Positive Support Plan
Client: Click here to enter text. Date: Click here to enter text.
Functional Assessment Completed on: Click here to enter text.
Description of Challenging Behavior: Click here to enter text.
Baseline Frequency, Intensity & Duration of Challenging Behavior: Click here to enter text.
Medical & Mental Health Assessment:
Physical Health Issues contributing to the Challenging Behavior? Yes ☐ No ☐ Explain
Psychosocial Issues contributing to the Challenging Behavior? Yes ☐ No ☐ Explain Click here to enter text.
Any history of trauma? Click here to enter text.
Will this trauma history be impacted by the interventions? Click here to enter text.
How will physical or mental health conditions be addressed? Click here to enter text.
Psychiatric Medications
Psychotropic Medication for Challenging Behavior: Yes ☐ No ☐
If yes, attach Psychotropic Medication Support Plan.
Positive Support
Recommendations for improving the general quality of a Person’s life: Click here to enter text.
Recommendations for more meaningful activities: Click here to enter text.
Events and environmental factors that are likely to provoke Challenging Behaviors and steps to reduce them: Click here to enter text.
Strategies for teaching the Person skills to meet their own needs without resorting to Challenging Behavior: Click here to enter text.
Strategies and training for the staff to interact with the Person when they are exhibiting Challenging behavior: Click here to enter text.
Evaluation and treatment for medical, psychiatric and neurological issues: Click here to enter text.
Support for self-direction and building relationships: Click here to enter text.
Modifications to the physical and interpersonal environment: Click here to enter text.
Strategies to address communication barriers and a plan to enhance the Person’s ability to communicate: Click here to enter text.
In-Home Stabilization
Will In-Home Stabilization be utilized to provide support and assessment to the Person?
Yes ☐ No ☐
If yes, attach the In-Home Stabilization Plan
Transition Plan
Will a token economy system be used as a Positive Behavior Modification Technique?
Yes ☐ No ☐
If yes, what is the plan to move toward more natural reinforcers and personal control: Click here to enter text.
Discontinuation Plan
What will it look like when the plan is no longer necessary: Click here to enter text.
What is the Planning Team’s plan to evaluate and modify the Positive Support Plan? Click here to enter text.