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People display challenging or distressed behaviours for a reason. It could be the only way they can communicate at that time, or an expression of their feelings or of pain. A range of approaches can help us understand what this behaviour means and support people in such a way that protects their human rights and means that behaviours which put them or others at risk of harm are less likely.


Local networks

Local networks can help you share what’s worked well and learn from others, to improve best practice. Download the list of networks and communities of practice. If you want us to add your details to the list, email innovation@skillsforcare.org.uk.


Recognising behaviour as distress

In April 2019, The national autistic task force published , the first independent and autistic-authored guide to what good quality care and support looks like, for autistic people of all ages and right across the autistic spectrum.  

We have heavily drawn on their recommendation 7; Recognising behaviour as distress, which should be relevant to support for all people whether autistic or not:

  • Treat the use of any physical intervention, pharmaceutical control of behaviour or any other forms of restraint as failures and seek to create a service free from physical interventions and pharmaceutical control of behaviour.
  • Don’t blame (autism) or the person’s disability. ‘Challenging’ behaviours are not an inevitable consequence of autism or a learning disability.
  • Don’t label people as ‘complex’, seek to understand and empathise with their perspective.
  • Do not remove choice and control from a person, seek to find more ways they can have choice and control over their own lives.
  • Challenge proposals/decisions to remove a person from their local community.
  • Modify the environment to meet needs, look for underlying causes not just triggers.
  • Work with, not against, the person (and where relevant their family) – supporting them to manage stress and recover from distress.
  • Avoid focussing on behaviour ‘management’ at the expense of meeting needs.
  • Accept and accommodate behaviours that do not infringe on the rights of others.
  • Support people to find practical ways to meet their needs which minimise overall harm to themselves and respect the rights of others.
  • Recognise when service policies, placement environments or particular staff are not the right match for the individual.
  • Identify when stretched public resources are leading to short term decisions which are unlikely to be cost effective in the long term.
  • Identify when behaviour is related to an unmet need, and meet the need.


Restraint Reduction Network (RRN) Training Standards 2019

These standards provide a national benchmark for training in restrictive practices and focus on the fundamental principles that apply to all populations (people with a mental health condition, learning disability, autism or dementia) and settings (across education health and social care).  


Approaches to supporting people

Information about a range of approaches to supporting people with challenging or distressed behaviour.

Positive behavioural support (PBS)

Specific information about positive behavioural support (PBS), a way of supporting people that involves understanding the reasons behind challenging and distressed behaviour.