Rehab of NBD

Which methods aren’t the most effective?

• Pharmacological interventions

• CBT

Gold-standard for rehab: combination of 2 methods

• Positive behaviour support (PBS)/antecedent control

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• Contingency management

PBS description (1)

• Modify environment (e.g. remove/prevent triggers) to prevent challenging behaviour

Contingency management description

• Manipulate post-behaviour consequences to reinforce adaptive behaviours + extinguish challenging ones

Examples of contingency management (2): name + description

• Differential reinforcement: reward positive, incompatible behaviours (can do through token economies)

• Non-aversive extinction: remove reinforcing factors of challenging behaviours (e.g. withdraw attention to aggressive behaviours)

Impact of combining PBS w contingency management (1)

• Reduce/extinguish challenging behaviours + replace them with new, adaptive ones

The Neurobehavioural Rehabilitation (NbR) Model (1→3) (don’t need to know too well)

Specialised psychosocial rehabilitation paradigm delivered within a structured residential or community setting.

• Transdisciplinary Team (TDT) Approach: Rather than working in isolated silos, all team members (neuropsychologists, occupational therapists, nurses, support workers) are trained to deliver a unified behavioural treatment program continuously across the entire day.

• Prosthetics & Social Milieu: The daily environment acts as a "cognitive prosthetic," providing the external structure, routine, and feedback that the individual's damaged prefrontal cortex can no longer generate internally.

• Single-Case Experimental Evaluation: Because client profiles are highly heterogeneous, treatment efficacy in NbR is evaluated using rigorous Single-Case Experimental Designs (SCEDs) and quality frameworks like the Risk of Bias in N-of-1 Trials (RoBiNT) scale