Keywords

 

Authors

  1. Ducharme, Joseph M. PhD

Abstract

Background: Individuals with brain injury are prone to severe behavior problems related to various postinjury variables, including confusion, emotional distress, fear of challenging activity, and loss of skills to access desired outcomes.

 

Objectives: This article proposes the use of a new model, errorless rehabilitation, to improve rehabilitation outcomes by systematically focusing on graduated and success-based exposure of clients with brain injury to increasingly demanding circumstances, to provide them with the ability to tolerate and manage the natural environment.

 

Main Outcome Measures: Research on difficulties parents with brain injury experience with their children is subsequently reviewed and a new approach (based on the same principles as Errorless Rehabilitation) to treatment of parent-child relationship issues after brain injury is described.

 

Conclusions: A case study of a father with brain injury and his oppositional son is presented to demonstrate a specific application of this model for enhancing the quality of life of parents with such impairments.

 

PEOPLE WITH BRAIN INJURY often encounter a range of incapacitating sequelae, including cognitive, emotional, and behavioral impairments. 1 Such aftereffects can be debilitating and may require extensive inpatient or outpatient rehabilitation efforts. Ducharme 2,3 discussed a conceptual model for proactive management of behavioral difficulties in people with brain injury based on recent research in the field of behavior therapy and on intensive clinical experiences with this population. This article will provide a synthesis of components of that model into a unified and conceptually driven approach to behavioral rehabilitation. After this discussion, the article will review issues affecting people who must fulfill the role of parent while managing the various disabling effects of their own brain injury. This will lead into discussion of a new approach to remediation of parent-child relationship difficulties after brain injury and an illustrative case study demonstrating the implementation of this "errorless" approach.