PMVA Behaviour Support & Advanced Restrictive Interventions Training

RRN Accredited Training Using the Able Target System (ATS) Model

Gain the knowledge, confidence and practical competence to understand, prevent and safely respond to higher-risk behaviours that may challenge with this PMVA Behaviour Support & Advanced Restrictive Interventions Training course. Designed for specialist health, social care, education and support services across the UK, this intensive four-day programme equips learners with the knowledge, judgement and practical skills required to support individuals whose behaviour may present a significant and immediate risk of harm.

Ideal for organisations supporting autistic individuals, people with learning disabilities, individuals experiencing mental health difficulties and those with complex support needs, this course places behaviour support, prevention and de-escalation at the centre of practice before progressing into personal safety, physical intervention, restrictive intervention and advanced floor-based responses.

Delivered using the Able Target System (ATS) model, this programme is accredited by the Restraint Reduction Network (RRN) and supports standards recognised by the Institute of Conflict Management (ICM). The course prioritises restraint reduction, human rights, professional accountability and the least restrictive response capable of maintaining safety.

The programme follows a progressive four-day structure. Learners first develop a detailed understanding of behaviours that may challenge, prevention, proactive planning, communication and de-escalation. They then progress through personal safety and breakaway skills, physical and restrictive interventions, and finally advanced higher-threshold techniques where these are justified by organisational need and a comprehensive Training Needs Analysis.

Advanced restrictive interventions are never presented as routine responses or substitutes for effective support. Learners are taught to consider whether an intervention is lawful, necessary, proportionate, reasonable and the least restrictive option available, while continually monitoring the physical and psychological wellbeing of the individual.

What this course offers

Delivered over four days, this comprehensive and highly practical programme provides learners with an in-depth understanding of behaviour support, violence and aggression prevention, dynamic risk assessment and advanced restrictive intervention practice.

The programme begins by exploring why behaviours occur, how distress and unmet needs may be communicated through behaviour, and how staff responses, communication, culture, environment and support planning can influence outcomes.

Learners develop practical skills in early recognition, relational de-escalation and proactive support before progressing into keeping-safe positions, breakaway responses, guided movement, physical interventions and restrictive holds.

The programme then introduces advanced restrictive and floor-based intervention content for organisations where a significant, foreseeable risk has been identified. This specialist content is delivered as additional learning and is not compressed into the time allocated for lower-level training.

Significant time is protected for trainer demonstration, coached practice, learner rehearsal, realistic scenario work and assessment of competence. Practical competence includes much more than reproducing a physical movement. Learners must demonstrate appropriate decision-making, communication, spacing, monitoring, teamwork, safe release and post-incident awareness.

Why this training matters

Prevention, communication and de-escalation should always remain the first response to behaviours that may challenge. However, some specialist services support individuals whose behaviour may occasionally create a serious and immediate risk that cannot be safely managed through non-physical responses alone.

Where restrictive intervention is necessary, staff must be able to act lawfully, proportionately and safely. They must understand the physical and psychological risks associated with restraint, recognise signs of medical deterioration, communicate effectively and end the intervention as soon as it is safe to do so.

Advanced and floor-based interventions introduce additional risks and require particularly careful governance, individual assessment, competent teamwork and continuous monitoring. The ATS framework therefore treats this material as specialist, additional course content selected according to organisational need, foreseeable risk, staffing, environment and service profile.

By combining preventative behaviour support with advanced practical competence, this course helps organisations strengthen safety while maintaining a clear commitment to dignity, human rights and restraint reduction.

Understanding Behaviour and Prevention

Effective intervention starts long before an incident occurs. Learners develop an in-depth understanding of the factors that may contribute to distress, escalation and behaviours that may challenge.

Areas explored include:

• Understanding behaviours that may challenge

• Defining workplace violence and aggression

• Prevention, proactive management and responsive strategies

• The Six C’s framework

• Trust, communication, culture and language

• Person-centred and therapeutic support

• Positive Behaviour Support principles

• Behaviour as communication

• The Six-Stage TARGET Model

• Identifying reflex, reactive and intentional routes into behaviour

• Understanding motivation, emotional regulation and unmet needs

• The influence of trauma, cognition, pain, communication and life history

• Neurodevelopmental and sensory differences

• Proactive support planning

• Coping and replacement strategies

• Developing adaptive skills and positive outcomes

• Reducing environmental and relational stressors

• Recognising escalation earlier

• Learning from incidents to reduce their recurrence

The programme reinforces the principle that effective support is not built around control. It is built around curiosity, context, relationships, prevention and a clear understanding of the individual.

