Michael D. Wesolowski

Managing hypersexual disorders in brain-injured clients

Three case studies involving hypersexuality in brain-injured clients are illustrated. Two cases involved the inappropriate touching of the opposite sex, and the third case involved exhibitionism. In one case of touching, feedback was used to decrease inappropriate touching. In the other case of touching, scheduled massage was used to shift stimulus control to an appropriate setting. In the case of exhibitionism, a combination of self-monitoring, private self-stimulation and dating-skills training were used to suppress the behaviour.

A comparison of four memory strategies with traumatically brain-injured clients

Six traumatically brain-injured clients were trained in four memory improvement strategies. These were written rehearsal, verbal rehearsal, acronym formation, and memory notebook logging. This study showed that only memory notebook logging was effective in increasing recall of classroom material.

Antecedent control in the treatment of brain-injured clients

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.

Memory notebook training with traumatically brain-injured clients

Four brain-injured clients continually demonstrated short-term memory deficits including difficulty learning new material and forgetting appointments. Training in the use of memory notebooks improved performance of homework assignments and keeping appointments.

The rehabilitation of adolescents with traumatic brain injury: Outcome and follow-up

Outcome data from 17 brain-injured adolescents discharged from a rehabilitation centre during a 2-year period were analysed. The outcome measures were academic status and living environment. The descriptive variables were demographic, behavioural, psychological and neuropsychological data for each client. Before admission, 24% of the adolescents were living at home with their parents, 29% were in rehabilitation hospitals and 47% were in psychiatric settings. At discharge, 58% were living with their families, 23% were living in group homes, 12% were in supervised apartments and 5% were in an alternative rehabilitation centre. Academically, 53% were discharged into public schools, 23% were competitively employed and 23% attended special schools. Follow-up reports, dated 8-24 months post-discharge, found that 40% of the adolescents continued to live with their parents and 30% were in public schools. All of the adolescents were living and working or attending school in the community. Factors in the successful rehabilitation of brain-injured adolescents are discussed.

Comparing motivational systems with two non-compliant head-injured adolescents

Behavioural contracting, point systems and point systems plus response costs were compared to determine their effectiveness in increasing the attendance of two head-injured adolescents at class and therapy sessions. All of the motivational systems increased attendance, although the point system plus response cost seemed slightly more effective for one client.

Is the social network analysis necessary in the rehabilitation of individuals with head injury

A social network is a support system in which one can obtain assistance for simple daily needs and in emergency situations. A diminished social network can result in failure to integrate into normalized environments. The results of this investigation clearly showed that social networks among a group of 70 people who were traumatically brain injured had significantly fewer members than a control group of non-injured respondents. Additionally, the make-up of social networks was different. Specifically, respondents who were traumatically brain injured had social networks consisting mainly of family and staff members of the rehabilitation facility, while non-injured respondents had mostly friends or acquaintances, coworkers, and family members, in that order.

Teaching socially appropriate behavior to eliminate hoarding in a brain injured adult

A brain injured male hoarded large quantities of unuseable items at every opportunity. The treatment consisted of two phases. First, he was taught to collect baseball cards. Second, after each meal, the client was provided with an apron and a glove and asked to pick up trash in the area and deposit the trash in an appropriate receptacle. If he hoarded, he was told not to pick up trash without his apron and glove and escorted to a quiet area for about 10 seconds. The procedure was successful in suppressing the behavior within 8 days.

The use of a new relaxation method in a case of tension headache

A tension headache sufferer was treated with a newly developed procedure called behavioral relaxation training that assumes relaxed postures. The client was a 21 yr old female who had a 15-yr chronicity of headaches. During treatment, headache activity was reduced to a near zero level. After the first week of behavioral relaxation training, a second week of that training was administered combined with EMG biofeedback, followed by one more week of behavioral relaxation training alone. The combination phase was employed to determine if the addition of biofeedback would produce a more relaxed state. There were no significant differences in terms of EMG levels of muscular activity. Results are discussed regarding alternative explanations of the results and future research proposals.