Antecedent control in the treatment of brain-injured clients

Abstract

Three brain-injured clients failed to respond significantly to consequence management programmes designed to increase attendance, use of a cane, and to reduce unauthorized breaks. When antecedent stimulus control procedures were applied, attendance and use of a cane increased and unauthorized breaks decreased. The study shows that antecedent control may be the treatment of choice when treating brain-injured clients with memory loss.

Interventions to increase engagement with rehabilitation in adults with acquired brain injury: A systematic review

“…found that a contingent reward points system increased rehabilitation attendance in two adolescents; in one client this was enhanced with the addition of a response cost procedure. However, 100% attendance was only reached and sustained for both clients once financial rewards were introduced -in contrast to their Zencius, Wesolowski, Burke and McQuade (1989) study. Corrigan and colleagues (Corrigan et al, 2005;Corrigan & Bogner, 2007) conducted randomised controlled trials in adults with ABI receiving substance abuse treatment and found that financial incentives led to improved initial attendance at and engagement with treatment, which has been shown to be important in developing a therapeutic alliance and enhance subsequent retention (Newman, 1997), and reduced premature termination of treatment.…”

“…In 4 of their studies, contracting alone increased adherence to rehabilitation but this behaviour change was not sustained without additional intervention. In another study, a verbal contract combined with a contingent financial reward was ineffective in increasing use of a walking cane (Zencius, Wesolowski, Burke & McQuade, 1989).…”

“…Eight studies reported interventions using predominantly behavioural modification techniques (Hegel, 1988Zencius, Wesolowski, Burke & McQuade, 1989;Yuen, 1996;Manchester, Hodgkinson, Pfaff & Nguyan, 1997;Newell, 1997;Sohlberg, Lemoncello & Lee, 2011;Hufford et al, 2012), 5 studies primarily cognitive techniques (Pegg et al, 2005;Lane-Brown & Tate, 2010;Skidmore et al, 2011;Hsieh, Ponsford, Wong, Schönberger, Taffe & Mckay, 2012;Hsieh, Ponsford, Wong, Schönberger, Mckay & Haines, 2012) and 2 studies reported a mixture of the two (Corrigan, Bogner, Lamb-Hart, Heinemann & Moore, 2005;Corrigan & Bogner, 2007).…”

“…Zencius, Wesolowski, Burke and McQuade (1989) successfully instigated three simple antecedent control procedures -a simple visual cue, daily provision of a walking cane and a written invitation to rehabilitation -to enhance adherence to rehabilitation therapies and goals.…”

“…Newell (1997) describes a case study in which contracting vastly improved a client's abusive behaviour, feelings of control and rehabilitation costs. and Zencius, Wesolowski, Burke and McQuade (1989) compared the effectiveness of behavioural contracting with other techniques. In 4 of their studies, contracting alone increased adherence to rehabilitation but this behaviour change was not sustained without additional intervention.…”