What Is Behavioral Rehabilitation?
Behavior rehabilitation after an acquired brain injury focuses on changes that may show up in the way people feel and express those feelings.
Behavioral rehabilitation helps people learn to manage inappropriate actions that may cause problems relating to family members, friends, co-workers and others.
Symptoms that behavioral rehabilitation can address include:
- Increased irritability
- Saying or doing inappropriate things
- Mood swings
- Intense emotional expression from anger to joy (emotional lability)
- Lack of emotional control
- Acting out
- Substance use
- Depression, anxiety, grief (suicide rates after TBI increase over 2X)
- Not complying during rehabilitation
- Aggressiveness or violence toward others
- Agitation, restlessness
- Lack of inhibitions
- Elopment (running away)
It's not just the injury to the brain that drives behavioral changes. It's also all the added stresses from brain injury. Defining which is which is crucial to behavioral rehabilitation. People with brain injuries must cope with:
- Frustration with abilities and functioning
- Changes to relationships
- Communications issues
- Feeling that no one else understands
- Increased isolation
- Confusion due to cognitive processing problems
Research shows that areas of the brain associated with social function and decision-making are particularly vulnerable areas for injury.2
Treating behavior problems is complex. There is no magic wand to make behavior problems disappear quickly or sometimes ever. In the rehab setting treatment must also protect staff and other patients.
Cognitive rehabilitation therapy is focused on managing or minimizing symptoms. It's not about forcing people to do things. Pate therapists may use various techniques to help alter behaviors including:
- Behavior therapy (reinforcement and consequences, and manipulating these factors if needed)
- Cognitive behavioral therapy - altering perceptions of events
- Psychotherapy - insights and awareness
2. Cicerone KD, Tanenbaum LN. Disturbance of social cognition after traumatic orbitofrontal brain injury. Arch Clin Neuropsychol. 1997;12:173-188.