To explore ethical issues in using deception to improve participation in a patient with severe traumatic brain injury who had not responded to traditional behavioral and pharmacologic approaches.Design:
A male in inpatient neurorehabilitation with history of severe traumatic brain injury and significant behavioral disruption that limited his therapy participation.Methods:
Behavior modification program using principles of operant conditioning that required deception.Results:
Participation in therapies significantly improved and disruptive behaviors decreased.Conclusion:
When used cautiously and with careful consideration of the ethical implications, deception may be permissible as part of an intervention strategy with this population but only as a last resort.