ABA in the Treatment of Traumatic Brain Injury
Applied behavior analysis (ABA) has proven to be one of the most effective methods for managing mood, behavioral and other mental disorders associated with brain damage. While this treatment strategy has garnered attention as a possible solution to various isolated neurological disorders, it also has broader applications in general care of patients suffering from a traumatic brain injury (TBI). It is not a guaranteed solution to emerging or latent issues, but it is one of the most powerful tools available to limit unwanted behaviors and develop a more functional mental state.
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Defining Traumatic Brain Injury
Many children and young adults have to get a medical exam to check for concussions at least a few times throughout their lives, but most of these cases have little to no lasting effect on the patient’s quality of life. Concussions are the mildest form of TBI, but even they can still be dangerous if the victim doesn’t seek treatment. Unfortunately, more severe jolts or blows to the head can cause chronic pain, loss of consciousness and other pronounced symptoms even with prompt professional attention. There is also a potential for swelling or bleeding around the brain, which can lead to permanent or fatal damage without immediate medical intervention.
Patients suffering from a brain injury may experience a wide range of symptoms ranging from mild inconveniences to severe debilitation. Changes in neurological function, behavior and thought patterns can arise immediately following a physical trauma, or they may emerge days or even months later. The exact manifestation of these issues in individual cases is highly variable, so some patients get through TBI treatment with almost no issue while others require years of therapy to make a full recovery.
Occurrence and Risk Factors
Traumatic physical injury to the brain is a serious public health concern in the United States, impacting people across various age and gender demographics. Research shows that TBIs are involved in almost a third of all injury-related deaths and these incidents contribute to tens of thousands of deaths annually, according to the United States Centers for Disease Control and Prevention (CDC). Deaths attributed to TBI are most common among seniors over the age of 75, but young adults active in physical sports are also at higher risk. Vehicle collisions are also a notable source of traumatic brain damage throughout the US.
Implications for Mental and Behavioral Health
There are many aspects of brain function and health that are still debated within the scientific and medical communities, but there is no doubt that TBIs can leave a permanent mark on the patient’s neurological function. Victims of brain injury can develop numerous mental and behavioral problems, including insomnia, diminished memory, poor judgment and attention deficit disorders. Physical and emotional pain can also lead to negative changes in personality, including chronic depression, suicidal impulses, lack of social ability and increased stress levels.
Applications for Applied Behavior Analysis
As a patient-oriented therapy, ABA focuses on identifying and correcting visible behavioral issues presented in each individual case. It can be applied to help patients re-learn skills that were lost following the injury or learn new behaviors to adapt to fundamental changes in lifestyle. Behavior analysts can also apply their practice to help patients adopt a more flexible and communicative attitude in social settings, which can be crucial for building their personal and professional lives in the future. ABA has also proven effective at dealing with some types of depression, anxiety and other mood disorders stemming from physical brain injury.
When dealing with patients suffering from memory or cognitive issues, ABA therapists can apply basic treatment principles and build on them over time. This is usually accomplished through basic psychological techniques, including positive reinforcement, behavior chaining and response conditioning. Therapists frequently utilize the patient’s environment and individual interests or circumstances to design a customized treatment plan.
ABA as Part of a Comprehensive Recovery Plan
Behavioral and psychological issues aren’t the only potential consequences of a TBI. Patients may experience loss of motor or nerve function, visual impairment, hormone imbalances and other physical disorders alongside neurological ones. This means that ABA therapists typically work as part of a larger team, including doctors and other specialists, to provide comprehensive patient care.
One of the biggest advantages of behavior analysis is its ability to be tailored to the unique needs of the individual. Therapists can work alongside other patient care providers to find safe and effective ways to communicate with patients and set priorities for treatment sessions. Treatment strategies can be constantly adjusted and expanded to accommodate changes in the patient’s overall health, which is useful when dealing with brain damage and other complex physical injuries.
Qualifications for Performing ABA in TBI Cases
Practitioners of ABA typically need a master’s degree in psychology, education or a related program from an accredited university to become fully certified. Certification is overseen by the Behavior Analyst Certification Board (BACB), which is a nonprofit corporation founded in 1998 to elevate standards of care in the behavior analysis profession, according to the BACB website. In addition to a degree, individuals seeking certification also need to adhere to the official code of ethics in their practice and participate in professional development annually.
While this type of certification is not always mandatory for ABA positions, it is usually required for treating patients with brain injuries. Therapists who want to work with TBI patients should also develop their experience in the medical field, including the basics of general healthcare practices. Professionals who want to seek further qualification can become credentialed as a Certified Brain Injury Specialist (CBIS) by the Brain Injury Association of America.
There is no simple solution to mental, behavioral and emotional disorders stemming from brain damage. However, progress is almost always possible even in cases where complete recovery is unlikely. While there are numerous challenges facing both therapists and patients during the recovery process, applied behavior analysis is still a simple and effective treatment for various conditions resulting from traumatic brain injury.
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