Communication, De-escalation and Dynamic Risk Assessment

Learners explore how their language, positioning, emotional regulation and decision-making can either reduce or increase risk.

This includes:

• Recognising early warning signs and escalation levels

• Dynamic risk assessment

• Environmental awareness

• Distance, positioning and access to exits

• Using space and withdrawal safely

• DAPPER principles

• HEART and HELP communication frameworks

• Relational de-escalation

• Calm, boundaried communication

• Using one lead communicator

• Active listening and emotional attunement

• Responding proportionately under pressure

• Knowing when physical intervention is not appropriate

• Ethical and non-shaming responses

• Recording, reporting and reflective learning

• Post-incident support, repair and review

Learners are encouraged to regulate themselves first, remain professionally curious and avoid allowing urgency to develop into an unnecessarily controlling response.

Personal Safety and Breakaway Skills

Before progressing into restrictive interventions, learners develop personal safety and disengagement skills intended to create space, separation and an opportunity to withdraw safely.

Depending on the Training Needs Analysis, practical content may include:

• Safe approaches and entry

• Active palms and keeping-safe stances

• Wrist and hand-grab releases

• Clothing-grab releases

• Hair-grab responses

• Strike-defence principles

• Choke and neck-grab responses

• Bite-defence strategies

• Assisted disengagement

• Fight-separation responses

• Personal safety during higher-risk incidents

• Team communication and coordinated withdrawal

Knowing when stopping, stepping away or summoning additional assistance is the safest response

These skills are taught within a wider decision-making framework and are not presented as ways to overpower, punish or gain control over an individual.

Physical and Restrictive Interventions

Where organisational risks justify their inclusion, learners progress into a range of physical and restrictive interventions intended to prevent harm while using the least restrictive response appropriate to the circumstances.

Content may include:

• Guides and Supportive Interventions

• Standing Supports and Restrictive Holds

• Relocation and Stabilisation

The selection of individual techniques is informed by the Training Needs Analysis, the people being supported, the service environment, staffing arrangements, incident history and organisational governance. Techniques are not included simply because they form part of the wider training system.

Advanced Restrictive and Floor-Based Interventions

The fourth day introduces specialist, higher-threshold content for organisations where advanced restrictive or floor-based intervention requirements have been clearly identified.

Depending on the Training Needs Analysis and approved scope, learners may explore:

• Supporting an individual to the floor

• Two-person seated restraint

• Supine floor holds

• Prone-related emergency management

• Supine transitions

• Transitioning safely from prone to supine

• Advanced team interventions

• Team roles during floor-based incidents

• Monitoring during advanced interventions

• Emergency release and stopping criteria

• Responding to medical deterioration

• Post-intervention monitoring and aftercare

Prone positioning is not taught as a routine or deliberate target position. Where prone-related content is included, it focuses on responding when an individual has taken themselves to the floor, moving away from higher-risk positioning and transitioning to a safer option where possible, unless a specific individual risk assessment provides a clear alternative justification.

Advanced content must not become normalised or used for convenience, compliance or punishment. It is relevant only where the risk, setting, governance arrangements and individual needs justify it.

Safe Intervention Practice and Medical Risk

Restrictive interventions can carry significant physical and psychological risks. Learners therefore explore the safety, monitoring and emergency considerations that must remain visible throughout every intervention.

This includes:

• Physical and psychological risks of restraint

• Positional asphyxia awareness

• Acute behavioural disturbance where relevant to the setting

• Breathing and circulation concerns

• Signs of medical deterioration

• Changes in responsiveness

• Pain, distress and communication difficulties

• The effect of frailty, mobility needs and existing health conditions

• Trauma-informed considerations

• Moving and handling risks

• Continuous monitoring and communication

• Emergency release and stopping criteria

• Summoning medical assistance

• Reducing the intensity and duration of interventions

• Returning to a less restrictive response as soon as possible

• Post-incident physical and emotional support

Restrictive interventions must continue only for as long as they remain necessary. Monitoring, communication, safe release and emergency response are integrated into practical coaching rather than treated as separate theoretical topics.

Mechanical Equipment and Specialist Systems

Where an organisation has identified a need for specialist equipment or mechanical restraint systems, these requirements must be considered separately through appropriate governance, policy, risk assessment and authorisation.

Mechanical equipment is not automatically included as part of the standard four-day programme. Any training involving equipment-based systems requires specific organisational justification, suitable governance and inclusion within the approved scope of delivery.

