Behavior Planning

Behavior Planning

Robert Karol, Ph.D., LP, ABPP, CBIST

Families and caregivers of traumatic brain injury survivors are faced with a significant challenge when the survivor begins to exhibit difficulty controlling behavior(s). This tip card provides a listing of common behaviors, who should be enlisted to provide assistance, how to develop effective behavior plans, and the importance of cooperation between all those involved in the treatment and recovery of the person with brain injury.

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Full Description

A brain injury does not always cause difficulty controlling behavior. “Behavioral Dyscontrol” can surprise, confuse and worry family/caregivers. “What can be done? Can the behavior be changed? Who can help?” are questions needing answers. It can be difficult to treat behavioral dyscontrol after acquired brain injury. But, effective BEHAVIOR PLANNING can and does address the problem(s).

It is extremely important for family/caregivers to recognize their own behavior and emotions impact the person with brain injury’s progress. This impact may easily outweigh any professionally devised plan. How family members and caregivers act and behave needs to be consistent with the Behavior Plan and treatment team instructions.

This Tip Card seeks to provide clear, easily implemented strategies, give insight into how cooperation is necessary for all involved in the recovery process, and how Behavior Planning is evidence-based and proven to be effective.

Pages 8
Year 2016


Robert Karol, Ph.D., LP, ABPP, CBIST

Dr. Karol is Vice President of Brain Injury Services for Welcov Healthcare and he is also President of a group private practice, Karol Neuropsychological Services & Consulting, in Minneapolis. Dr. Karol is Board Certified by the American Board of Professional Psychology (ABPP) as a Rehabilitation Psychologist and is Certified by the Academy of Certified Brain Injury Specialists (ACBIS) as a Certified Brain Injury Specialist Trainer (CBIST). He received the American Psychological Association Rehabilitation Division Lifetime Practice Excellence Award in 2015 for excellence in clinical practice and contributions to the field of rehabilitation psychology.



Planning Process

  • Understanding the Person Before Brain Injury
  • Understanding the problematicť behavior
  • Understanding the person after brain injury
  • Interventions and goals
  • Conceptualizing the behavior
  • Treatment Interventions
  • Family and Caregiver roles





It is difficult to treat behavioral dyscontrol after acquired brain injury.

Family members and caregivers should look for a treatment team that are experts in brain injury and in treatment of behavioral dyscontrol after brain injury.

Family members and caregivers should be prepared to provide information about the person with a brain injury across all areas of life.

The team should take the time to clearly identify the nature of the behavior: when, where, and how the behavior happens.

The team will need to fully understand the current status of the person and how all variables (cognitive, emotional, social, etc.) contribute to the behavior.

Realistic goals need to be established so that everyone is heading in the same direction.

Select interventions that will treat the underlying causes of the behavior and best achieve the agreed upon goals from among the following: psychotherapy, skill building, rewards, environmental change (people and physical), and medications.

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