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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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Presented at the Annual Conference of National Alliance for the Mentally Ill, Orlando Florida, June 2008

Holistic

RECOVERY:

  • Building Life Skills
  • Healing the Brain
slide3

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.

slide4

1982:

Right Brain/Left Brain Models lead to a Homeostatic Brain Model

1989:

Adapting the NYU Rusk and the Recanati Institute’s 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

slide5

Assessment-personality neuropsychological

  • Therapeutic community meetings
  • Family involvement
  • Brain plasticity training
  • Interpersonal skills development
  • Brain biofeedback training
slide6

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

slide7

Effectiveness based treatment demonstrates:

improved ecologically valid functional behavior

improved psychophysiological functioning

the ability to engage in the treatment process

slide8

In this presentation we measure:

    • Improved functional behavior by the Orientation Remediation Module subtest Zero Accuracy Conditioner
    • Improved psychophysiological functioning by EEG Brain Biofeedback
slide9

Zero Accuracy Conditioner (ZAC)

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

slide10

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 Responseby 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.
slide15

ZACMagnitudeof 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”

slide16

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

slide17

Abnormal

Normal

Standard 10/20 System-Voice Box, Heart Rate, and GSR

slide18

The red shows increased frontal activity

Activity is in a slow Delta Wave Range

(8 to 12 cycles a second)

slide19

Theresultssuggest 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

slide20

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.

slide21

InConclusion:

Hopewell –

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

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@hopewell.cc
    • www.hopewell.cc
  • MIRAN APPROACH
    • Esta Miran
    • 272 Sylvan Rd.
    • Rochester, NY 14618
    • (585) 473-3558 Voice
    • emiran@mirantherapy.com
    • mirantherapy.org