A non-aversive rehabilitation approach for people with severe behavioural problems resulting from brain injury

An approach is presented which uses exclusively non-aversive methods in the behavioural rehabilitation of people with severe behaviour problems result ing from acquired brain injury. The approach has five components: (1) behav ioural assessment: analysing the way all aspects of a person's functioning may affect their behaviour, (2) positive programming: teaching the skills n ecessary to allow the person to achieve their desired ends without resortin g to inappropriate behaviour, (3) ecological change: altering the environme nt to achieve a better march with the individual's cognitive deficits, (1) focussed treatment: using behavioural contingencies to achieve a rapid redu ction in target behaviour, and (5)reactive strategies: specifying action to be taken to gain short-term control over episodes of challenging behaviour . The current literature on behavioural rehabilitation is reviewed in the c ontext of this approach. Two case studies are presented illustrating the us e of the approach in practice. The strengths and potential pitfalls of the approach are discussed, along with issues which need to be considered for e ffective implementation.