The latest edition of the International Journal of Positive Behavioural Support specifically focuses on the how current conceptualisations of mental health and negative life events fit with Positive Behavioural Support, both in terms of understanding the presentation of challenging behaviour by people with intellectual disabilities and the provision of appropriate support.
The idea for this special focus grew out of conversations taking place amongst member of the PBS Academy which went along the lines of “yes we have made huge progress in getting PBS out there – but there are some people - highly placed and influential professionals - who would appear to be not quite as enthusiastic as us and god forbid – critical”.
Of course, the immediate defensive response was “how dare they?’ – ‘it’s their problem”, etc. After all PBS was built upon the assumption that it is both multi-component and embraced multiple theoretical perspectives. Indeed, when we wrote the definitions paper (Gore et al., 2013) and the theory paper (Hastings et al 2013) for the first special edition of the IJPBS, the intention was to place mental health problems and the experience of negative life events into an explanatory framework alongside other psycho-social and biological vulnerability factors. Whilst the definitions paper highlighted the important role of other therapeutic approaches (providing they were evidenced based and compatible with a functional approach, i.e. that the challenging behaviours were in some way seen as adaptive for the individual and not purely a manifestation of psychopathology).
Of course, the criticisms could be based upon some of the historical abuses of ABA where aversive contingencies have been applied ranging from mild reprimand to the application of electric shocks. But of course, PBS came about as a reaction to these abuses. Maybe the lack of acceptance was based upon crude caricatures often manufactured by those with axes to grind, professionals who had their own favoured approaches regardless of evidence.
Or perhaps they might have a point - we have not got it right yet. Perhaps we need to do a bit more work at understanding the role of mental health difficulties and experience of negative/traumatic life events in the causation of challenging behaviour and the implications for support. This conference is part of that process with have papers exploring trauma, attachment, behavioural activation – hopefully the start of a grown-up conversation.
Dr Peter Baker
Senior Lecturer, Tizard Centre University of Kent and Senior editor, International Journal of Positive Behavioural Support.