General Management Guidelines

Environmental conditions can have a significant impact on behavior. Organizing the therapeutic setting and carefully planning your approach can increase opportunities for successful learning and decrease the chances of a behavioral episode.

Increase rest time - People with TBI can become fatigued easily, which can contribute to behavioral problems. Keep the environment simple - People with a brain injury are easily over stimulated by their surroundings. Keep instructions simple - Instructions, prompts, and cues should be kept as concrete and simple as possible. Give feedback and set goals - Due to diminished self-monitoring skills clients must rely on others to provide feedback until the ability is relearned. Setting goals helps give the client direction and some incentive to complete therapy. Be calm and redirect to task - People who cannot control their own behavior need others to model calm, stable, non-threatening behavior.

Provide choices - Providing clients with choices can reduce serious behavior problems. It also allows clients an element of freedom and a measure of control over their environment. Decrease chance of failure - Do not work above the individual's level of ability. This will only lead to frustration and increase the chance of a behavioral episode. Try to keep the success rate above 80%. This ensures that the client is challenged, while at the same time feel successful. Vary activities - Therapy can become boring and frustrating if the same tasks are endlessly repeated. Vary the activities to maintain interest and increase success. Over-plan - Do not approach a session with only a few ideas or activities. Be prepared for anything and you'll be less likely to have to confront a behavior problem. Task-analyze - Break tasks down into smaller steps. For example, the simple act of putting on a shirt can be broken down into several, smaller and more managable steps.

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