Course Outline
2 Day Intermediate Trauma and Positive Approaches Behaviours of Concerns (T-PABC)
‘Moving organisations away from reactive cultures of care toward proactive cultures of care’
Day 1
Session 1. Value base and defining Trauma and PBS informed approaches
The values and key concepts associated with Trauma and PBS informed approaches to behaviours of concern. Making the connection between restrictive practices, quality of life and behaviours of concern. Principle of least restriction, social validity, and the commitment to reducing restrictive practices.
Session 2. Understanding behaviours of concern part 1
Hastings Model
Understanding the underlying Biological/Genetic and Psycho-social factors that contribute to behaviours of concern.
Negative Life Events – Trauma
Defining different types of trauma, understanding the pervasive impact of trauma on an individual
Session 3. Understanding behaviours of concern part 2
Attachment
Understanding different attachment patterns, concepts of secure base and safe haven. How one’s own attachment disposition may impact on the support delivered to young people with a different attachment pattern.
Impact
The cumulative and cyclical impact of behaviours of concern on quality of life
Session 4. Unlocking the meaning behind the behaviour
Using a 4-phase contingency model to understand what purpose (function) a behaviour serves a child.
The importance of gathering information and accurate descriptions of behaviours of concern
Understanding functions of behaviour from a trauma informed perspective.
Using the Motivation Assessment Scale to identify functions
Day 2
Session 5. Quality of Life and Wellbeing Interventions
The importance of quality of life, wellbeing, and happiness interventions in reducing restrictive practices and behaviours of concern are also covered. When children are happy, cared for, and connected to the people around them they engage in less behaviour of concern. Recovery from past trauma can then begin.
Supporting recovery from trauma. PERMA Model, House Model including PACE
Session 6. Individual Behaviour Support Plans (IBSP’s)
The structure of IBSP’s.
Understanding the difference between proactive preventative and proactive developmental strategies, and why failure to include the latter can result in poorer outcomes for children.
Understanding the difference between proactive and reactive strategies and knowing when a potential strategy may be aversive.
Session 7. Reactive Strategies including none-aversive reactive strategies (NARS)
Using the time intensity model (cycle of arousal) to inform de-escalation strategies to use during build up, NARS to use during crisis point, and the place of restrictive physical interventions*
Session 8 Restoring the environment / Post incident Support
Moving on from critical incidents, re-attuning with young people, connection before correction, consequences vs punishment/sanction-based approaches.
Staff support post incident, emotional triage, and post crisis reflection
*Please note there are no physical restraint techniques taught on this course. Restraint training can be provided as part of a two-, three- or four-day delegate course and instructor (train the trainer) programmes (link)
Course Outcomes
Following training staff will understand the following key concepts and be able to use a range of skills including:
- Key values underpinning good quality child centred thinking, planning and action
- PBS and Trauma informed approach to behaviours of concern
- The concepts of quality of life, wellbeing, and happiness interventions as a platform for reducing behaviours of concern and restrictive practices.
- The biological and psycho-social vulnerabilities associated with behaviours of concern within children in the looked after system. A more in-depth knowledge of genetic factors and in particular adverse childhood experiences, attachment, and guilt and shame. The impact of these factors on overall physiological, neuro-physiological, and psychological development. How this in turn impacts on behaviour.
- The impact of behaviours of concern e.g., exclusion from the typical activities and places non-looked after children might enjoy, harm to self and harm to others and exposure to restrictive practices How this results in a self-perpetuating cycle of continued diminishment in quality of life and wellbeing. In turn, how this then results in even more behaviours of concern.
- How this cycle may be interrupted to promote recovery from past trauma
- House Model of Parenting including PACE (Hughes and Golding) to create safe, nurturing environments which promote empathetic trusting relationships to facilitate recovery from past trauma
- The difference between the concepts of ‘important for’ the child and ‘important to’ the child to support thinking around child centred planning around quality of life and happiness interventions
- The PERMA Model (Seligman 2011) as a vehicle for increasing child centred activity to improve happiness, wellbeing, and quality of life outcomes and ensure a good balance between ‘important for’ and ‘important to’ the child
- The principles of ‘least restriction,’ and the principle of social validity.
- The relationship between restrictive practices, quality of life and behaviours of concern
- Understanding ‘functions’ of behaviour from a trauma informed perspective and how this understanding helps with proactive behaviour support planning.
- A practical toolkit for identifying functions of behaviour (the 4-phase contingency model and, Motivation Assessment Scale)
- Individualised behaviour support planning including the difference between proactive preventative, proactive developmental and reactive strategies.
- The difference between restrictive and non-restrictive strategies and when a strategy may be aversive
- The principle that punishment-based strategies are counter therapeutic and to be avoided. Contrasting this with the importance of natural consequences)
- Maslow’s Hierarchy of needs in relation to ingrained behaviours
- The time intensity model (cycle of arousal).
- A range of de-escalation and defusion strategies proven to be effective in helping young people restore their equilibrium and avoid spiralling into crisis
- The ‘fallacy of alignment’ and non-aversive reactive strategies (NARS) used to support behaviours that are at crisis point that may negate the need to use a restrictive physical intervention
Generic Outcomes
The positive outcomes of implementing practices based on Trauma and PBS theory and research include-
- Organisations can be confident their staff are working within an evidence-based framework, one which is more like to succeed.
- Improvements to health, wellbeing, and the quality of life of both looked after children and those supporting them including practitioners, carers, and family members
- Improvements in staff confidence in creating environments that meet children’s needs better
- Staff more skilled in redirecting behaviour which may be heading towards crisis.
- Reductions in behaviours of concern and critical incidents.
- Reductions in restrictive practices.
- Happier more stable placements, improved staff retention
- Increased credibility with commissioners and regulators.
- Better overall organisational and financial outcomes.
