IngentaConnect Behavioural treatment of non-compliance in adolescents with newly...

Authors: Gorski, Jo Anne¹; Slifer, Keith J.¹; Townsend, Vanessa¹; Kelly-Suttka, Jennifer¹; Amari, Adrianna¹

Source: Pediatric Rehabilitation, Volume 8, Number 3, July–September 2005 , pp. 187-198(12)

Abstract:

Purpose : To demonstrate the efficacy of using differential reinforcement to treat non-compliance in adolescents with spinal cord injury. Method : A case series design was used to examine three adolescents (aged 14–16 years) with tetraplegia who received multi-disciplinary rehabilitation treatment and a behavioural contract programme during an in-patient hospital admission. Assessment included collecting data on each patient's weekly percentage of compliance with all rehabilitation goals, weekly percentage of negative affect observed in therapy sessions and scores on a measure of mobility in physical therapy. Results : Compliance with rehabilitation demands improved from a baseline of 20–65% to 80% or greater after the patients received differential reinforcement for participating in the rehabilitation regimen. Patients exhibited less anger, sadness and frustration during therapy sessions once contracts were started. Conclusions : The adolescents demonstrated greater compliance after the implementation of a behavioural contract. Future studies should identify the specific variables that affect psychological adjustment and predict ‘readiness' to participate in rehabilitation.

Keywords: Spinal cord injury; compliance; behavioural contract; behaviour modification

Document Type: Research article

DOI: 10.1080/13638490400021438

Affiliations: 1: The Kennedy Krieger Institute, Maryland, USA

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Behavioural treatment of non-compliance in adolescents with newly acquired spinal cord injuries