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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. Hopewell is a healing environment for individuals recovering from mental illness.
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The Mirans adapt the Neuropsychological Therapeutic Community Treatment Model for remediating cognitive deficits and improving brain function.
Right Brain/Left Brain Models lead to a Homeostatic Brain Model
Adapting the NYU Rusk and the Recanati Institute’s Neuropsychological Therapeutic Community Model
(a brain injury treatment)
Grant from NYS Office of Mental Health
Treatment sites in Brooklyn, Jaffa and Poughkeepsie
Collaboration with Hopewell
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
improved ecologically valid functional behavior
improved psychophysiological functioning
the ability to engage in the treatment process
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
Subtests are progressively more difficult and involve more frontal lobe activity
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.
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”
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
Standard 10/20 System-Voice Box, Heart Rate, and GSR
Activity is in a slow Delta Wave Range
(8 to 12 cycles a second)
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
Improve psychophysiological functioning
As frontal lobe circuits are activated, hallucinations and circular negative thoughts are diminished by the process of reciprocal inhibition
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.
a nurturing residential environment
Miran’s Neuropsychological Treatment
Improves functional behavior and brain activity
New Metrics –
measures effectiveness based treatment
New Technologies for Treatment –
enables the transformation of brain function
An urgent need for individuals to feel better