Brain-injured individuals often experience problems with aggression which can prevent full community reintegration. Two cases involving individuals (one 4 years, one 17 years post-injury) who had been placed in a state psychiatric hospital due to aggressive and/or self-injurious behaviours are discussed. Utilizing medication dosages and behavioural acuity indicators over a 2 year period, the authors demonstrate the efficacy of lithium carbonate in treating aggressive behaviours. Lithium, in concert with other medications, not only led to a decrease in the frequency of aggressive outbursts and in the need for restrictive and costly behaviour control techniques, but also allowed for a significant reduction in the use of neuroleptic medication in one case. The authors conclude that the use of lithium, within the context of an intensive, behavioural rehabilitation programme, may yield positive effects in the control of aggressive behaviour even in long-term post-injury cases.
Within the field of psychiatric rehabilitation, a growing body of evidence suggests the cognitive deficits associated with schizophrenia can exert a significant impact on an individual's rehabilitative potential. In this report we describe two studies centering around improvements in cognitive skills with multiply-impaired individuals with psychiatric disabilities residing in a rehabilitation program based on Paul and Lentz' (1977) social learning approach. In the first study, we compared improvements in reading and mathematics skills of two groups of inpatients over a nine-month period; one group was of lower functioning individuals seen in academicallyoriented shaping classes, the other was a higher functioning group seen in more traditional academic classes. This study found subjects in shaping classes to demonstrate significant improvements in both basic reading and mathematics skills, while participants in the traditional classes made modest gain in reading skills only. In the second study, we investigated the relationship between academic skills, self-care skills and on-ward behavior of a group of individuals with pervasive psychiatric disabilities, who received six to eight academically-oriented shaping classes per week, over a twenty month period. We found these individuals to demonstrate continued improvements in both reading and mathematics skills, while showing a more gradual reduction of problematic behaviors. Improved self-care skills, once attained, were exhibited at a relatively steady rate over the twenty month period. Correlations found no significant relationships between improved academic skills, self-care skills and on-ward behavior. These results support the conclusion that persons with multiple impairments can benefit from learning-based procedures.
Economic and political pressures have led state governments to shrink and close long-term psychiatric inpatient units in favor of community-based treatment. These pressures present inpatient clinicians with an opportunity to examine their clinical practices and question whether the focus of treatment addresses the behaviors most relevant to helping patients achieve discharge and maintain community tenure. The social learning approach of Gordon Paul is the empirically validated treatment of choice for long-term psychiatric inpatients. In this study, we compared changes in daily functioning of sixty-four chronic psychiatric inpatients treated in two rehabilitation programs based extensively on Gordon Paul's social learning approach. Half of the participants were successfully discharged from the hospital. Analysis found both similarities and differences in behavioral improvements between the groups. These results provide some clarity to the relationship between selfcare skills, participation in programs, maladaptive behaviors, and achieving hospital discharge for chronically hospitalized individuals.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.