Positive behavioural support (PBS) is a non-aversive, preventive approach to behavioural management. The use of proactive approaches such as PBS has been suggested for multiple contexts and client groups as part of the restraint-reduction, ‘positive-and-safe’ agenda in the UK. PBS was introduced into a psychiatric intensive care unit (PICU) in a south Wales forensic service. However, the approach employed needed to be adapted to improve ‘goodness of fit’ for the PICU setting. This article describes the actions taken in the service to improve the fit of PBS in the PICU. To read the full article, log in using your MPFT NHS OpenAthens details.