Using the SECURED Model with care teams

People with learning disabilities are more likely to be exposed to adverse and traumatic life events and are vulnerable to disrupted attachments. Current approaches such as Positive Behavioural Support (PBS) can be applied in a way that may lack understanding of trauma and attachment disruptions experienced by people with learning disabilities, and its role in displays of distressed behaviours. The article explores the use of an attachment and trauma informed ‘SECURED’ framework implemented in staff training alongside PBS. The aim of this approach was to foster and maintain attachment informed relationships and emotional attunement in a residential service. Following intervention, incident reports reduced by 74% compared to the year prior, and there was an improvement in clinical and psychosocial outcomes measured using the HoNOS-LD. Staff also reported greater confidence, empowerment and reduced reliance on restrictive practices. These findings highlight the importance of embedding attachment informed approaches into PBS to increase quality of life for service users. Easy to read summary ■ Positive behaviour support is often used to support people with learning disabilities when they show behaviours that are challenging to others. ■ We used a different approach to train support staff to focus on the past relationships that people with learning disabilities have had with others. ■ Staff found it helpful to think about these past relationships and it helped them support people with learning disabilities differently. ■ After the training the person with learning disabilities had better quality of life and less behaviour that challenged others.