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  1. Matthes, Jessica PhD
  2. Caples, Heather PhD


Objective: 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: Case study.


Participant: 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.