Maryland Positive Behavior Support Training

Other Tier 2 & 3 Practices

Sometimes other practices are used to help people at tiers 2 and 3. These other practices often address social and emotional skills. Not all people who need tier 2 or 3 supports will include other practices. However, in some situations, the challenges a person encounters require other types of supports. Some examples of practices are included on this page.

A person-centered plan is a process that is used to create a plan for a positive and meaningful life for someone by building on his or her interests and strengths.  There are different methods that can be used to help a person create their dreams for a better future.  The person who asks for a person-centered plan chooses the people who will become part of the person-centered team, identifies a facilitator, and picks the location where the event is held. The goal of a person-centered plan is to create a list of steps that will help people live their best lives. There are many planning models that can be used to guide the brainstorming process. the best person-centered planning process uses elements from different approaches to meet the needs of each person.

Four disabled people of color face each other in a open circle during a meeting. Two Black people sit on a couch with a cane leaning off the side while a Black non-binary person stands with a tablet and cane. A South Asian person in a wheelchair takes notes.

 Photo credit: Disabled and Here

This practice is used to help people observe their own thoughts and focus on the present moment without judgment. Mindfulness has been used to address a large number of challenges including managing strong emotions, decreasing stress, treating heart disease and lowering blood pressure, coping with chronic pain and improving sleep. Mindfulness interventions have been studied in the disability field with positive outcomes reported for people receiving support, direct support staff members, and for family members as well.

Word cloud with words and phrases related to the idea of mindfulness

Dialectical behavior therapy or DBT is a type of cognitive behavioral treatment originally used to support people with borderline personality disorder. Over time, this practice has been expanded to support people with a range of issues that are related to managing emotions. DBT has been used to address a number of mental health issues including post-traumatic stress, binge eating, depression and substance misuse. The main goal of DBT is to learn four strategies: 1) develop skills to regulate emotions, 2) practice mindfulness skills that help people to live in the moment, 3) increase the ability to tolerate distress, and 4) expand relationship-building skills. Therapeutic settings for DBT involve working in groups to learn new behavioral skills, meeting for individual therapy, and engaging in coaching sessions.

Person with image in brain area

Traumatic life experiences such as child or domestic abuse, natural disasters, or other negative life events can have a lasting impact on a person’s health and emotional wellbeing. Trauma-focused cognitive behavior therapy is an evidence-based practice that helps people cope with trauma that is experienced in life. Trauma-focused cognitive behavior therapy is a positive support that teaches children and adults skills to recognize negative or unhealthy thoughts associated with past experiences and to engage in stress management and coping strategies when these thoughts occur. This approach can also include teaching new skills for parents and caregivers of children involved in therapy. A family therapy approach is used to help recognize family dynamics, teach new parenting skills, support stress management for both child and family members, and work on improving communication skills.

Child with two adults arguing in background.