Constraint-induced movement therapy (Taub)

Domain IX · Biomedical, neuro & digital · Edward Taub · 1994 · University of Alabama at Birmingham, USA

What it is

Who delivers it and where it sits. Constraint-induced movement therapy (CI therapy, CIMT) is a neurorehabilitation treatment for the more-affected arm after stroke and other neurological injury. It is delivered one-to-one by trained therapists; at UAB the clinic contact is an occupational…

Format

• CI therapy is a time-limited, intensive outpatient course with a defined before, during and after. The phases below follow the UAB sources; how the psychotherapist fits into each is marked.
• Phase C — After treatment. Goal: maintain and extend real-world use. The published protocol continues home practice indefinitely after the course ("home practice-after") and makes weekly phone contacts for the first month, with the MAL repeated by phone; the clinic sends people home with an…

Who practises it, and how they are trained or regulated

• Phase A — Referral, screening and assessment. Goal: decide candidacy and set measurable goals. At the UAB clinic: a patient information form, therapist review, a video screening, then an in-person assessment; patients should apply for themselves, want to improve, set realistic measurable goals and commit to the programme; a companion is strongly recommended because people who come alone often struggle with home…
• Who delivers it and where it sits. Constraint-induced movement therapy (CI therapy, CIMT) is a neurorehabilitation treatment for the more-affected arm after stroke and other neurological injury. It is delivered one-to-one by trained therapists; at UAB the clinic contact is an occupational therapist, and in the expanded-CIMT trial treatment was given by an occupational therapist and the placebo by a physical…
• This guide is written for the psychotherapist working alongside the rehabilitation team. You do not deliver CI therapy. Your work is collaboration, referral, and integrating psychological care (mood, adjustment, frustration, motivation, family strain) around an intensive, behaviourally demanding treatment. CI therapy is itself partly behavioural: its developer, Edward Taub, is a behavioural neuroscientist, and the…

Evidence status, as the guide reports it

• Version followed: the upper-extremity CI therapy protocol of the UAB (University of Alabama at Birmingham) CI Therapy Research Group, as characterised by Morris, Taub and Mark (2006) and used in Taub et al.'s 2006 placebo-controlled trial, with the transfer package as described in those papers; the…

Questions to explore with your client

• What drew you to it, and what are you hoping it will change?
• Does it involve intense or unusual breathing? Have you been told about the medical conditions for which that is not advised?
• Is it a group, retreat or community? How do they respond if someone wants to leave or raises a concern?
• Does it use a device, heat, cold, water or a physical procedure? Has a medical professional checked that it is safe for you?
• Who runs it, and what training or registration do they hold?
• What actually happens in a session or meeting, and how often?
• What does it cost, and is there pressure to commit to more?
• How do you feel afterwards, in the hours and days that follow?
• Does it fit with, or clash with, the work we do here?

What practitioners of it watch for

• competing demands on the client's limited energy.
• clients minimising problems to avoid being stopped.
• hearing it as "you weren't trying"; correct that explicitly.
• low scores read as personal failure; bring the client's own goals back into view.
• catastrophic reactions, tearfulness that does not settle, anger at the family or staff.

When to involve someone else

• New or worsening physical symptoms, or advice to stop or change prescribed medication: involve the client's doctor or prescriber.
• Signs of coercion, isolation from family and friends, escalating costs or secrecy: discuss openly and consider safeguarding.
• A crisis or thoughts of suicide: follow your crisis protocol. In the US, call or text 988; in the UK and Ireland, Samaritans on 116 123.

Drawn automatically from the guide's own sections. Stay curious: neither endorse nor dismiss what the client values, and check anything that matters against the full guide and its sources. Not medical advice.