Introduction to Positive Behavior Supports (PBS)

by Justine McDonald, Positive Behavior Supports Coordinator


By now, you may or may not have heard about PBS.  Either way, let’s talk about it by addressing some frequently asked questions.

Q: What is PBS?

A:  According to DDS, Positive Behavior Support (PBS) is “a systematic, person centered approach to understanding the reasons for behavior and applying evidence based practices for prevention, proactive intervention, teaching and responding to behavior, with the goal of achieving meaningful social outcomes, increasing learning and enhancing the quality of life across the lifespan.”  It’s primary focus is on prevention rather than reaction.  It emphasizes proactive strategies such as offering choices and empowering people where they live and work by creating more supportive environments that are sensitive to individuals’ preferences and interests.  Building rapport, communicating and listening, providing structure and consistency, and creating a positive and reinforcing atmosphere through social praise and re-direction are other universal concepts to PBS.

Q: What are the three Tiers of PBS?

A: The three Tiers of support ensure that every individual gets the level of support they need.  Universal Supports is a level of support that everyone receives all the time that consists of proactive intervention.  If slightly more support is needed (such as a formal reinforcement program with contingencies) a “targeted” support would be indicated.   If even more support is required (i.e. use of restrictive  interventions), then an intensive support plan would be needed.  This visual of a pyramid below may help you conceptualize these levels of support.

Q: Why is Life-Skills, Inc. implementing PBS?

A: Life-Skills, Inc. is implementing PBS (specifically Universal Supports) for two reasons.  First, Universal Supports and its focus on prevention are best practice and we have evidence within our agency that it benefits the individuals we serve.  We have seen general positive outcomes such as a more proactive culture and specific positive outcomes such as decreased staff turnover rates associated with Universal interventions.  Second, PBS is a DDS  (Department of Developmental Services) initiative in which DDS is recommending PBS implementation to improve the quality of behavioral practices and quality of life for individuals served by provider agencies.

Q: What research is out there about PBS to show that it is effective as best clinical practice?

A: Positive Behavior Supports has mainly been implemented in school systems with a fair amount of research to indicate its effectiveness in that setting.  It has just recently migrated into adult services for people with developmental disabilities so there is less research demonstrating its effectiveness in this setting. Massachusetts is one of only a few states nationwide to support the PBS initiative in adult services.