QualitativeJournal of applied research in intellectual disabilities : JARID2025

Frontline Staff and Trainer Perspectives on Implementing and Adhering to Positive Behaviour Support in Intellectual Disabilities Care: A Mixed-Methods Study.

Eke Bruinsma, Annelies A de Bildt, Pieter J Hoekstra and 2 others

PMID 39988456

WHAT IT FOUND

Frontline staff found positive behaviour support training clear and useful, but applying it was hard: only half read the full manual, 8 of 12 could not apply it without the manual, and PBS was not formally in service policy.

Key findings

01Frontline staff described the PBS training as clear and useful, but applying it was difficult: only half read the complete manual and 8 of 12 said they could not use the techniques without it.

02Staff and trainers said PBS needed to be embedded across the whole organisation, yet all frontline staff reported PBS was not formally incorporated into policy and new staff were not informed about PBS.

03Adherence was seen as depending on time, psychologist support, visible and accessible plans, shorter plans, and regular team evaluation.

STILL TO COME

How it was doneWhat they found

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What it does not show

Only 12 frontline staff and 9 trainers were included, from six of the 14 group homes that were eligible. The study did not include people with intellectual disabilities, managers, or other stakeholders. Participants were staff and trainers who completed the training, and more positive participants may have been more willing to join. The findings are perspectives on implementation, not measured patient outcomes, so they cannot show that PBS changed behaviour. Focus groups were held online during pandemic quarantine, which may have changed how people discussed the issues.

Declared interests

The authors declared no conflicts of interest.

The easy way to misread this

Do not read this as proof that positive behaviour support training changes behaviour. It reports staff and trainer views about training and implementation, from a small sample, not measured patient outcomes.

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The study

Participants
12 frontline staff (9 in focus group) and 9 trainers
Certainty of evidence
Very low

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    Eke Bruinsma, Annelies A de Bildt, Pieter J Hoekstra, et al. Frontline Staff and Trainer Perspectives on Implementing and Adhering to Positive Behaviour Support in Intellectual Disabilities Care: A Mixed-Methods Study. Journal of applied research in intellectual disabilities : JARID. 2025.

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