The relational neurobehavioral approach: can a non-aversive program manage adults with brain injury-related aggression without seclusion/restraint?
PRIMARY OBJECTIVE To examine the effectiveness of a programme developed for persons with persisting neurobehavioural/ neuropsychiatric disorders. RESEARCH DESIGN Descriptive study of a programme that has a philosophy of normalization, respect, non-confrontation, positive engagement, support and functional and behavioural skill development. METHODS AND PROCEDURES Participants were the 40 clients admitted during the initial 20 months of operation. Prior to admission clients had recurrent placement failures secondary to behavioural disregulation and typically were housed at County or State Hospitals. An expanded version of the Overt Aggression Scale Modified for Neurorehabilitation was used to provide detailed descriptions of assaults. MAIN OUTCOMES AND RESULTS Over the 20-month period, 49 incidents of client-to-client aggression occurred representing a rate of 0.11 incidents per client month. Thirty-five of 40 clients remained at the end of 20 months, with only three discharges due to behaviour. CONCLUSIONS A long-term, stable living environment has been provided for individuals who had been intractable management problems elsewhere.