Positive behaviour support: a systematic literature review of the effect of staff training and organisational behaviour management
PBS staff training changes staff actions, yet proof that clients actually benefit is almost missing—track client outcomes to fix this.
01Research in Context
What this study did
Konstantinidou et al. (2023) hunted for every paper that tested PBS staff training plus organisational behaviour management.
They kept studies from any country, any setting, as long as staff got training and bosses used OBM tools.
The team then graded each study for rigor and looked for real-life gains for the people receiving support.
What they found
Staff almost always started using PBS skills after training.
Only one of the reviewed studies showed clear, lasting gains for clients.
Most papers tracked staff behavior, not client behavior, so the trail stops at the staff door.
How this fits with other research
Andzik et al. (2017) saw the same gap in pyramidal training: staff skills soared, but only 43% of clients improved.
Britwum et al. (2025) buck the trend. Their small trial paired brief instructions with real-time acoustic feedback and both staff praise and client target behavior rose, holding for 1-3 weeks.
The difference is measurement. Kwadwo watched clients too, while most PBS training studies, included in Konstantinidou’s review, stopped after staff checked the box.
Freeman et al. (2025) extend the call, mapping drivers organisations need to move from “staff trained” to “lives improved.”
Why it matters
You can run the best staff workshop ever, but if you do not measure what happens to the people served, you will not know if it matters.
Add one client-level probe to your next PBS training plan: count challenging behavior, engagement, or quality of life for at least three weeks post-training.
That single extra sheet of data turns a staff exercise into a client win.
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02At a glance
03Original abstract
Positive Behaviour Support is an applied behaviour analytic system of support that is utilised in schools and in residential care settings for children and adults with disabilities who engage in challenging behaviour. Implementation fidelity depends on appropriate staff training and organisational behaviour management. A systematic literature review is reported that evaluated the evidence in relation to change in staff and service user behaviour and the impact of organisational behaviour management systems on effectiveness, generalization, and maintenance of these outcomes. Nine relevant articles were identified and analysed according to (1) the demographics of staff and residents and methods of staff training; (2) organisational behaviour management systems; (3) staff and service-user behavioural outcome measures; and (4) the methodological quality of the study. A combination of antecedent and consequence-based training strategies was used in the studies. Eight studies reported on the organisational behaviour management systems that were used, with five reporting on the responsibility of trainees to transfer their training to their untrained teams (pyramidal training). Although the studies reported on staff behaviour change following the training, only one of the studies reported significant increases of service user quality of life as a result of staff training and only two studies provided adequate methodological strength.
International Journal of Developmental Disabilities, 2023 · doi:10.1080/20473869.2022.2123199