Implementation of Setting-Wide Positive Behaviour Support in Adult Disability Settings: A Research Synthesis

Abstract

Background: Positive behaviour support (PBS) is mandated under the Health Act 2007 as a recommended intervention for vulnerable adults experiencing distress in residential settings. There is limited investigation in effective implementation systems for this model of support. This paper provides a synthesis of the research exploring the use of a systemic model of PBS with adult populations. Methods: A systematic review of the literature was undertaken using COVIDENCE. The resulting studies were critically appraised using the quality assessment tool for reviewing studies with diverse designs (QATSDD) and were coded and analysed using an adapted version of the standard data extraction template on the Covidence platform. Results: Nine studies met the inclusion criteria and were published between 2003 and 2021 and are reported in respect to descriptive features, methodological rigour, treatment components, outcomes observed and recommendations for future research. Conclusions: There is a growing body of literature evidencing the efficacy of systemic applications of PBS in promoting quality of life outcomes and reducing problem behaviours and restrictive practices. However, few studies to date have focused on adult populations. The most frequently reported treatment component across the included studies was workforce development programmes. Recommendations for future research include scaling up of the interventions so that SWPBS might be applied regionally or nationally, with a view to embedding this culture into disability practice and building capacity across the state.