Was yesterday National Positive Behaviour Support Day? Or has it been the whole week? The reason that I ask is that my social media timelines have been choc-a-bloc of adverts for PBS, blogs on the subject, Youtube clips. You name it – PBS has been omnipresent.
It’s no secret that I struggle with PBS. Obviously it goes back to Steven’s time in the Unit and their zealous approach to the topic. Every new initiative was presented like a cure for cancer and woe betide you if you questioned the validity of such a model. We had the introduction of the alarm clock that would be set for a specific time to let Steven know when he could do something he had been asking for. One Saturday morning, he woke up asking to watch a Mr Bean DVD and they set the alarm for four hours hence. After two hours, one of the residents threw the clock and the shift leader reset it for another four hours. After asking at 8pm, Steven eventually got to see Mr Bean at 2pm, at precisely the moment I turned up for a weekly visit. Then there was the time, the experts decided to scrap all of Steven’s coping mechanisms and introduce new ones. At the gym, his routine before he started training was to touch each of the photos of the gym members on the wall. That was stopped and they printed off some pictures of the gym equipment Steven was about to use. We then had another risk assessment and support plan to refocus Steven from the members’ photos to the equipment photos. I could give scores of examples of these approaches.
The big problem was that the Unit were totally convinced that their’s was the only way that worked. And when the Court psychologist wrote his report, the first paragraph included the shocking phrase, “Minimal attention has been given to Steven’s autism”. If you are going to deny an important part of who he is, any strategy is likely to fall flat on its face.
The other major issue was the Unit steadfastly refused to acknowledge any part they might be playing in the behaviour that they were so committed to correcting. In the many paged reports of Steven’s escapes from the Unit, there isn’t one single consideration given to what they staff were or weren’t doing to enable the escape. There were no positive behaviour support plans to enable Steven’s request to have a male worker attend to his personal care, so when a female staff tried to apply his excema cream to his groin, all hell broke lose and Steven’s distress was used as further evidence to keep him in the Unit. The whole PBS was a shambles.
I know what will happen when I post this blog. It happens every time I write about Positive Behaviour Support. I will be inundated with messages from the PBS crowd telling me that I’ve got it all wrong and that I shouldn’t dismiss a whole model on the basis of one bad experience. I can actually. Sometimes, an experience is so wrong and so traumatic that to try and go through the experience again to get a more favourable outcome can be too much to bare.
I remember an early lesson I learned in my counselling career. I had been doing telephone assessments all day and my job after doing them was to speak to the manager to match the new clients up with counsellors who had available spaces. I’d spent over 90 minutes on a particularly tricky assessment and towards the end of the conversation, the client mentioned that she had been to our agency before, about four years previously and asked me not to match her up with the previous counsellor. I knew who she was talking about and it was a counsellor who favoured a rigid psychodynamic approach. The client told me how scarred she’d been by the earlier sessions and it had taken all her courage to make today’s call. I admired her greatly and was hoping that I would be able to see her myself. However, when I spoke to the manager, I was told to get back to her and inform her that the previous counsellor was the only one available and that working through the issues from the previous counselling would be an invaluable experience for her. There was no room for debate or discussion. That was the what I had to tell her. The follow up phone call was ghastly and not unsurprisingly, she declined to proceed.
Yesterday, I suggested to Steven that we did a music DVD session. It was a regular on our weekly schedule for over 10 years but since we moved, Steven has dropped it from his weekly routine. He was very up for the idea and we had a great two hours playing a vast repertoire from The Beautiful South, through to Barry Mainlow via Steps. We made no reference to the positive behaviour support plan at all. In fact, I’m not sure where they are anymore.
I favour love. Positive Love Support. It goes a long way and gets a lot done.