Behavioral approaches to neuropsychological rehabilitation.

Abstract

Behavioral approaches have been applied to a wide variety of behavioral and cognitive disturbances resulting from brain damage or disease. This article provides a comprehensive and critical review of the literature concerned with behavioral interventions in neuropsychological rehabilitation. The article examines six categories of target behavior: inappropriate social behavior, attention and motivation, unawareness of deficits, memory, language and speech, and motor disturbance. The efficacy of behavioral approaches for treatment of the neurologically impaired and implications for the future role of behavioral approaches in neuropsychological rehabilitation are discussed.

Rehabilitation Treatments for Adults with Behavioral and Psychosocial Disorders Following Acquired Brain Injury: A Systematic Review

“…Finally, as outlined by McGlynn (1990) and Prigatano (2003), but rarely discussed in the rehabilitation literature, the quality of the therapeutic relationship plays an important role in every type of non-pharmacological treatment. A patient who does not trust or respect the rehabilitation therapist will be unlikely to cooperate and thus will not benefit as much as a patient who has a positive attitude toward the working relationship.…”

“…Treatment programs are usually time-limited, individualized and problem-focused in the sense that only one or few behaviors are targeted for intervention. Environmental structuring, stimulus-response analysis, systematic monitoring, and planned contingency management constitute the treatment requirements for successful interventions (McGlynn 1990;Ducharme 1999). A trusting and safe therapeutic alliance is viewed as an essential ingredient, but not as the main vehicle of change.…”

Esquizofrenia: Funções Cognitivas, Análise do Comportamento e Propostas de Reabilitação

“…Como benefícios, apontam: as teorias que embasam a técnica behaviorista são resgatadas de diversas disciplinas, tornando a aplicação apta a variados contextos; os objetivos são claramente definidos no início do programa; a avaliação funcional não é descartada mesmo após aplicação de testes neuropsicológicos, pois se acredita que avaliação e tratamento andam juntos, devendo serem observadas as habilidades e dificuldades do paciente na prática cotidiana, e não baseadas apenas nos resultados de testes (que auxiliam a identificar o que está preservado e o que pode ser melhorado, mas não indica que contingências estão envolvidas na manutenção do comportamentoalvo); o tratamento é individualizado, pois cada paciente é olhado como único e suas interações com o ambiente são observadas da mesma forma; entre outras. McGlynn (1990) analisou, a partir de um estudo de revisão, seis comportamentos-alvo utilizados em programas de reabilitação. São eles: comportamento social inapropriado, atenção e motivação, inabilidade em reconhecer os déficits, memória, linguagem e discurso e distúrbios motores.…”

Behavior management for children and adolescents with acquired brain injury

“…Since that time behavior analysis-based interventions have been increasingly adopted as a vital part of interdisciplinary ABI rehabilitation [McGlynn, 1990;Jacobs, 1993;Weslowski and Zencius, 1994;Slifer et al,1993Slifer et al, , 1995Slifer et al, , 1996Slifer et al, , 1997Slifer et al, , 2002. Ducharme [2000] has pointed out that despite the fact that individuals with ABI are surviving in increasing numbers due to advances in emergency medical care, there have been relatively few well-controlled experimental intervention studies for the sequelae of ABI [see Franzen, 1991;Cope, 1995;Kehle et al, 1996, notable exceptions].…”