Treatment of interpersonal deficits for head-trauma patients in inpatient rehabilitation settings

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Abstract
Deficits in interpersonal behavior are common after closed-head injury and frequently are a major source of disability. Although modest success in treating interpersonal deficits during the postacute phase of rehabilitation has been noted, few attempts to treat interpersonal deficits during inpatient rehabilitation have been reported. Problems with interpersonal behavior can be the result of neurological injury, emotional reaction to injury, premorbid personality, or some combination of these factors. Treatment begins with accurate assessment of the source of the aberrant interpersonal behavior. Because of differences in stage of recovery, patient abilities, and treatment setting, assessment and treatment methods will vary from methods used in the postacute phase of rehabilitation. Interpersonal deficits can be treated in the context of group-therapeutic activities, in one-to-one contacts with therapists, and during unstructured time on the ward. Accurate feedback regarding inappropriate interpersonal behavior, behavioral modification techniques, alternative behaviors, and group psychotherapy can be used to modify inappropriate interpersonal behavior. The clinical neuropsychologist can play a pivotal role on the rehabilitation team in planning and implementing such treatment.