BEHAVIOR PLAN WORKBOOK: A Step-By-Step Guide to Writing Plans to Treat Behavioral Issues After Acquired Brain Injury

BEHAVIOR PLAN WORKBOOK: A Step-By-Step Guide to Writing Plans to Treat Behavioral Issues After Acquired Brain Injury

Robert L. Karol, Ph.D., ABPP-RP, CBIST

Robert L. Karol, Ph.D., ABPP-RP, CBIST has written this book as a step-by-step guide to writing plans that successfully treat behavioral issues after acquired brain injury. It guides the professional with a series of worksheets that span three functions: [1] detailing and conceptualizing the observed behavior; [2] understanding the causes of the behavior; and [3] writing behavior plans that will change the behavior. The focus is on the development of applied, real (not theory) plans with an expressed goal for each person with a brain injury having a workable, concrete intervention plan.

USB Drive included containing printable worksheets

Price: $55.00
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Full Description

The Behavior Plan Workbook is designed to take a clinician through the steps of targeted behavior plan development. The workbook begins with forms to clarify the nature of the behavior to be changed, thus targeting individual needs of the patient. Chapters provide worksheets to comprehend and assess the influence of emotional, adjustment, and cognitive variables, social history, and health status on the occurrence of the targeted behavior. Next, worksheets guide the process of integrating the information into a comprehensive “Phenomenology of Dyscontrol,” a conceptualization of the etiology of the behavior. This is followed by utilizing worksheets to write an individualized plan. The process within the workbook concludes with a post-implementation review. Upon completion of the series of worksheets, the professional will have developed flexible, comprehensive, individualized behavior plans that work.

These worksheets are based on years of expert experience in devising behavior plans that work with even the most difficult, complicated, and previously treatment-resistant behaviors, but are just as applicable to more straightforward behaviors. They identify and concretize the steps senior professionals utilize experientially. After using these worksheets a few times, the steps will become second nature. As the book states, “You will be the expert other staff or programs turn to for help.” Beyond guiding practicing clinicians, the workbook also has a place as a training tool for new staff and students.

ISBN# 9781931117548
Pages 96 pages + USB Drive with Printable PDF Worksheets
Year 2016


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.

He specializes in the treatment of behavioral dyscontrol after acquired brain injury. He has designed and been the administrator for brain injury programs in both hospital and nursing home environments, as well as consulting for group homes.

He previously published a text book on behavioral dyscontrol after acquired brain injury: Neuropsychosocial Intervention: The Practical Treatment of Severe Behavioral Dyscontrol After Acquired Brain Injury in addition to authoring two book chapters on the topic, Principles of behavioral analysis and modification in the text book Brain Injury Medicine and its revision Principles of behavioral analysis and treatment. Among other publications, he authored invited articles on how to design behavioral crisis units: Neurobehavioral Crisis Hospitalization: On the Need to Provide Specialized Hospital Brain Injury Crisis Programming and on how to structure teams: Team Models in Neurorehabilitation: Structure, Function, and Culture Change. He is also the co-author of two books: Overcoming Grief and Loss after Brain Injury and Therapists’ Guide to Overcoming Grief and Loss after Brain Injury. He has a book chapter in press titled Issues in Consultation in the text book Practical Psychology in Medical Rehabilitation.

He is a member of the Board of Directors of the United States Brain Injury Alliance and he co-founded its Minnesota affiliate, the Minnesota Brain Injury Alliance, serving on its Board of Directors for 14 years and he is a past Chairman of the Board. He served for 6 years on the Board of Directors of Accessible Space, Inc. He has advised providers of brain injury vocational services, brain injury chemical health programming, and brain injury residential services. He has served on: the Minnesota Department of Human Services Traumatic Brain Injury Advisory Committee, Neuropsychological Services Ad-Hoc Committee, and Needs of Adults with Brain Impairment Committee; the Minnesota Department of Corrections Traumatic Brain Injury Expert Advisory Panel; the Supreme Court of Minnesota Board of Law Examiners Special Test Accommodation Panel; and the Minnesota Psychological Association Payer Committee, Statewide Referral Service Advisory Committee, and Hospital/Medical Psychology Committee. He has been a national speaker for both Health Ed and CMI/PESI. He is an Adjunct Professor at Argosy University.




