Understanding the Difference: Positive Systems Approach vs. Traditional Behavioural Treatment Programs

When it comes to supporting individuals with developmental or behavioural challenges, the methods employed can significantly impact the outcomes and overall well-being of those individuals. Although both Positive Systems Approach (PSA) and traditional behavioral treatment programs (particularly those grounded in Applied Behavior Analysis (ABA)) aim to improve behaviours and enhance the quality of life, they diverge in several key areas. This blog post will focus on problems with focusing merely on "behavioural suppression" often using punishment-based behavioral approaches and highlight the benefits of a more holistic and humane approach.

Recognizing Internal Human Traits

One of the most significant differences between PSA and traditional ABA is PSA’s recognition of internal human traits such as thoughts, emotions, and cognitive processes. Traditional ABA has often been critiqued for its focus on observable behaviours, sometimes neglecting the less visible but equally important internal experiences of individuals. PSA acknowledges that many individuals have experienced trauma, which can profoundly influence their ability to form trusting relationships and manage anxiety or depression. Understanding and addressing these internal states is crucial.

PSA incorporates strategies from Cognitive Behavioural Therapy (CBT), Mindfulness, Relaxation Training, and Dialectical Behaviour Therapy (DBT) to help individuals develop coping mechanisms. This holistic approach is geared towards fostering resilience and emotional well-being, recognizing that behaviour is not just a product of external stimuli but is also deeply influenced by internal factors.

Problems with Punishment in Traditional ABA

Traditional ABA sometimes incorporates punishment techniques, especially in severe cases like self-injurious behaviors. While these methods can produce rapid behavior suppression, they come with significant drawbacks:

1. Emotional and Psychological Effects: Punishment techniques can induce fear, anxiety, and emotional distress. The use of aversive stimuli, such as water mist sprays or contingent skin shock, is highly controversial and debated within the ABA community. The moral and ethical implications of these methods often outweigh the potential benefits of quick response reduction.

2. Failure to Address Root Causes: Punishment-based approaches may suppress behaviours temporarily but fail to address the underlying causes. Without understanding and resolving these root issues, long-term behaviour change is unlikely.

3. Limited Generalization: Punishment strategies often only work in the specific context where they are applied. This limitation means that desired behaviours may not generalize to other settings, making it challenging to achieve consistent behaviour change across different environments.

4. Negative Side Effects: The use of punishment can lead to undesirable outcomes such as increased aggression or avoidance behaviours. These reactions can damage the therapeutic relationship, making it harder to engage individuals in positive behaviour change efforts.

5. Ethical Concerns: There are substantial ethical concerns regarding the use of punishment to suppress behaviours rather than focusing on teaching alternative, appropriate behaviours. The current shift within ABA towards promoting positive behaviour change reflects a growing recognition of these ethical issues.

The Foundation of Positive Systems Approach

PSA moves away from punishment and instead emphasizes consideration of system factors and building a positive, supportive relationship based on trust and respect. This approach is comprehensive and tailored to the unique needs of each individual. Key elements include:

• Individualized Support Plans: Every individual is unique, and PSA advocates for support plans that are based on extensive analysis and assessment of the behaviour’s function. This ensures that interventions are tailored to the individual’s specific needs and circumstances.

• Coping Strategies: By incorporating tools from learning theory (e.g. - teaching social skills), CBT, Mindfulness, and DBT, PSA helps individuals develop effective coping strategies. This holistic approach aims to address both observable behaviours and underlying emotional and cognitive processes.

• Positive Behaviour Support: PSA focuses on promoting positive behaviour change, teaching new skills, and improving overall quality of life. This approach seeks to empower individuals rather than control them through punitive measures.

• Consideration for System Factors: Considering system factors is crucial when supporting vulnerable individuals with behavioural challenges. These factors encompass the larger context within which individuals receive care and services, including policies, organizations, funding, and community resources. Recognizing and addressing these system factors is essential for providing effective and holistic support. System factors influence an individual's ability to access necessary services and support. Barriers such as limited availability, long waiting lists, or complex eligibility criteria can prevent vulnerable individuals from receiving timely assistance. Adequate funding and resources are essential for providing quality care and interventions. An effective support system requires coordination among various service providers and agencies. Fragmented or uncoordinated care can lead to gaps in service delivery and challenges in addressing the complex needs of individuals with developmental disabilities. System factors determine the availability of training and education for caregivers, professionals, and service providers. Well-trained staff are essential to putting into operation a Positive Systems Approach. Once this has been implemented, we also need to ensure that we have in place quality assurance mechanisms and monitoring systems. These systems help identify and address issues related to the quality of care, safety, and the prevention of abuse or neglect. System factors are also important in determining the availability and effectiveness of crisis intervention services.

• Ethical and Supportive Environment: PSA emphasizes creating an environment where individuals feel supported and understood. This includes rejecting punitive approaches that can damage trust and instead fostering a therapeutic relationship built on mutual respect.

Conclusion

In summary, the Positive Systems Approach represents a significant shift from traditional behavioural treatment programs. By recognizing the importance of internal human traits and avoiding punitive measures, PSA offers a more humane, ethical, and effective means of supporting individuals with behavioural challenges. Positive Systems Approach (PSA) is not a mere technique employed solely when addressing severe behavioural issues; rather, it is a philosophy that demands adoption by support workers, managers, and all caregivers. PSA represents a 24-hour, seven-days-a-week strategy with a strong focus on prevention through the reconfiguration of environmental and support arrangements, ultimately enhancing an individual's prospects for success. This approach is often characterized as a synthesis of the favorable aspects of Applied Behaviour Analysis and Systems Theory. This approach not only aims for immediate behavior change but also strives for long-term well-being and personal growth, ensuring that support is both compassionate and comprehensive. For a more in depth discussion of the differences between PSA and traditional behavioural approaches, please refer to our book: Managing Disruptive Behaviours through a Positive Systems Approach: How to Prevent Challenging Behaviours Before They Occur - now available in digital format or hard cover on Amazon. https://www.amazon.ca/s?k=managing+disruptive+behaviour+with+a+positive+systems+approach&crid=1NNHZ1610EV3W&sprefix=managing+disruptive%2Caps%2C227&ref=nb_sb_ss_pltr-sample-20_1_19