This ensures specialist equipment is not treated as an ordinary extension of manual restraint and that appropriate safeguards, oversight and accountability remain in place.

Training Needs Analysis (TNA)

A comprehensive Training Needs Analysis (TNA) is completed before the course to establish whether this level of training is appropriate and to identify the techniques and learning relevant to the organisation.

The TNA considers:

• The people being supported

• Known behaviours and foreseeable risks

• Previous incidents and emerging patterns

• Individual physical and psychological vulnerabilities

• The service environment

• Staffing levels and team structures

• Lone-working considerations

• Existing behaviour support plans and risk assessments

• Organisational policies and governance

• Required intervention levels

• The suitability of specific practical techniques

• Emergency and post-incident arrangements

The four-day course is not a generic package of every available restraint technique. Practical content is selected because it is necessary, proportionate and relevant to the organisation, not simply because a technique exists within the wider system.

Assessment and Competence

Learners are assessed throughout the programme to ensure that they can apply the course principles safely, professionally and proportionately.

Assessment may include:

• Theory assessments

• Trainer observation

• Coached practical activities

• Demonstration of mandatory practical outcomes

• Scenario-based assessment

• Communication and decision-making

• Dynamic risk assessment

• Recognition of intervention thresholds

• Monitoring and stopping criteria

• Teamwork and role allocation

• Safe disengagement and release

• Post-incident reflection

Practical competence is not determined solely by whether a learner can reproduce a technique. Learners must also demonstrate the correct rationale, judgement, communication, safety, monitoring and control. A learner may require additional coaching or referral if a movement can be reproduced but cannot be applied safely or proportionately.

Course Benefits

• Develop an advanced understanding of behaviours that may challenge

• Strengthen preventative and Positive Behaviour Support approaches

• Improve early recognition and de-escalation skills

• Develop confidence in dynamic risk assessment and decision-making

• Learn breakaway, physical intervention and restrictive intervention skills

• Develop specialist competence in approved floor-based responses

• Understand the physical and psychological risks associated with restraint

• Recognise medical warning signs and emergency stopping criteria

• Improve communication and teamwork during higher-risk incidents

• Understand legal, ethical and professional responsibilities

• Promote restraint reduction and least restrictive practice

• Support safer organisational practice and stronger governance

• Reduce risks to staff and the individuals being supported

• Promote dignity, human rights and positive outcomes

Certification and Progression

On successful completion, learners will receive a PMVA Behaviour Support & Advanced Restrictive Interventions Training Certificate.

This programme is accredited by the Restraint Reduction Network (RRN), delivered using the Able Target System (ATS) model and supports standards recognised by the Institute of Conflict Management (ICM).

Certification is based on the approved course scope, techniques delivered, required time allocation and evidence of learner competence. Certification cannot be guaranteed where required evidence is incomplete or a learner has not demonstrated the necessary level of safe practice.

Due to the specialist nature of the techniques and the importance of maintaining practical competence, annual refresher training is required.

Annual refresher training should reconnect learners with prevention, proactive planning, dynamic risk assessment, de-escalation, restraint reduction, communication, monitoring, safe release, recording and post-incident learning. Practical technique rehearsal should remain a significant part of refresher delivery.

This course may support progression into:

• PMVA instructor development

• Positive Behaviour Support

• Advanced restraint-reduction practice

• Specialist autism and learning disability support

• Trauma-informed practice

• Organisational restrictive-practice leadership

• Behaviour support and governance roles

Other organisations may call this...

Depending on the provider, sector or service, similar training may be referred to by different names.

You may have come across terms such as:

• Advanced PMVA Training

• Four-Day PMVA Training

• Advanced Restrictive Interventions Training

• Advanced Physical Intervention Training

• Floor Restraint Training

• Floor-Based Intervention Training

• Safe Holding and Restraint Training

• Managing Behaviours That May Challenge

• Positive Behaviour Support and Restraint Training

• Violence and Aggression Training

• Advanced Safe Holding Training

• Restraint Reduction Training

• RRN Accredited PMVA Training

• Learning Disability Physical Intervention Training

• Autism Physical Intervention Training

• SEND Physical Intervention Training

• Advanced Care Staff Safety Training

• Higher-Risk Behaviour Support Training

• Crisis Intervention Training

• Personal Safety and Advanced Restraint Training

While terminology may differ, the aim remains the same: understanding behaviour, preventing escalation, reducing restrictive practice and ensuring that any intervention used to maintain safety is necessary, proportionate and the least restrictive response available.