Behaviour Support Plans, Explained Without the Jargon

Behaviour support is a funded NDIS support for participants whose behaviour is causing harm or distress, to themselves or to others, and which is understood to be communicating an unmet need rather than occurring without cause. The central document in that support is the behaviour support plan.

Plans of this kind are frequently described in language that obscures rather than explains, and they carry obligations that participants, families and providers are all expected to observe. This article sets out what the document contains, who is permitted to write it, how restrictive practices are regulated, and how a participant or family may request one.

1. What a plan contains

A behaviour support plan is not a list of rules for the participant. It is a working document that records an assessment and sets out a coordinated response. A properly constructed plan contains the following elements.

• A description of the behaviour of concern, in observable terms, together with the circumstances in which it is most likely to occur.
• An assessment of what the behaviour communicates, including any unmet need, skill deficit, pain, or environmental factor identified.
• The proactive strategies that reduce the likelihood of the behaviour, which are the substance of the plan and the part most often neglected in practice.
• The response strategies to be used when the behaviour occurs, written so that different people respond in the same way.
• The people responsible for each element, including family, support workers and clinicians.
• The skills to be taught, so that the plan reduces the behaviour over time rather than managing it indefinitely.
• The review date, and any restrictive practice that is included, together with its authorisation and reporting requirements.

A plan that contains only the fourth element is a containment document. One that leads with the third is doing the work that behaviour support is funded to do.

2. Who is permitted to write one

Behaviour support is a regulated activity. A behaviour support practitioner must be registered with the NDIS Quality and Safeguards Commission to deliver behaviour support to NDIS participants, and the practitioner’s registration reflects the level of complexity the Commission has assessed them as competent to work with.

This is why a plan may not be written by a general support worker, however well the worker knows the participant, and why a practitioner’s scope of registration matters when a plan involves restrictive practices. Where a provider engages a practitioner outside the appropriate level, the plan will not carry the standing it needs at review or at authorisation.

3. Restrictive practices, and why they are treated differently

A restrictive practice is any intervention that restricts the rights or freedom of movement of a person with disability, and it includes chemical, mechanical, physical, environmental and seclusion practices. These interventions are subject to specific legal requirements rather than being a matter of clinical preference.

Where a regulated restrictive practice is used, three conditions apply together. The practice must be authorised under the relevant state or territory legislation, which means the rules are not uniform across Australia. It must be included in a behaviour support plan written by a registered practitioner. And its use must be recorded by the provider and reported to the Commission.

The practical implication for a family is direct. A restrictive practice that is not authorised, or that is used outside the terms of a plan, is not a management technique. It is an incident, and it should be raised with the provider and with the Commission.

4. Interim plans and comprehensive plans

Not every plan is the full document. Where a restrictive practice must be introduced before a complete assessment can be completed, an interim plan may be lodged with the Commission while the full plan is developed. An interim plan is a temporary instrument with a shorter review period, and it should not become the permanent arrangement by inattention.

5. How behaviour support is funded

Behaviour support is generally funded through capacity building supports in a participant’s plan, with the practitioner’s hours set out and claimed against the funding available. The price limits that apply to those hours are published in the NDIS pricing arrangements and are updated periodically, so the figure a provider quotes should be checkable against a current published document rather than accepted as given.

Where a plan requires clinical input that sits outside behaviour support, that work is funded through a different pathway. Psychological support for a participant, including the question of who pays for it and how sessions are arranged, is dealt with separately.

6. How to ask for one

• Raise it with the support coordinator or the plan manager, and ask that it be included in the plan or raised at the next review.
• Describe what is happening in concrete terms: what the behaviour looks like, when it occurs, what has already been tried, and what it is costing the participant in daily life.
• Ask specifically for a registered practitioner, and ask which level of registration the practitioner holds.
• Ask for the plan to identify the proactive strategies, not only the responses.
• If the plan exists and is not being followed by the people delivering support, raise that with the provider in writing. A plan that is not implemented is a compliance matter, and the pathway for raising it is the same as any other concern about a registered provider.

7. Where the plan sits among the other supports

A behaviour support plan does not replace the arrangements that surround it. Where the participant’s living situation is changing, the provider arrangement may need to change with it, and the mechanics of changing providers are a separate process from the plan itself. What matters is that the plan is reviewed when the circumstances it was written for change, rather than being left in place until the next scheduled date.

What a working plan changes

Start with the person who coordinates the plan, put the request in writing, and ask for a registered practitioner by name and level. Ask what the plan will change in the first three months. A plan that produces new strategies, new skills and a shorter list of incidents is working. A plan that produces a folder is not.

Sources: the NDIS Quality and Safeguards Commission (ndiscommission.gov.au) publishes the behaviour support practitioner registration requirements, the rules on regulated restrictive practices, and the reporting obligations of providers; the NDIS pricing arrangements are published at ndis.gov.au. Restrictive practice authorisation is governed by state and territory legislation and differs between jurisdictions.