Management of behavior on a spinal cord injury unit

Individuals sustaining spinal cord injury often display initial distress followed by relatively effective coping allowing effective participation in rehabilitation. For those patients who continue to display significant symptoms of subjective distress or objective behavioral disturbance, behavior management interventions may help the individual cope with the demands of rehabilitation. A range of intervention strategies, drawn from many theories of behavior are needed to address the range of problems that occur. In the approach described in this article, traditional behavior modification programs, recruitment of family, and patient-community meetings are considered as behavior management strategies. Those strategies are considered with respect to three broad areas of behavioral disturbance: (1) problems of attitude, (2) disorders of mood, and (3) disturbances of character. Behavior management is conceptualized as a method of affirming the patient's autonomy, independence, and self-determination. Suggestions are made regarding program development.