Biographical Summary

Chapter 1 – Understanding Behavioral Dyscontrol

Chapter 2 – Defining the Behavior

Chapter 3 – Necessary Information – Emotions

Chapter 4 – Necessary Information – Cognition

Chapter 5 – Necessary Information – Social History

Chapter 6 – Necessary Information – Health Status

Chapter 7 – Determining the Phenomenology of Dyscontrol

Chapter 8 – Writing the Treatment Plan

Chapter 9 – Post Plan Review and Closing Thoughts



I have worked in various settings, hospital, nursing home, and group home, treating behavioral dyscontrol either as employed staff or as an independent consultant. I have been a frontline clinical provider and a program administrator. These positions range from efforts on specialty brain injury behavioral units to general brain injury services. Throughout all of these experiences I have sought out the hardest cases. The brain is infinitely fascinating and the etiology of its behavioral manifestations when injured are a puzzle I enjoy solving. My best work happens when I think like a detective trying to piece together the clues.

The behaviors that I have treated include physical aggression against people, physical aggression against objects, verbal aggression, social inappropriateness, sexual inappropriateness, withdrawal, non-adherence, self-injurious behavior, suicidal ideation/behavior, demanding/manipulation, risk to elope/elopement, wandering, hoarding, poor safety judgment/ impulsivity, unawareness of deficits, somatization, hallucinations/delusions, and agitation, among other behaviors. In some settings these behaviors have been mild in nature and in other settings they were severe and dangerous. However, my goal has always been to have the person with a brain injury be able to function in the community and in this, following the steps in this Workbook, I have been successful.

Still, readers of this Workbook need to know that working with people who exhibit behavioral dyscontrol can sometimes be dangerous, particularly if the behavior entails physical aggression. While this book will help you with the process of treating behavioral issues, nothing can completely remove the risk. Readers must take responsibility to keep safe themselves, other people, and the person with a brain injury.

Nevertheless, I believe that behavioral dyscontrol, even when severe, is treatable. I look at every case as an opportunity to fit together the clues as to why the behavior occurs. I do not give up; when the plan is not working it is because my team and I have missed something, not because the person with a brain injury is untreatable. Do not be discouraged when initial treatment plans fail to result in sufficient behavior change. You will not get all of the clues right the first time. Be persistent; be dogged; be optimistic: be tenacious in your pursuit of the clues.

There is no such thing as unprovoked behavior. People do not act for random reasons; “unprovoked” merely means that we have not been smart enough yet to understand the distal and proximal causes of the behavior. This Workbook will take you through the steps necessary to understand the drivers of the behavior and then be able to treat them.

Behavior planning is hard work. This Workbook provides you with a step by step methodology for successfully navigating the process of plan development. At first glance completing the Worksheets can seem daunting. Rest assured, however, that after practice the process becomes second nature. You will find that after completing the Worksheets for a few persons with a brain injury you will likely internalize the steps in the Worksheets and your thinking about behavioral dyscontrol treatment will take place more easily and automatically. You will find that your internal thinking about behavior will change as your observations become structured along the lines of the Worksheets; your conceptualizations will form differently. You will notice things other staff miss. You will find yourself having insights that others do not have and seeing connections between clinical variables and behavior that are not evident to other staff.

You are to be commended for working with behavioral dyscontrol. Too often persons with a brain injury with behavioral issues are discharged as non-compliant or dangerous; they are then transferred to another facility where the process of writing them off begins anew. However, after using this Workbook you will be the expert other staff or programs turn to for help.

I hope you find it as exhilarating as I do to help persons with brain injury that everyone else has given up on.

Be innovative: do not think outside the box; throw the box away.

Robert L. Karol, Ph.D., ABPP-RP, CBIST


Dr. Karol’s workbook does a remarkable job of helping the clinician tease out the complex, multifaceted (and often overlooked) components underlying behavioral dyscontrol- ranging from contributing emotions and cognitive deficits, to social history and overall health comorbidities. The workbook exercises provide step-by-step assistance for thoughtful dissection of the problem. Once the hidden contributors to the phenomenology are revealed, the workbook helps the therapist weave the pieces together for a comprehensive picture of the problem and the creation of a well-thought-out, holistic treatment plan that is likely to be a success.

Review by: Dr. Dawn Neumann, an Assistant Research Professor at the Indiana University School of Medicine in the Department of Physical Medicine and Rehabilitation, and Clinical Research Faculty at the Rehabilitation Hospital of Indiana.

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