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RPGs for Brain Injury - Applicable Therapeutic Recreation Interventions

by Hawke Robinson published Nov 12, 2016 10:15 AM, last modified Nov 12, 2016 10:15 AM

When the client is actually in the coma and at the Rancho Los Amigos Cognitive Level I, RT is not able to implement anything in the way of an interactive intervention. However, once the client is out of the coma, even at just Rancho Los Amigos Cognitive Levels II & III, the RT can begin to implement various modifications of role-playing games as a recreation therapy intervention.

Initially the client is too disoriented and has such significant cognitive and memory impairment that using the “Choose Your Own Adventure” CYOA form of RPG is probably contraindicated, but after just a few days, when the functioning is closer to b11428.2, and within a week around b11428.1. At this stage the client may be able to engage in “let's pretend” imaginary scenarios and differentiate from the real and imagined situations. Though the client has memory issues, and may not remember every detail from 30 seconds to a few minutes ago, the exercises could still be useful for stimulating 
“neuro-plasticity” related recovery. The client may need repetition and occasional reminders, but is now potentially ready to begin the CYOA form of RPG TR treatment.

Though the client had previously enjoyed and participated in RPGs, he/she did not do so constantly, so it is not believed to be an “over-learned leisure skill”(Porter, p 144), so that it may still be a reasonable activity for monitoring and assessment of overall recovery.