Noble Behavioral Services Competency Verification Training

Positive Behavioral supports are an array of services designed to support individuals who are experiencing or are likely to experience challenges accessing, and actively participating in the community because of behavioral, social, or emotional challenges. Behavioral support services are intended to empower individuals and families (by leveraging their strengths and unique abilities) to achieve self-determination, interdependence, productivity, integration, and inclusion in all facets of community life, across all environments, across the life.

Noble believes strongly in the philosophy of positive behavioral supports. Following this approach means every effort is utilized to use the least restrictive approach possible. Procedures, curriculums, and all documents directing staff in Noble Behavioral Services will follow this approach. Usage of physical restraint and medication will be limited, with a focus on behavioral supports that utilize less intrusive or restrictive methods being tried first.

Client Name: *

First NameLast Name

Date of Behavior Support plan:*

Who is the Behavior Consultant?

Other Name:

What are the target behaviors? *

What are the Replacement Behaviors? *

Describe interventions for the Primary Target Behavior: *

What is a proactive strategy for working with this person? *

Who do you contact with questions on the Behavior Support Plan? *

Completed Role Play?*

YesNo

Training Addressed the Following:

Current Behavior PlanPsychotropic MedicationsData CollectionOther

I, family/staff, acknowledge that I was provided training regarding his/her positive behavioral support program. Training was provided directly (by the clinician/trainer) or indirectly (family/staff reviewed the plan without the clinician/trainer present).Psychotropic medication treatment program was reviewed, including current medications and potential side effects. If there is a PRN, this process was reviewed to ensure family/staff are aware of the proper procedure. Training was provided directly (by the clinician/trainer) or indirectly (family/staff reviewed the plan without the clinician/trainer present). Family/staff have been made aware of how to contact the Behavior Specialist should any new behaviors arise or further assistance or training be needed.

YesNo

Trainee Full Name: *

First NameLast Name

Title: *

EX: DSP, Parents, Therapist, Other

Training Date:

Date

Duration of Training: *

Location of Training : *

Virtual, Noble East, Tibbs, Site #

By signing below, I am acknowledging that I have read and understand the information in the Behavior Support Plan, its expectations, proactive strategies and response expectations. I have received direct or indirect training on
Positive Behavioral Support Program, Psychotropic Medications, and Data Collection/Documentation. I understand that if I have questions, at any time, regarding the Behavior Support plan I will consult with the Behavior Consultant or my immediate supervisor.

Signature

Behavioral Services Competency Based Training