Abstract
A thirty-six-year-old man who developed maladaptive behavior after a traumatic brain injury suffered 18 years ago was admitted to our hospital for evaluation. His maladaptive behavior was so severe that he could not continue to use facilities designated for the physically disabled or mentally ill. The result of our evaluation revealed that he had intellectual deficits, memory dysfunction and disinhibition. However, he could perform easy tasks and follow engagements such as not smoking or asking for money while he stayed in the hospital. Our evaluation was that he was able to use a rehabilitation facility for the mentally handicapped. We advised the facility that he should be kept under a tight daily schedule with a behavioral check sheet and rules. Also, he should be kept away from situations that might trigger maladaptive behavior and any appropriate behavior exhibited by him should be reinforced positively. As a result of such an approach in the facility for about 9 months, his maladaptive behavior lessened and his smoking tapered off, as did his need for psychotropic drugs. A structured environment and behavior modification in a facility for the mentally disabled might be effective for treating those patients who have cognitive and behavioral problems such as this patient.
