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Part 2 How do you help people with schizophrenia change their brain functioning

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Title: Part 2 How do you help people with schizophrenia change their brain functioning The Miran s Approach Author: Michael D. Miran, Ph.D. – PowerPoint PPT presentation

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Title: Part 2 How do you help people with schizophrenia change their brain functioning


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Presented at the
Annual Conference of National Alliance for the
Mentally Ill, Orlando Florida, June 2008
Holistic RECOVERY
Building Life Skills Healing the Brain
3
Hopewell 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

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  • 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

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In this presentation we measure Improved
functional behavior by the Orientation
Remediation Module subtest Zero Accuracy
Conditioner Improved psychophysiological
functioning by EEG Brain Biofeedback
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  • 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

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  • 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.

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Zero Accuracy Conditioner (ZAC)
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ZACCorrect 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.
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Magnitude of Deviation from
Correct Responses
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ZACMagnitude 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

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  • 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

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Abnormal
Normal
Standard 10/20 System-Voice Box, Heart Rate, and
GSR
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The red shows increased frontal
activity Activity is in a slow Delta Wave
Range (8 to 12 cycles a second)
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  • 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

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  • 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.

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In 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

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HOPEWELL 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
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