Psychology vs Positive Behaviour Support: Which Does Your NDIS Participant Need?

When a participant is struggling with emotions, relationships or behaviour, it is not always clear whether to refer to a psychologist or a Positive Behaviour Support (PBS) practitioner. Both services may support a person’s wellbeing and participation, but they have different primary purposes.

The short answer: psychology usually focuses on working directly with the participant to build psychological and functional skills, such as emotional regulation, coping and adjustment. Positive Behaviour Support focuses on understanding why behaviours of concern happen and changing the environment, routines and supports around the person so those behaviours are less likely to occur. Choosing the right pathway starts with understanding the problem you are trying to solve.

This guide explains the difference between psychology and Positive Behaviour Support under the NDIS, when each may be the better starting point, when a participant may need both, and the questions Support Coordinators can ask before making a referral.

Psychology vs Positive Behaviour Support at a glance

What does an NDIS psychologist do?

Psychologists may support disability-related functional needs involving emotional regulation, coping, behaviour, interpersonal skills, adjustment, problem-solving and psychosocial functioning. When delivered as an NDIS therapy support, the work should be linked to the participant’s disability-related goals and functional outcomes.

In practice, this might look like a psychologist helping a participant:

• recognise early signs of distress and use strategies to manage it

• build social and communication confidence in relationships

• adjust to a new diagnosis, acquired disability or major life change

• develop problem-solving skills that support greater independence

The NDIS is not a replacement for the mainstream health system. The NDIA’s guidance, Would We Fund It? Psychology Supports and Mental Health, explains that NDIS psychology supports focus on building and maintaining a person’s functional capacity, while clinical mental health supports such as assessment, diagnosis and symptom-focused treatment remain the responsibility of the health system. Treatment primarily directed at a general mental health condition may therefore sit with health or mental health services rather than the NDIS, depending on the circumstances.

Learn more about how CARED’s NDIS psychology service works, or read how to prepare for a first psychology session.

What is Positive Behaviour Support?

Positive Behaviour Support focuses on understanding behaviours of concern, their function and the factors that influence them. It uses person-centred, evidence-informed strategies to improve quality of life, build skills and reduce the need for behaviours of concern.

PBS starts from the idea that behaviour communicates something. A behaviour of concern may help a person escape a demand, get access to something they want, cope with sensory overload or express pain or frustration. Once the function is understood, the support team can change what happens before and after the behaviour and teach safer, more effective alternatives.

A Behaviour Support Practitioner may undertake a functional behaviour assessment, develop behaviour support strategies and a Behaviour Support Plan, and support the people around the participant to implement those strategies consistently. That last part matters: PBS often succeeds or fails based on how consistently families, support workers and other providers apply the plan.

Behaviour support and restrictive practices

The NDIS Quality and Safeguards Commission oversees behaviour support and the use of regulated restrictive practices, such as seclusion and chemical, mechanical, physical or environmental restraint. Behaviour support plans that include regulated restrictive practices must be developed by an NDIS behaviour support practitioner whom the Commission considers suitable, and the provider must be registered for specialist behaviour support. The Commission also monitors how these practices are used, with the aim of reducing and eliminating them over time.

You can read more about CARED’s Positive Behaviour Support service.

When psychology may be the better starting point

Psychology may be appropriate where the central issue involves disability-related emotional regulation, coping, adjustment, interpersonal functioning, psychological skills or psychosocial functioning, and the participant can meaningfully engage in psychological intervention.

For example, psychology may be the better first referral when:

• the participant can describe their experience and wants to work on it themselves

• difficulties show up mostly in how the person feels, thinks or relates to others

• there are no significant behaviours of concern placing the person or others at risk

• the goal is to build the participant’s own strategies rather than change their environment

When Positive Behaviour Support may be the better starting point

PBS may be appropriate where there are behaviours of concern that require functional assessment, environmental understanding, proactive strategies, skill building and coordinated implementation by the participant’s support network. It is particularly important where restrictive practices are involved or being considered.

