Working with the adult and their support
network
Contemporary practice in disability support for adults with an intellectual or cognitive disability
dictates that disability service providers engage the adult in the planning and delivery of services
and programs. Contemporary practice also dictates that disability service providers engage the
person’s family, friends and/or significant others in the development and delivery of services and
programs. These principles are reflected in the Disability Services Act 2006 (the Act) and in the
Guardianship and Administration Act 2000.
Person-centred approach
While the Act requires service providers to engage with the adult, this should be done in a manner
that is meaningful to all involved. A person-centred approach will maximise the meaningfulness of
the engagement — providing support and services in a way that focuses on the adult and views
their abilities and needs from a holistic perspective. The advantages of the person-centred
approach include:

providing the adult with a sense of control;

improving the adult’s quality of life;

allowing the adult to make significant choices;

acknowledging the adult’s strengths and skills; and

thinking about and achieving the adult’s priorities and goals.
Positive Behaviour Support
The Act outlines the need for a positive behaviour support approach, not just where restrictive
practices are required. Positive behaviour support is an approach that is responsive to an
individual's needs. It requires a thorough understanding of a person and their behaviour in order to
determine the best ways to support them.
The primary goal of positive behaviour support is to improve a person’s quality of life with a
secondary goal of reducing challenging behaviours. Central to this approach is a positive
behaviour support plan, which is informed by an assessment and outlines strategies that respond
to the person’s needs and the functions of the challenging behaviour.
Any clients with challenging behaviours should have a positive behaviour support plan which
involves the engagement of the adult their families and others in their support network.
Consultation
The Act details specific requirements regarding engagement with the adult and their network
throughout the process of developing a positive behaviour support plan and seeking approval or
consent to use a restrictive practice
Providing the statement about the use of restrictive practices
Consistent with contemporary practice expectations, the Act explicitly requires disability service
providers — who are considering the use of restrictive practices to support adults with an
intellectual or cognitive disability — to engage the adult and significant others in the assessment
and planning associated with the use of those restrictive practices. The Act includes a requirement
for relevant service providers to give a statement about the use of restrictive practices to the adult,
their family and others in their support network. The statement must state why the relevant service
provider is considering using restrictive practices in relation to the adult and how the adult and the
interested person can be involved and express their views in relation to the use of restrictive
practices.
It must also include who decides whether restrictive practices will be used in relation to the adult
and how the adult and the interested person can make a complaint about, or seek review of, the
use of restrictive practices.
The relevant service provider must explain the statement to the adult in the language or way the
adult is most likely to understand and in a way that has appropriate regard to the adult’s age,
culture, disability and communication ability.
Development of positive behaviour support plans
For any matter involving containment and seclusion it is the responsibility of the Chief Executive of
the Department of Communities, Child Safety (the Chief Executive) to decide whether a
multidisciplinary assessment of the adult will be conducted and then if a positive behaviour support
plan will be developed.
For all other restrictive practice types (except for where the person is only receiving community
access or respite) the assessment of the person and subsequent development of a positive
behaviour support plan is the responsibility of the relevant service provider.
In either case the following people must be consulted:

the adult;

their guardian or informal decision-maker;

each relevant service provider providing disability services to the adult;

the treating doctor – if the plan includes the use of chemical restraint;

if the person is subject to a forensic order or involuntary treatment order under the Mental
Health Act 2000—the authorised psychiatrist responsible for treatment of the person under
that Act;

if the person is a forensic disability client—a senior practitioner responsible for the care and
support of the person under the Forensic Disability Act 2011; and

any other person considered to be integral to the development of the plan.
Where a person is receiving community access or respite only, a community access/respite plan is
required to be developed by the service provider (except for fixed dose comical restraint in respite
only). A community access or respite service provider must consult and consider the views of:

the adult;

their guardian or informal decision-maker;

any other relevant service provider providing disability services to the adult; and

any other person considered to be integral to the development of the plan.
A collaborative approach
A holistic view of the adult is fundamental to understanding their needs. As such, engaging with the
adult’s network (family, friends and significant others) is essential. A focus on collaborative practice
helps to ensure a planned and coordinated approach to understanding and meeting the needs of
the adult.
Strategies that facilitate collaborative practice include:

being respectful of other individuals and agencies;

respecting the knowledge and experience of others;

being willing to listen and understand the needs, goals and procedures of others;

keeping the goals achievable and clear;

developing a trusting relationship - consultation may be the first step;

making realistic commitments - small successes are preferable to failures;

agreeing to disagree - total agreement on everything is neither possible nor necessary;

being flexible enough to try many options in working to achieve the identified goal;

relinquishing some decision-making power;

being the first to share resources, assist in activities, or try different ways;

letting someone else take the lead in initiating an activity; and

giving others credit for accomplishing an objective or achieving success.
The advantages of engaging in a collaborative approach include:

gaining a deeper, shared understanding of who the adult is, their life so far and what they
want to achieve;

clarifying each person’s role in supporting the adult;

identifying the adult’s preferred strategies for assistance in achieving their goals;

having opportunities to support ‘thinking outside of the square’ and to follow up these
opportunities and possibilities;

assisting the support network to build confidence through the process;

allowing stakeholders to express their views and wishes in a safe environment; and

preventing crises, through being proactive and focusing on strengths.
Further Information
For more information, refer to the “Positive Behaviour Support:” page on the Disability Services
website: http://www.communities.qld.gov.au/disability/key-projects/positive-behaviour-support or
contact the Centre of Excellence for Clinical Innovation and Behaviour Support on 1800 902
006.
July 2016
Please note: The information in this document is provided as an initial guide only. It is not
intended to be and is not a substitute for legal advice. Service providers should seek their
own independent legal advice with reference to the implementation of the legislation