RRN statement responding to the CAPBS paper on separation of pBS and physical intervention training in the uK

The Restraint Reduction Network welcomes the publication of the Centre for the Advancement of Positive Behaviour Support paper on Positive Behavioural Support and physical intervention, and the opportunity it creates for constructive discussion across the sector about PBS, prevention, physical intervention training and the continued reduction of restrictive practices. 

The Centre for the Advancement of Positive Behaviour Support (CAPBS), as part of their work as a not-for-profit centre within the British Institute of Learning Disabilities (Bild), set out CAPBS’s position on the importance of distinguishing clearly between Positive Behaviour Support (PBS) and physical intervention. We recognise the value of this contribution. The paper builds on earlier work explaining the important differences between PBS and physical intervention which can be accessed here. You can read the full CAPBS paper here.

Greater clarity about PBS as a preventative, rights-based approach is important for people receiving support, families, commissioners, practitioners and training providers. 

PBS is one of several preventative approaches that may support restraint reduction, alongside approaches such as trauma informed practice, safe wards and active support. Restraint techniques are not part of the PBS model. Confusing PBS with physical intervention can be harmful, particularly for people with lived experience of restraint, and can lead staff and commissioners to misunderstand what PBS is intended to achieve. 

The mission of the Restraint Reduction Network (RRN) is to end the misuse of restrictive practices and support services to respond to distress with compassion, curiosity and effective prevention. Our Training Standards are rooted in a trauma informed, human rights approach and require prevention to be taught before any physical intervention techniques are taught. 

We want to reassure stakeholders that there is no change to the RRN Training Standards. The Standards continue to apply to training that includes a restrictive component. They do not accredit PBS itself, or any standalone preventative approach. Where PBS is used as part of preventative content within training, it remains important that providers are clear with learners about what PBS is, what physical intervention is, and how each sit within a wider commitment to restraint reduction. 

The CAPBS paper does not suggest that people should not be taught physical intervention where this is necessary to prevent immediate and serious harm. Nor does it suggest that providers who deliver both preventative and physical intervention training should not be certified. The RRN Training Standards are focused on prevention, and certified training must include prevention. The CAPBS paper asks that training providers make the distinction between PBS and physical intervention clear and transparent. 

This distinction matters because restraint should be rare, exceptional and used only where it is the only way to prevent immediate harm. Too often restraint is used where crisis was avoidable, where support came too late, or where services did not understand what was driving a person’s distress. Effective prevention, including good PBS where it is the chosen model, should improve quality of life, strengthen relationships and reduce reliance on restrictive practices over time. 

As part of the Bild partnership of charities and the wider community, we welcome continued dialogue with CAPBS, Bild, Association of Certified Training (ACT), certified training providers, commissioners, practitioners, people with lived experience and wider sector partners about how best to support clarity, consistency and good practice. We are grateful to all those working to reduce restraint, protect rights and improve outcomes for people supported by services.  

RRN have a Community of Practice on LinkedIn where best practice can be shared. The Community of Practice is open to all RRN Individual Members. You can apply to join here.