Changes in personality and behavior are often the most tragic and limiting consequences of brain injury. Although some issues, such as severe physical and verbal aggression, are quite obvious, others including reduced inhibition, judgement, and initiation can be much less so. Behavioral expression of these difficulties can range from subtle, off-color comments to frankly disinhibited and extreme sexual responding. Unfortunately, behavior patterns of this type often set up a “revolving door” pattern that starts with inappropriate behavior, legal attention, psychiatric placement, and rapid discharge to begin the pattern again.
Our staff secured Neurobehavioral Rehabilitation Program was established with the specific purpose of providing effective treatment that would stop this “revolving door” cycle, and for those individuals with neurologic impairment whose behavior has made them ineligible for other treatment programs.
Neurobehavioral Problems Include:
- Physical Aggression
- Verbal Aggression
- Self-injurious Behavior
- Poor Judgement and Safety
- Substance Abuse
- Medication Compliance
- A Reduced Ability to Initiate
- Inappropriate Social Behavior
- Sexual Disinhibition
- Property Destruction
- Escape/Elopement Risk
The Neurobehavioral Rehabilitation Program is based on the idea that positive teaching is a more effective way to change behavior than punishment and restriction. Initially, individuals are provided with the level of staff support and supervision required to minimize the factors in the environment that prompt loss of control. Simultaneously, teaching in the areas of self management and self control strategies occurs at the level permitted by current cognitive functioning. Strategies range from the fairly simple and concrete to the sophisticated and abstract, with an emphasis on learning positive control. Frequent and intensive rehearsal and practice of simple coping skills occurs with ample opportunities for practice of newly acquired skills.
In the Neurobehavioral Rehabilitation Program, structure and safety are maintained through staff supervision rather than locked units, chemical restraint, or mechanical restraint. Achieving increased self monitoring and self control is stressed, praised, and reinforced rather than simply encouraging individuals to comply so as to avoid negative and arbitrary consequences. As progress with regard to behavior, internal control, and motivation occurs, external prompts, aids, and supports are reduced to the point where available support matches the needs of the individual.