often a sign
that you’re taking the work seriously – that you understand the stakes, and that you care
about getting it right for the people you support. But caring deeply and moving forward
aren’t mutually exclusive. In fact, one of the most important skills in PBS practice isn’t
knowing all the answers. It’s knowing how to seek guidance and support when you don’t.
If you’ve ever felt stuck or unsure of what to do next in your positive behaviour support
practice, you’re not alone.
Here’s the practice advice I give my supervisees, and myself,
when the next right step isn’t quite clear.
1. Go back to basics
a. What is the goal for support? This informs your scope of work and provides
direction for what you want to achieve
b. Are these the right goals? Whose goals are they? Oftentimes there can be a
number of competing goals that are being driven by various stakeholders, but not
necessarily the person themselves. Ensure the goals are aligned to the person’s
interests, skills, and abilities and that stakeholders are supported to collaborate
on goals
c. Where is the person’s voice and choice? Consider how the person’s perspective
and wishes are gathered. Designing support with someone is motivating and gives
the best chance of success.
d. Functional communication-Does the person have functional ways to
communicate their wants and needs? Are these methods consistently in use and
responded to by others? If not, this is a great place to start.
e. What is the function, or the unmet need, underlying the behaviour? What does
your assessment tell you? Your assessment should inform your intervention.
Make sure any strategies you recommend match the underlying function, or
unmet need, of the behaviour. If there are any gaps in your assessment process,
this would be a good time to go over them again and action anything missed.
f. Don’t just focus on reducing behaviours of concern. What supports and skills are
being targeted for increase? Don’t just measure the absence of behaviour of
concern. Measure the alternative support, skill, or behaviour to increase.
Considering measuring the behaviour of the people implementing the supports
and what behaviour of theirs to target for increase or decrease.
2. Unpack the barriers: consider what barriers may be in place to successful support. By
considering the barriers, you can formulate a plan for how to address, mitigate, or offset
them. Common barriers include:
a. Resources: Funding and support needs mismatches, unstable or inconsistent
staffing, limited budgets
b. Breakdowns in communication
c. Lack of Readiness: Carer burnout, vicarious trauma, support person personal
values and beliefs about behaviour
3. Seek supervision: A good supervisor is worth their weight in gold. A supervisor should
provide non-judgemental practical guidance and advice to help you grow and deliver
best practice. If your regular supervisor is out of ideas, consider having 1-2 sessions with
a supervisor who specialises in the area you require support for.
4. Collaborate: Seek the advice and input of other members of the care team.
Muldisciplinary teams are invaluable for the strength and diversity of perspectives they
bring in working towards a common goal.
5. Hit the books! Use google scholar to search for evidence-based research on pbs
supports and strategies relevant to the context
6. Look for professional development opportunities in the subject. If you’re looking to
strengthen your knowledge in a particular area or grow your skillset, there’s lots of great
PBS courses, workshops, and trainings available.
7. Refer on: Part of ethical practice is knowing when to say no. If a person’s needs or
circumstances are outside your scope of practice and this can’t be changed through any
of the prior suggestions then it may be time to refer on to another practitioner who may
be a better fit. This is not a failure on your part but rather a strength in practice by
recognising that we can’t be all things to all people.
