When a person’s behaviour creates a genuine risk of harm, families and support teams can feel pressure to act quickly. The question of PBS versus restrictive practices is not about choosing one approach over another. Positive Behaviour Support is the proactive framework intended to understand behaviour, build skills and improve quality of life. Restrictive practices are tightly regulated interventions that may only be considered when there is a serious safety concern and no less restrictive option is effective.
For NDIS participants, carers and providers, understanding the difference matters. It helps everyone ask better questions, protect the participant’s rights and work towards support that is safe, respectful and sustainable.
PBS versus restrictive practices: the key difference
Positive Behaviour Support, often called PBS, begins with a simple but important principle: behaviour is communication. A behaviour that others find difficult or unsafe may be communicating pain, fear, sensory overload, uncertainty, a need for control, difficulty expressing a need, or an attempt to escape a situation that feels overwhelming.
PBS does not focus on making behaviour disappear for the convenience of others. It seeks to understand what is happening before, during and after the behaviour, then changes the conditions that make distress more likely. It also teaches practical alternatives so the person has safer and more effective ways to communicate their needs.
Restrictive practices, by contrast, limit a person’s rights or freedom of movement in response to a risk of harm. Under the NDIS framework, they are not behaviour support strategies to use because they are easier, familiar or helpful for managing a busy environment. They are measures of last resort, used only under strict conditions and with the aim of reducing and eliminating their use over time.
The distinction is critical. PBS asks, “What support does this person need to be safe and heard?” Restrictive practice asks, “What temporary limitation is necessary to prevent immediate harm when other options are not enough?”
What a Positive Behaviour Support plan should do
A good behaviour support plan is practical, individualised and written for the people who will use it every day. It is developed through a careful assessment of the person’s strengths, preferences, communication, health, environment, relationships and behaviour patterns.
This assessment may identify triggers, but it should go further than a list of things to avoid. For example, a participant who becomes distressed when asked to leave the house may not simply be “refusing”. They may be anxious about unpredictable transport, worried about noise, unable to communicate that they need more preparation time, or experiencing discomfort that has not yet been recognised.
A PBS plan may recommend changes such as clearer routines, visual supports, communication tools, choice-making opportunities, sensory adjustments, gradual transitions and skill development. It should also give carers and support workers clear guidance on how to respond early, before distress escalates.
Effective PBS supports the whole team. Families and workers need strategies that are realistic in a home, school, day program or community setting. A plan that is too complex to follow during a stressful moment is unlikely to deliver the intended benefit.
Behaviour support is not a one-size-fits-all plan
What works for one person may be unhelpful for another. Some people benefit from predictable schedules and quiet spaces, while others need supported opportunities to build tolerance for change. A strategy should be based on assessment, consent where possible, and the person’s own goals and preferences.
Health factors must also be considered. Pain, sleep difficulties, medication changes, mental health concerns, trauma history, communication barriers and sensory needs can all influence behaviour. PBS is most effective when it brings these factors into view rather than treating behaviour as an isolated problem.
What counts as a restrictive practice?
The NDIS Commission identifies five regulated restrictive practices: seclusion, chemical restraint, mechanical restraint, physical restraint and environmental restraint. Each has a specific meaning, and the legal requirements around use can vary according to state or territory arrangements.
Seclusion involves confining a person alone in a room or physical space at any time of day or night where voluntary exit is prevented. Environmental restraint restricts a person’s free access to parts of their environment, such as locking food cupboards or limiting access to areas of a home. Mechanical restraint involves using a device to restrict movement, while physical restraint involves physical force to prevent free movement.
Chemical restraint refers to medication used primarily to influence a person’s behaviour rather than to treat a diagnosed mental or physical condition. Medication prescribed and administered appropriately to treat a health condition is not automatically chemical restraint. This distinction requires careful clinical consideration and should never be assumed.
Sometimes a family or provider may introduce a restriction with understandable safety intentions, such as locking away knives after a serious incident. Whether it meets the definition of a regulated restrictive practice depends on the circumstances, purpose and effect on the person. This is why early advice from an appropriately qualified behaviour support practitioner is so valuable.
When restrictive practices may be considered
There are situations where a person presents an immediate and serious risk to themselves or others, and a restrictive practice may be proposed while safer long-term supports are put in place. This does not mean the practice is routine, open-ended or automatically acceptable.
Where a regulated restrictive practice is used, it must be authorised in line with relevant state or territory requirements, included in an appropriate behaviour support plan, reported as required, and regularly reviewed. Providers have obligations under the NDIS framework to ensure staff understand the plan, use the least restrictive response possible and keep accurate records.
In Queensland, this can involve additional safeguards and processes depending on the person’s circumstances and the setting. Families should feel comfortable asking who has authorised the practice, why it is considered necessary, what alternatives were trialled, how incidents are documented, and when the restriction will be reviewed.
The intended direction is always reduction. A restrictive practice should not become part of someone’s ordinary life simply because it appears to manage a risk in the short term.
The risks of relying on restriction
Restrictive practices can have serious consequences. They may increase fear, distress, trauma and mistrust, particularly for people who have experienced previous trauma or have limited control over their daily lives. They can also make it harder to identify the underlying reason for behaviour.
There is a practical risk as well. If restriction becomes the main response, the person may not be given the skills, communication supports or environmental changes needed to reduce incidents over time. Workers can also become reliant on a strategy that does not address the cause of the behaviour.
That said, reducing restrictive practices is not achieved by simply removing them without preparation. Abruptly withdrawing a measure without a safe, well-supported alternative can expose the participant, family members or staff to unacceptable risk. A considered reduction plan, informed by data and supported by training, is usually the safer path.
Questions families and carers can ask
Families are often the people who know a participant’s communication, routines and early warning signs best. Their observations should be central to assessment and planning. If a restrictive practice has been suggested or is already in place, ask whether the support team has identified the function of the behaviour and whether a current behaviour support plan is available.
It is also reasonable to ask what proactive supports are being used, what skill the person is being supported to learn, how staff are trained, and how progress is measured. A useful plan should make clear what success looks like beyond fewer incidents. This may include greater choice, improved communication, more participation in community life or stronger relationships.
If you are concerned that a restriction is unnecessary, poorly explained or causing distress, raise this with the provider and seek independent guidance. Participants have the right to dignity, respect, safety and meaningful involvement in decisions about their support.
Choosing support that keeps the person at the centre
Positive Behaviour Support is most helpful when it is more than a document completed for compliance. It should create a shared, practical approach that helps the participant experience more safety, control and opportunity in daily life.
At In Mind Therapy, behaviour support is approached through careful assessment, collaborative planning and strategies that can work across home, community and funded support settings. The purpose is not to judge behaviour, but to understand it and help the person and their support network move towards safer, more fulfilling days.
When safety concerns are complex, compassionate support and clear safeguards can sit together. The best next step is often to pause, understand what the behaviour may be communicating, and build supports that give the person a safer way to be heard.