Alexa is a 20 years old female living in McKellar apartment. She had brain injury before 3years and Brain injury services of Northan Ontario provides her basic support to complete her daily activities. After a brain injury, it was harder for her to control their feelings and thoughts, especially when she is tired.
She says or does things that have negative consequences. She gets into arguments or feels isolated from her family and friends. Problem behavior is only a problem if it gets in the way of their life or negatively affects people in their life.
She is emotionally distress because difficult to adjust to the injury and inability to participate in past activities both work and recreation or inability to generate ideas made her to start smoking which gives her relaxation. She changed her personality.
Now she has difficulty to control her anger and acting inappropriately in social settings, causing conflict or avoidance in social relationships. She expresses her emotions that do not fit the situation.
The baseline phase started in first week. I instructed her to not alter her smoking just self-monitored and write it down the frequency and duration of smoking. If it is possible just self-control to cut down the frequency of smoking.
I reported that she smokes 2 times in an hour. I set with her and played snacks and ladder for atlis one hour and she didn’t smoke in that hour because she got interested in playing. Next day I gathered other client and with them I made her to play games she felt loved and happy and quit her smoking for 2 hours.
Week 2
I thought her self management by giving her some tips
Keep oral substitutes handy: carrot, pickles, apples, chew, sugarless, gum, or cinnamon stick.
Change surrounding: sit in social gathering.
Take a nap or shower
Call and talked with your mother
Refused the offering by other people if you are angry write it down paper
Plan more activities that you have time and make a list of things you like to do
Move! Do not stay in the same place too long.
Look at what is going on around you (notice the shape of buildings, Listen to the sounds of the city/outdoors)
Carry something to keep your hands busy.
She started to take walk in hall way when she feels to smoke, or she makes her own coffee and drink. She reduced 3 smokes in day
Week 3
She used to get angry or depressed and stressed out I taught her breathing exercise which helps her to relieve from nicotine cravings and improve her lungs function. Physical and modelling prompts were used to show exercise.
Belly breathing
- Step 1 sit in the quit place, sit tall keep your hand on your belly and breathe in deeply
- Step 2 allowing your belly to expand as your lungs fill with air
- Step 3 pay attention to your diaphragm as it moves up and down with your breath.
Do hold your breath
- Step 1 To start, inhale and exhale to a count of 6 Maintain a steady and even rhythm
- Step 2 after an inhale, hold your breath when your lungs are their fullest.
- Step 3 Hold for a count of 3, then exhale.
Open your mouth and say “Ahh”
I explained pranayama is a one type of yoga exercise which increase your lung capacity and allow you to take deeper breath that will help to feel better after quitting smoking.
- Step 1 take a breath from your nose.
- Step 2 when your lungs are full open your mouth with “Ahhh” sound
- Step 3 exhale air out
She did all the exercise very well and she reported that she feels good and she reduced smoke
All the steps of quitting smoking helped her a lot to reduced smoking
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