A cognitive-behavioral intervention for controlling impulsive behavior in brain-injured adults
Abstract
A stress inoculation training program involving relaxation training, self-instructional training, and coping skills training was delivered to five moderately to severely brain injured clients in attempt to reduce the frequency of their impulsive behaviors. A multiple-baseline, across subjects design was utilized to evaluate the effectiveness of the 10-week intervention. Dependent measures included frequency of impulsive behaviors as recorded by staff members at the residential facility where all five clients were involved in programming, ratings of role-play probes, psychometric measures (WAIS-R subtests and Matching Familiar Figures Test), effectiveness ratings by the clients' rehabilitation counselors, and interview information obtained from the clients and their counselors. The results indicated clear improvement in all dependent measures for one mildly to moderately impaired brain injured subject, only a slight reduction in impulsive behaviors for two severely impaired subjects and one moderately impaired subject, and a reduction in impulsive behaviors attributed to extraneous factors (i.e., medication and implementation of a token economy) for the fifth moderately impaired subject. Additionally, results indicated that changes in error rate on the Matching Familiar Figures Test and changes in role-play ratings did not correspond to changes in in-vivo behavioral frequency recordings for four out of five subjects. Overall, it was concluded that the cognitive-behavioral techniques were not effective in controlling impulsive outbursts in severely brain injured individuals. These results suggest that more severely impaired individuals will require salient behavioral contingencies and consistent cueing procedures in order to control their impulsive behavior. It was recommended that further research evaluating the effectiveness of cognitive-behavioral techniques focus on mildly impaired brain injured clients.
Degree
Ph.D.
Advisors
Aeschleman, Purdue University.
Subject Area
Psychotherapy|Behaviorial sciences
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