Can behaviour support interventions successfully treat inappropriate sexual behaviour after acquired brain injury in community settings? A case series (N =24)

摘要

Inappropriate sexual behaviours (ISX) are challenging clinical sequelae of acquired brain injury (ABI). Limited evidence exists about treatment approaches, with few case studies published to date. This study reports an exploratory clinical trial of community-based behaviour support interventions as a treatment approach to ISX after ABI. From routine referrals to a state-wide service specializing in challenging behaviours after ABI, a cohort (n = 24) displaying ISXs were selected. The interventions addressed multiple behavioural domains, and used a variety of approaches including environmental change, psychoeducation, and specific behavioural techniques. These approaches targetted change in the person with ABI, support personnel, or other environmental domains. Behaviour data were collected using the Overt Behaviour Scale (OBS) at baseline, closure and follow-up. Visual inspection and multilevel models were used to analyse the data. For the sample as a whole, there was a significant decline in ISXs from baseline to closure that was maintained at follow-up. Results at an individual level are also presented. Specificity of the intervention was demonstrated by comparison with concurrent challenging behaviours (aggression, perseveration, absconding) which showed no significant change over the same three time points. The results demonstrate the potential efficacy of community-based behaviour support interventions in treating ISXs after ABI.