Positive Behavioural Support — MRCPsych Paper B MCQ

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EasyIntellectual DisabilityPositive Behavioural SupportMRCPsych Paper B

A community learning-disability team is developing a positive behavioural support plan for a 40-year-old woman whose behaviour sometimes challenges. Which principle best characterises this approach?

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Correct answer: B — Use functional assessment to design proactive, person-centred support that improves quality of life

Positive behavioural support uses functional assessment to understand what triggers and maintains behaviour and what purpose it serves for the person. This formulation informs proactive, individualised interventions, including environmental adaptations, meaningful activities, communication or coping skills, and reinforcement of alternative behaviours. Its broader aim is improved quality of life, not simply behavioural suppression. Sanctions are inconsistent with its person-centred preventive emphasis. Medication is not a stand-alone PBS intervention, although treatment may be indicated for relevant coexisting mental or physical illness. Restraint and seclusion are restrictive reactive measures rather than the defining basis of PBS and should not be used routinely as preventive strategies.

Reference: National Institute for Health and Care Excellence. NG11: Challenging behaviour and learning disabilities: prevention and interventions for people with learning disabilities whose behaviour challenges. Recommendations 1.5.9 and 1.6.1. 2015, minor update 2020. https://www.nice.org.uk/guidance/ng11/chapter/recommendations