top of page


( Alcohol-Related Brain Damage)

We are the

Only Rehab
In Wales

offering specific interventions
to support people with ARBD. 

Brynawel Rehab main house

Our rehab programme is specifically designed to achieve the patients optimum recovery.

The Five Stages of ARBD Treatment

Stage One

Initial diagnosis

Physical stabilisation and a period of detoxification in a hospital setting

  • An assessment period of up to six months in the protective environment of Brynawel. Care planning with a multi-disciplinary team in the context of psychosocial and mental capacity assessments.

  • Abstinence.

  • Good nutrition.  Healthier lifestyle choices. Thiamine.

  • Regularised sleep.

  • Calm stable environment.

  • Introduction of psychosocial support.

  • Early engagement with family and others.

Stage Two

Assessment period - 6 months

( See overview of stage 2, below )

Stage Three

Treatment stage - 2 to 3 years 

Active psychosocial rehabilitiation.

  • Development of activities of "daily living" encouraged.

  • Continued involvement of multi-disciplinary teams.

  • Prioritising abstinence.

Interventions principally based on a behavioural model.

  • Diary keeping.

  • Activity scheduling.

  • Graded tasking.

  • Problem solving.

  • Memory cuing.

When further cognitive / behavioural improvement is not anticipated, there should be a seamless transition to the fourth stage.

Where the individual is established in an environment which facilitiates as much independence as possible.​

Stage Four

Resettlement in the community

Stage Five

Relapse prevention in the community 

Individuals encouraged to engage in structured activities, promoting long term independence and minimising the likelihood of relapse.

It is anticipated that the majority of ARBD Patients will engage in early stage cognitive rehabilitation i.e. elements of Stage 3 during their six months assessment stage but it will be determined by their own pace of recovery.

The following gives an overview of how we will achieve results, with stages 2 and 3 having the following objectives:-

  • Developing autonomy

  • Promoting functional recovery

  • Orientation and memory support

  • Impulse and behaviour support

  • Managing apathy and motivation

  • Managing alcohol

  • Developing relationships

  • Familiarising the patient with routine and activities of daily living

  • Understanding the immediate physical environment (including labelling, signs, colour coding, orientation cues)

  • Identification of staff and key workers, knowing where to turn for advice and help, management of unacceptable and impulsive behaviour and social boundaries

  • Promotion of the optimal level of stimulation and reducing disruption (including noise management)

  • The enhancement of appropriate coping strategies

  • Helping the patient through the use of distraction techniques

  • Adopting an ‘active’ listening approach in which patients feel they are talking to people that care

  • Using an “errorless” learning approach.

  • Building a personal history of the patient with the patient and family/carers (developing a personal passport)

  • Introduction of personal journal

  • Memory and Orientation support

  • Alcohol Education

  • Continual ongoing, regular psychological assessment

Our personal care service extends to helping clients with dressing, administering medication and bathing. Maintaining the patient’s dignity is of paramount importance to us.

Patients will be registered with the nearby Llanharan Surgery.

Nursing support will only be delivered by Brynawel by prior arrangement with the purchaser.

The ratio of dedicated ARBD support staff is two to one. At some stages of the patient’s treatment this may change to one to one support.

The immediate team providing support for patients will be:  dedicated ARBD Support Workers, Therapists, a visiting Consultant Psychiatrist and Consultant Psychologist and Brynawel’s Client Recovery Manager.

Each patient will have their own keyworker and Brynawel Care Manager.

An individual care plan will be developed with the patient, involving whenever possible, their family members and social & healthcare care workers/referring agency. The care plan will be regularly reviewed and modified to meet the patient’s developmental needs.


The aim of the programme is to instigate change in the lives of both the patients and their families. In order to measure change and evaluate outcomes we regularly screen the ARBD patients utilising a range of evidence based and self-reporting tools, as often the patient’s own views are discounted.

These tools include the HADS (Hospital Anxiety and Depression Scale) which is commonly used to determine the levels of anxiety and depression that a patient is experiencing.

Your Health & Well-being Questionnaire

Daily observations, which inform a monthly observation report,  are utilised to update and influence patients care plans as well as indicating the level of support from friends and relatives, one’s ability to work, interest in one’s accommodation, patients expectations for the future, and of course, health and disabilities are regularly monitored.

For more information on the Admissions Criteria

Contact Us

If you would like to know more about our ARBD treatment programme, please contact:-

Paul Doster, Lead Therapist.


01443 226 864

or chat with us online

bottom of page