Workshop - Dr Kirrily Rogers, Dr Fiona Fisher, Dr Jacqueline Owens, Ms Madeleine Lucas, Ms Bella Peterson
Integrating trauma sensitive principles into positive behaviour support for clients with complex needs
Abstract
Positive behaviour support (PBS) is a widely accepted gold-standard intervention designed to reduce challenging behaviour and promote skill development in individuals with compromised brain function. While this approach has been extensively researched in populations with rehabilitation potential (e.g., paediatrics and acquired brain injury), its application in neurodegenerative conditions like Huntington’s disease is less understood. When working with cohorts of adults with rare progressive neurodegeneration, such as Huntington’s disease, existing PBS models require adaption to account for progressive deterioration in cognition, communication, and functional abilities, as well as fluctuating neuropsychiatric symptoms (e.g., irritability and apathy). Additionally, challenging behaviours are common among individuals with histories of trauma or early adversity, such as abuse or neglect, which are highly prevalent in neurodegenerative conditions, especially autosomal dominant genetic diseases such as Huntington’s disease.
Standard PBS approaches can fail to consider the impact of trauma, particularly when it is undiagnosed or untreated before the onset of a neurodegenerative condition. To bridge this gap, our psychology team has developed a trauma-sensitive PBS approach for adults with complex neurodegenerative disabilities. This approach focuses on promoting safety and healthy emotional expression, even with limited communication abilities in the context of severe disability. Trauma-sensitive PBS emphasizes proactive safety measures and individualized reactive strategies to support emotional regulation. This session will demonstrate key elements of trauma-sensitive PBS work with selected case studies demonstrating its effectiveness in managing challenging behaviours in neurodegenerative conditions.
Keywords: trauma-sensitive, positive behaviour support, neurodegenerative disease
Learning goals include:
•Broadening your functional behavioural analysis to incorporate trauma-informed principles including identifying “red-flags” for applying a trauma-sensitive PBS approach
• How to implement a trauma-sensitive PBS plan across settings (e.g. inpatient, outpatient and NDIS settings).
•Novel strategies to enhance emotion-focused interventions adapted for individuals with severe communication and physical disabilities.