Positive Behaviour Support may be the better first referral when:

• behaviours of concern are frequent, escalating or pose a risk of harm

• the participant has limited capacity to engage in talk-based therapy

• several people are supporting the participant and responding in different ways

• a restrictive practice is being used, has been proposed or is in an existing plan

• behaviours occur mainly in particular settings, such as at home, school or in supported accommodation

For examples of how this works with autistic participants, see how Positive Behaviour Support can help people with autism.

Can a participant need both psychology and PBS?

Yes. A participant may benefit from both services when the clinical needs are distinct and the roles are coordinated. For example, a psychologist may work directly with the participant on emotional regulation while a Behaviour Support Practitioner assesses environmental triggers and supports the broader team to implement consistent strategies.

When both services are involved, coordination is essential. Practitioners should agree on shared goals, avoid giving the participant or their supports conflicting strategies and, with consent, share relevant information so the work in therapy and the Behaviour Support Plan reinforce each other.

Where do OT and neuropsychology fit?

Behaviour and emotional difficulties do not always have a purely psychological cause. Other disciplines can help clarify what is going on.

Occupational Therapy (OT) may be relevant where sensory processing, routines, daily living skills, environmental demands or participation are contributing to the problem. A behaviour that appears psychological may sometimes be strongly influenced by communication, sensory or environmental factors. Find out more about CARED’s Occupational Therapy service or how FCA, OT and PBS can work together for complex needs.

Neuropsychology may help where questions about memory, attention, learning or thinking skills are affecting behaviour and day-to-day functioning. A neuropsychological assessment can help the team understand a participant’s cognitive profile, which in turn can shape both therapy and behaviour support strategies.

Communication difficulties can also sit behind behaviours of concern. In those cases, input from Speech Pathology may be worth considering alongside psychology or PBS.

Referral questions for Support Coordinators

Before choosing a discipline, it helps to work through a few questions with the participant and their supports:

1. What is happening? Describe the behaviour or difficulty in specific, observable terms.

2. In what situations? Note when, where and with whom it occurs, and what tends to happen before and after.

3. Who is affected? Consider the participant, family members, support workers, housemates and others.

4. Is there immediate risk? If there is a risk of serious harm, contact emergency services or the relevant crisis service first.

5. Are there restrictive practices? Check whether any are being used, proposed or already included in a plan.

6. What is the goal? Is it direct psychological therapy, understanding the function of behaviour, changing the environment, training the support team, or several of these?

Those answers usually point more clearly to the right discipline than the participant’s diagnosis alone.

Next step

The right support depends on the participant’s needs, goals and circumstances, and this article is general information rather than individual clinical or NDIS advice. CARED provides both Psychology and Positive Behaviour Support, along with Occupational Therapy, Neuropsychology and other allied health services, so referrals can be triaged according to what the participant needs.

Unsure where to refer? Send CARED the referral question and our team can help triage it, or contact our team to talk it through.

Frequently asked questions

Is Positive Behaviour Support the same as psychology?
No. They can overlap in some areas, but they have different purposes, frameworks and practitioner roles. Psychology mainly builds the participant’s own skills, while PBS focuses on the function of behaviours of concern and the supports around the person.

Can a psychologist write a Behaviour Support Plan?
Only if they are also an NDIS behaviour support practitioner. Behaviour support plans under the NDIS behaviour support framework need to meet applicable requirements and be developed by practitioners the NDIS Commission considers suitable. Being a registered psychologist does not by itself meet this requirement. Check current NDIS Commission requirements for the participant’s circumstances.

Does the NDIS fund psychology for mental health conditions?
The NDIS may fund psychology that builds functional capacity related to a participant’s disability. Clinical mental health treatment focused on diagnosis or symptom reduction is generally the responsibility of the health system. Funding decisions depend on the participant’s plan and circumstances.

Can CARED provide both services?
Yes. CARED provides Psychology and Positive Behaviour Support, allowing referrals to be triaged according to the participant’s needs.