Establish agreed goals

Once a working hypothesis for the target behaviour has been developed, a behaviour support practitioner will establish goals for the intervention that are agreed among all involved. The person with disability should be included in this process as much as possible, and appropriate consent obtained. If the person has difficulty with decision making, a supported process is preferred (if possible). See Consent, capacity and decision making in people with developmental disability. Document the consent and any support needed in the person’s medical record.

Initially, goals for the intervention might include a decrease in the frequency, duration or intensity of the target behaviour within an agreed timeframe. Often it is unrealistic to expect the behaviour to change in the short-term, or to be eliminated entirely. Sometimes it is only possible to reduce (and not eliminate) the frequency, duration or intensity of a behaviour. Family members, support staff and others involved may need support to develop realistic expectations.

Goals for the intervention should include increasing the person’s opportunities for participation in activities that:

  • are meaningful to the person
  • allow for choice and self-determination
  • enhance the person’s skills (especially communication and coping skills) and their ability to act more independently in their preferred activities
  • enhance the person’s social connectedness with family, friends and peers
  • improve their health, wellbeing and quality of life.
When restrictive practices are involved in the behaviour support plan (eg chemical, mechanical, physical restraint, seclusion), their use must be in proportion to the potential negative consequence or risk of harm, and only be used for the shortest possible time to ensure the safety of the person with disability or others. There should be a clear plan to reduce and whenever possible eliminate such practices—regularly review the use of restrictive practices (ie circumstance, frequency and duration).