Many Positive Behaviour Support (PBS) models champion human rights, individualised interventions, and a holistic understanding of neurodivergent people and those with intellectual disabilities. Despite this, people subject to PBS report experiencing harm often caused by an overemphasis on behaviour and coercive control which act to detract from their agency, personhood and dignity.
My five most common bugbears with PBS:
1. Focusing on behaviours of concern
My bugbear:
When staff become focussed on behaviour, they overlook the underlying needs, emotions, and contexts. This narrow focus risks viewing behaviours as problems to be eradicated rather than expressions of trauma, unmet needs or simply a different neurology.
Impact:
A focus on behaviour can lead to punitive and coercive ‘support’ that increases distress and erodes trust in staff (and sadly the person can stop trusting themselves), which disrupts compassionate care.
Solutions:
· Take an experience sensitive approach (McGreevy et al., 2024) and look beyond behaviour to understand past trauma and underlying motivations.
· Prioritise relational support which addresses emotional, sensory and communication needs as these may cause underlying distress.
· Reframe your understanding of challenging behaviour as expressions of trauma, not just “challenge”.
2. Applying behaviour support as a top-down, rigid process
My bugbear:
Implementing behaviour plans uniformly and rigidly removes any nuance and opportunity for staff creativity to respond relationally and subjectively. Humans need flexibility and collaboration, not support that’s been turned into a script; not procedural activity rather than a dynamic, responsive process rooted in respect and understanding.
Impact:
This leads to feelings of being controlled or coerced, increasing resistance, anxiety, and objectification. My experience is that the person’s voice and preferences become secondary.
Solutions:
· Engage individuals, families, and care staff in co-developing support (including plans, day-to-day happenings and even spontaneous decision making!) that respect autonomy.
· Regularly review and adapt your relational strategies based on experience sensitive exploration.
· Make opportunities for the person to exercise their right to self-determination, no matter how small the act or decisions!
3. Using labels and theories to define personal identity
My bugbear:
Too often I was called a person with “challenging behaviour” and that came to define me. the term is associated with aggression, violence and being irrationally difficult! Relying on diagnostic labels or behavioural theories can risk defining people solely through deficits, trauma and/or stereotyped traits, ignoring their personhood and the richness of their histories and identities.
Impact:
It can perpetuate stereotypes that impact other attitudes, beliefs and actions. It also marginalises people, and hinder genuine understanding, replacing personhood with labels.
Solutions:
· Focus on strengths, preferences, and individual stories. Reframe your language.
· Use descriptions that highlight abilities and resilience alongside challenges.
· Promote professional development that encourages critical awareness of how labels impact perceptions and relationships.
4. Objectifying people as data sets
My bugbear:
Each week I was reduced to behavioural data points – frequency counted, incident logged and “problem” behaviours” recorded as such! This neglected my subjective experiences, stripping away my personhood and converting me into a collection of observable behaviours seeing my (re)actions as having intrinsic worth.
Impact:
Dehumanisation, loss of agency, and diminished self-identity means I become an object of management rather than a valued human being.
Solutions:
· Incorporate autoethnographic and self-narrative methods that foreground peoples voice and experience.
· Combine quantitative data with qualitative insights – stories, preferences, and emotional states – to form a more comprehensive understanding.
· Use language that emphasises respect and individuality.
5. Emphasising ‘normative’ behaviour at the expense of authentic Self
My bugbear:
I was constantly encouraged to conform to neuronormative standards meaning I had to mask and/or suppress my authentic self – e.g., stimming, sensory seeking, or other natural behaviours – that staff thought were “undesirable” or “difficult”.
Impact:
This suppresses authentic self-expression, erodes self-esteem, and fosters internalised shame, sometimes leading to meltdowns or trauma. I lost trust in my Self, and I didn’t know who I was anymore – this takes a long, long time to get back!
Solutions:
· Recognise autism and neurodiversity as natural variations, valuing all ways of being.
· Create spaces where sensory-seeking and self-expression are accepted and supported.
· Prioritise environments that meet emotional, communicative and sensory needs rather than forcing conformity.
Embracing therapeutic love in practice (Quinn, 2025)
Staff must reckon with the damaging effects of objectification and behaviour-centred models, replacing them with a foundation rooted in therapeutic love (Quinn, 2025 – DM me for the paper). This goes beyond superficial kindness; it embodies an authentic, compassionate commitment to recognising and honouring everyone’s humanity.
Therapeutic love invites us to see every person as inherently valuable, deserving of respect, acceptance, and genuine connection. It means cultivating empathy, patience, and humility – accepting that behaviour is often a manifestation of trauma, underlying needs, fears, and experiences that demand understanding rather than correction. When practice is guided by love, the focus shifts from merely managing behaviours to creating environments where individuals feel safe, seen, and valued for who they truly are.
Incorporating therapeutic love into our work involves mindfulness – listening deeply, validating feelings, and fostering trust. It challenges us to move beyond objective assessments and scripted interventions, instead engaging in relational acts of kindness and recognition that affirm the person’s dignity. It calls on us to see neurodivergence as a natural part of human variation, honouring authentic self-expression without shame or attempt to erase difference.
Ultimately, embracing therapeutic love transforms our approach from one of control and correction to one of partnership, compassion, and genuine care. It helps dismantle systems of objectification and behavioural coercion, paving the way for support practices that truly respect human rights, promote well-being, and nurture the full potential of every individual. When professionals operate from a place of love, they become not just caregivers, but allies and witnesses to the unique human journey of each person they serve.