Psychiatric Quarterly

, Volume 70, Issue 1, pp 27–37

Behavioral Rehabilitation and the Reduction of Aggressive and Self-Injurious Behaviors with Cognitively Impaired, Chronic Psychiatric Inpatients

  • Stephen B. Bellus
  • Joseph G. Vergo
  • Peter P. Kost
  • Diane Stewart
  • Scott R. Barkstrom


Aggressive behavior has been identified as a significant concern and occupational hazard in psychiatric inpatient settings. Several factors, including lax or unclear ward structure, have been identified as contributing to the exhibition of aggressive behavior. Token economies are effective in increasing ward structure and reducing aggressive behavior. This study evaluated the effects of rehabilitation programming, based on Gordon Paul's social learning approach (SLA), on rates of aggressive and self-injurious behaviors in a group of cognitively impaired, chronic psychiatric inpatients, compared to three long-term wards of similar patients. While no differences were found between the two groups prior to implementing SLA procedures, lower rates of aggression and self-injurious behavior were observed at one and two years on the Paul-derived ward. These results support the use of Paul's approach with multiply-impaired psychiatric inpatients in reducing patient aggression.


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Copyright information

© Human Sciences Press, Inc. 1999

Authors and Affiliations

  • Stephen B. Bellus
    • 1
  • Joseph G. Vergo
  • Peter P. Kost
    • 1
  • Diane Stewart
    • 2
  • Scott R. Barkstrom
    • 3
  1. 1.Staff psychologist and Program Manager of the BRITE I (Behavioral Rehabilitation and Interpersonal Treatment Environment I) Program at the Buffalo Psychiatric Center and Adjunct Assistant Professor of Counseling and Educational Psychology at the State University of New York (SUNY) atBuffalo
  2. 2.Treating psychiatrist for the BRITE I Program and is currently associated with the Clifton Springs HospitalClifton Springs
  3. 3.Graduate student at the Department of Counseling and Educational Psychology at SUNY at Buffalo during the third year of operation of BRITE I and is currently staff psychologist at the St. Francis HospitalPoughkeepsie

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