AmericanJournalof DanceTherapy

1985,Vol. 8, 46-66

Dance/Movement Therapy in the

Rehabilitation of Individuals Surviving
Severe Head Injuries
Cynthia F. Berrol, PhD, ADTR
Coordinator of Special Graduate Major, Dance/Movement Therapy
California State University, Hayward
Hayward, California
Stephanie S. Katz, ADTR
Dance/Movement Therapist, Therapeutic Recovery Program
Rehabilitation Resources, Inc.,
Southfield, Michigan
Approximately 700,000 individuals are admitted to hospitals an-
nually as a result of severe brain injuries. Of the survivors, up-
wards of 70,000 suffer pervasive, long-term disruption of all do-
mains of human function and marked alteration of the quality of
life. Effective treatment requires a well-orchestrated multidisciplin-
ary team approach. This paper will address rehabilitation issuesin
relation to dance/movement therapy. First the pathological conse-
quences of neurotrauma will be reviewed. Likewise, basic mecha-
nisms of recovery, treatment principles and special therapeutic
considerations will be addressed. Finally, intervention strategies
will be discussed within the context of both group and individual
settings and illustrated via case studies.

Every 16 seconds someone sustains a head injury; every 12 minutes

someone dies of a head injury (Generelli, Note 1). Approximately
700,000 individuals are admitted to hospitals each year as a result of
severe cerebral insults. Of the survivors, upwards of 70,000 suffer
marked, pervasive and long-term disruption of all domains of human
function--physical, cognitive and psycho-social. Every facet of life is
significantly altered--personal, familial, social, educational, vocation-
al and recreational. Regardless of the level of recovery, a somewhat
different person will emerge, a seeming stranger, someone who will
never be quite the same as before the injury.
A typical profile of individuals who have sustained severe cerebral
trauma is a male between the ages of 16 and 30 years, a student per-
haps or an independent wage earner, a family member, a person who
Requestsfor reprints: Cynthia Berrol, PhD, ADTR, Department of Kinesiology and Physical
Education, California State University, Hayward, CA 94542.

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 SEVERE HEAD INJURIES

prior to the event had some measure of control over his life.
Sheldon Berrol, MD (Note 2) vividly describes the chaotic experi-
ence of persons awakening from coma after severe cerebral insult.
Theyfind themselvesin a strangeroom surroundedby strangepeo-
ple wearing uniforms.Theyare tugged at, physicallymanipulated,
talked at, told what to do and ordered about. Theyhaveno memo-
ry of the catastrophic event that shattered their brain. Their last
recollectionof themselvesis that of an intact, functional individual.
It is no wonder that upon emerging from coma the individual is of-
ten frightened, confused, disoriented, frustrated, hostile and agitated.
It is a strange, unfamiliar environment, and there is no memory of what
happened, what one is doing in such strange surroundings or how one
got there. This is the beginning of the metamorphosis of the survivors of
profound head injury. This is the stage at which an interdisciplinary
team of health professionals is called upon to begin the challenging, all-
encompassing task of rehabilitation.
Rehabilitation
The goals of rehabilitation are multi-pronged. Early on it is critical to
prevent further medical complications. However, long range goals are
directed toward restoring function where possible, or at best, maximiz-
ing function. Survival skills are emphasized in order to attain optimal in-
dependence and potential for a meaningful and qualitative life.
Rehabilitation programs should be individually tailored, designed
to meet unique needs, concerns and interests. Moreover, a truly com-
prehensive program recognizes and is responsible to the "significant
others," those intimately involved in the lives of the survivors. Rehabili-
tation requires the interdisciplinary services of a well orchestrated
team. While the different disciplines work cooperatively toward com-
mon goals and objectives for the patient, it is the singular process of
each therapeutic modality that distinguishes one from the other and,
likewise, furnishes a distinct contribution to the entire treatment process.
Theoretical Considerations:Dance/MovementTherapy
The significance of motoric expression in human development has long
been recognized. Ayres (1973), Kephart (1971), Piaget (Piaget & In-
helder, 1969) postulate that physical interaction with and exploration
of the environment (via movement experiences) constitute the individu-
al's first level of learning in the developmental hierarchy, the means by
which s/he begins to make sense of the surroundings. Simply, we learn
about ourselves and the world around us through our bodies.

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