Title: Part 2 How do you help people with schizophrenia change their brain functioning
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2 Presented at the
Annual Conference of National Alliance for the
Mentally Ill, Orlando Florida, June 2008
Holistic RECOVERY
Building Life Skills Healing the Brain
3Hopewell is a healing environment for individuals
recovering from mental illness. The Mirans adapt
the Neuropsychological Therapeutic Community
Treatment Model for remediating cognitive
deficits and improving brain function.
4- 1982
- Right Brain/Left Brain Models lead to a
Homeostatic Brain Model - 1989
- Adapting the NYU Rusk and the Recanati
Institutes Neuropsychological Therapeutic
Community Model - (a brain injury treatment)
- 2000
- Grant from NYS Office of Mental Health
- 2000- present
- Treatment sites in Brooklyn, Jaffa and
Poughkeepsie - 2006
- Collaboration with Hopewell
5- Assessment-personality neuropsychological
- Therapeutic community meetings
- Family involvement
- Brain plasticity training
- Interpersonal skills development
- Brain biofeedback training
6- The Homeostatic Brain Model describes normal and
abnormal activating and inhibiting systems - Psychiatric symptoms occur when there are
disruptions in activating and inhibiting Frontal,
Temporal, Parietal, and Limbic regions of the
brain. - The human brain is plastic, and can recover
function and establish new neural-pathways
7- Effectiveness based treatment demonstrates
- improved ecologically valid functional behavior
- improved psychophysiological functioning
- the ability to engage in the treatment process
8In this presentation we measure Improved
functional behavior by the Orientation
Remediation Module subtest Zero Accuracy
Conditioner Improved psychophysiological
functioning by EEG Brain Biofeedback
9- The ZAC is a computerized cognitive training task
(developed by Yehuda Ben-Yishay, Ph.D. at the NYU
Rusk Institute, Working Approaches to Remediation
of Cognitive Deficits in Brain Damaged Persons,
1983) - Includes three subtests
- Immediate stop
- Short coast
- Long coast
- Subtests are progressively more difficult and
involve more frontal lobe activity
10- Next slide is a picture of the stimuli as seen by
the subject on the computer screen - Top Picture
- Subject achieves the correct response. The clock
hand stops at the top mark. - Bottom Picture
- Subject deviates from the correct response.
Deviations are counted.
11 Zero Accuracy Conditioner (ZAC)
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13ZACCorrect Response by Trials
The subject gradually improves ability to
achieve a correct response The summary of the
immediate stop begin at a score in the range of
6-7 and increase to a score in the range close to
8 (The immediate stop is a less demanding
task) The summary of the short coast begin at a
score of 0 and increase sharply to a score in
the range close to 3. The summary of the long
coast begin at a score of 0 and increase on a
straight line to the range close to 3.
14 Magnitude of Deviation from
Correct Responses
15ZACMagnitude of Deviation
- The subject gradually improves ability to achieve
a smaller magnitude of deviation -
- The summary of the immediate stop begin at a
score close to 0 and end at the same score (The
immediate stop is a less demanding task) - The summary of the short coast begin at a score
between 20-30 and decrease to a score close to
0 - The summary of the long coast begin at a score
between 80-90 and decrease to a score close to
0
16- The EEG Record is of a subject diagnosed with
Schizophrenia. Data collected as part of a New
York State Office of Mental Health Grant - The EEG Record shows a change in brain function
from an abnormal state to a normal state
associated with working on the ZAC, long coast
17Abnormal
Normal
Standard 10/20 System-Voice Box, Heart Rate, and
GSR
18The red shows increased frontal
activity Activity is in a slow Delta Wave
Range (8 to 12 cycles a second)
19- The results suggest that individuals can
- Improve information processing and functional
behavior - ZAC charts from three trials of 12 responses on a
single day. - The subject is focused and is able to engaged in
the treatment - process
- Improve psychophysiological functioning
- EEG Record
- As frontal lobe circuits are activated,
hallucinations and circular negative thoughts are
diminished by the process of reciprocal
inhibition
20- The above slides present single case data
demonstrating the possibility of producing
changes in brain functioning. - Due to the small sample size we cannot claim that
this data generalizes to any larger population. - It would be desirable to do a study with a larger
sample size and randomized controls.
21In Conclusion
- Hopewell
- a nurturing residential environment
- Mirans Neuropsychological Treatment
- Improves functional behavior and brain activity
- New Metrics
- measures effectiveness based treatment
- New Technologies for Treatment
- enables the transformation of brain function
- Recovery
- An urgent need for individuals to feel better
22HOPEWELL THEAPEUTIC COMMUNITY Candace
Carlton 9637 State Route 534 PO Box
193 Mesopotamia, OH 44439-0193 (440) 693-4074
Voice info_at_hopewell.cc www.hopewell.cc
MIRAN APPROACH Esta Miran 272 Sylvan
Rd. Rochester, NY 14618 (585) 473-3558
Voice emiran_at_mirantherapy.com mirantherapy.org