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Positive behaviour support has been positioned by current government policy as an important intervention for people with intellectual disabilities who display behaviours that challenge services. However, little is known about service user or carer opinions towards the use of this kind of model. The paper aims to discuss this issue.

Opinions and experiences of 25 carers and six service users were collected through semi-structured interview as part of the evaluation of an enhanced service, Complex Behaviour Service, based on positive behaviour support principles.

Content analysis indicated that the service was seen as acceptable and useful and that positive experiences of the service linked to: frequency and availability of the service; talking about behaviour and being listened to; understanding, and change in, the service user, carer and behaviour.

This adds to the small but growing literature on service user and carer opinions towards specific interventions and highlights themes that future services could consider in delivering evidence-based care.

Positive Behaviour Support (PBS) is thought to be an important model for working with people with intellectual disabilities who display behaviours challenging to service. The purpose of this paper is to explore clinical and service user outcomes associated with the delivery of PBS by a Complex Behaviour Service (CBS).

Clinical outcomes of 24 service users treated by the CBS team were assessed at baseline, six and 12 months and compared with those of 22 peers who received usual care. The main outcome was reduction in challenging behaviour measured by the Aberrant Behaviour Checklist (ABC). Secondary outcomes included measures of mental health needs, risk and social care supports.

At six months improvements were seen across all ABC domains in both groups, with greater improvement in the CBS group, compared to usual care in irritability and stereotypy. Between group differences were maintained only for stereotypy at 12 months. No other differences were found.

This paper suggests that PBS delivered by trained and dedicated staff may provide clinical benefits to individuals with challenging behaviours. However, there are issues around integration into existing services that need to be addressed in order to maximise efficiency.

Challenging behaviour has been a concern across forensic services. Traditionally these have been managed reactively using medication, seclusion and restraint; however, there is growing evidence that these approaches are ineffective and counter-therapeutic. A number of reports have recommended the use of preventative approaches such as positive behavioural support (PBS). The purpose of this paper is to identify “how staff within a secure forensic mental health setting perceived the application of PBS?”

In total, 11 multi-disciplinary staff were interviewed and thematic analysis was used to identify themes.

Five themes were identified: “The Functions”, “Appraising a new Approach”, “Collaborative Challenges”, “Staff Variables” and “Organisational Issues”.

PBS enables staff to understand challenging or risky behaviour. It empowers patients via collaboration, although there can be some challenges to this. Services need to invest in training, support and leadership to ensure the model is embed and promote fidelity. Consideration needs to be given to how quality of life can be improved within the limits of a forensic setting.

No previous studies asking staff about their experiences of PBS within a forensic mental health context.