Training the Brain-Injured Client in Behavioral Self-Management Skills

  • James Malec
Part of the Applied Clinical Psychology book series (NSSB)


Treatments based on clinical experience are often developed initially from theoretical assumptions exemplifying the state of the art in related scientific fields. In an area where clinical treatment of behavioral disorders following brain injury may occur without reference to the incompletely understood complex of relationships among behavioral/affective, neurological, and neuropsychological processes involved, a clear statement of assumptions on which behavioral treatments of the brain-injured are based is important. A behavior therapist, for instance, may recommend treatment for a brain-injured client based on the assumption that deviant behavior is learned and can be unlearned, but may fail to assess the effects of brain injury on the client’s learning abilities. A psychiatrist may recommend psychopharmacotherapy indicated by the presence of psychoticlike symptoms while failing to appreciate the way in which brain injury may have altered the neurochemical substrate on which therapeutic chemicals are layered. A rehabilitation counselor may fail to recognize a brain-injured client’s inability to perceive body schema and to function accurately and may thus incorrectly assume that, as for a spinal cord-injured person or an amputee, the brain-injured patient’s emotional lability is in reaction to perceived loss of physical abilities.


Behavioral Disturbance Cognitive Disability Closed Head Injury Behavioral Rule Verbal Mediation 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. Abramson, L. Y., Seligman, M. E. P., & Teasdale, J. D. Learned helplessness in humans: Critique and reformulation. Journal of Abnormal Psychology, 1978, 87, 49–74.PubMedCrossRefGoogle Scholar
  2. Azrin, N. H., & Foxx, R. M. A rapid method of toilet training the institutionalized retarded. Journal of Applied Behavior Analysis, 1971, 4, 89–99.PubMedCrossRefGoogle Scholar
  3. Azrin, N. H., & Wesolowski, M. D. Theft reversal: An overcorrection procedure for eliminating stealing by retarded persons. Journal of Applied Behavior Analysis, 1974, 7, 577–581.PubMedCrossRefGoogle Scholar
  4. Bandura, A. Principles of behavior modification. New York: Holt, 1969.Google Scholar
  5. Bandura, A. Self-efficacy: Toward a unifying theory of behavioral change. Psychological Review, 1977, 84, 191–215.PubMedCrossRefGoogle Scholar
  6. Beck, A. T., Rush, A. J., Shaw, B. G., & Emery, G. Cognitive therapy of depression. New York: Guilford Press, 1979.Google Scholar
  7. Benton, A. L. Behavioral consequences of closed head injury. In Guy L. Odom (Ed.), Central Nervous System Trauma Research Status Report 1979. Washington, D.C.: National Institute of Neurological and Communicative Disorders and Stroke, 1979.Google Scholar
  8. Bond, M. R. Assessment of the psychosocial outcome of severe head injury. Acta Neurochirurgica, 1976, 34, 57–70.PubMedCrossRefGoogle Scholar
  9. Buschke, H. Selective reminding for analysis of memory and learning. Journal of Verbal Learning and Verbal Behavior, 1973, 12, 543–550.CrossRefGoogle Scholar
  10. Dikman, S., & Reitan, R. M. Emotional sequelae of head injury. Annals of Neurology, 1977, 2, 492–494.CrossRefGoogle Scholar
  11. Ellis, A. Humanistic psychotherapy: The rational-emotive approach. New York: Julian Press, 1973.Google Scholar
  12. Lewinsohn, P. M., Biglan, A., & Zeiss, A. M. Behavioral treatment of depression. In P. O. Davidson (Ed.), The behavioral management of anxiety, depression and pain. New York: Brunner/Mazel, 1976.Google Scholar
  13. Levin, H. S., & Grossman, R. E. Behavioral sequelae of closed head injury. Archives of Neurology, 1978, 35, 720–727.PubMedCrossRefGoogle Scholar
  14. Levin, H. S., O’Donnell, V. M., & Grossman, R. G. The Galveston Orientation and Amnesia Test: A practical scale to assess cognition after head injury. The Journal of Nervous and Mental Disease, 1979, 675–684.Google Scholar
  15. Lezak, M. D. Neuropsychological assessment. New York: Oxford University Press, 1976.Google Scholar
  16. Lishman, W. A. Brain damage in relation to psychiatric disability after head injury. British Journal of Psychiatry, 1968, 214, 373–410.CrossRefGoogle Scholar
  17. Luria, A. R. The working brain. New York: Basic Books, 1973.Google Scholar
  18. Meichenbaum, D. Cognitive-behavior modification. New York: Plenum Press, 1977.CrossRefGoogle Scholar
  19. Reitan, R. M., & Davison, L. A. Clinical neuropsychology: Current status and applications. Washington, D.C.: Winston, 1974.Google Scholar
  20. Sparks, R. W., & Holland, A. L. Melodic intonation therapy for aphasia. Journal of Speech and Hearing Disorders, 1976, 41, 287–297.PubMedGoogle Scholar
  21. Timming, R. C., Cayner, J. J., Grady, S., Grafman, J., Haskin, R., Malec, J., & Thornsen, C. Multidisciplinary rehabilitation in severe head trauma. Wisconsin Medical Journal, 1980, 79, 49–52.PubMedGoogle Scholar
  22. Trieschmann, R. B. Spinal cord injuries: Psychological social, and vocational adjustment. New York: Pergamon Press, 1980.Google Scholar
  23. Varney, N. Assessment and classification of language comprehension deficits in aphasia. Presented at Midwest Neuropsychology Group, May 1980.Google Scholar
  24. Weinstein, E. A., & Lyerly, O.G. Language behavior during recovery from brain injury as predictive of later adjustment. Transactions of the American Neurological Association, 1968, 93, 292–294.PubMedGoogle Scholar

Copyright information

© Springer Science+Business Media New York 1984

Authors and Affiliations

  • James Malec
    • 1
  1. 1.Psychiatric and Behavioral MedicineMount Sinai Medical CenterMilwaukeeUSA

Personalised recommendations