Building Life Skills Healing the Brain
description
Transcript of Building Life Skills Healing the Brain
There is a world in each person’s brain
Presented at the Annual Conference of National Alliance for the Mentally Ill, Orlando Florida, June 2008
Building Life SkillsHealing the Brain
Holistic RECOVERY:
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.
Time-Line Development of the Miran’s Treatment
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 at- FEGS (Brooklyn), Jaffa Community Mental Health Center (Israel) and
Hudson River Psychiatric Center (NY)
2006-present: Collaboration with Hopewell (OH)
Treatment Techniques:
Assessment-personality neuropsychological
Therapeutic community meetings
Family involvement
Brain plasticity training
Interpersonal skills development
Brain biofeedback training
Basic Science/Brain Function
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
New MetricsMeasuring Effectiveness based Performance
Effectiveness based treatment demonstrates:
improved ecologically valid functional behavior
improved psychophysiological functioning
the ability to engage in the treatment process
Measuring Effectiveness Based Treatment
In this presentation we measure:
Improved functional behavior by the Orientation Remediation Module subtest Zero Accuracy Conditioner
Improved psychophysiological functioning by EEG Brain Biofeedback
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
Zero Accuracy Conditioner (ZAC)
Zero Accuracy Conditioner (ZAC)
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.
Zero Accuracy Conditioner
(ZAC)
Trial 1
Trial 2
Trial 3
0
1
2
3
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ZACNumber Correct Responses
3 Trials (each trial is a summary of 12 re-sponses)
Subject Diagnosed with Schizophrenia at Hopewell
Immediate StopShort CoastLong Coast
Num
ber o
f Cor
rect
resp
onse
s
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.
ZACCorrect Response by Trials
Trial 1Trial 2
Trial 3
0
10
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90
100
Immediate Stop
Short Coast
Long Coast
Immediate Stop
Short Coast
Long Coast
ZACMagnitude of Deviation from Correct Response
3 Trials (each trial is a summary of 12 responses)Subject Diagnosed with Schizophrenia at Hopewell
Mag
nitu
de o
f Dev
iatio
n fro
m C
orre
ct R
espo
nses
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”
ZACMagnitude of Deviation
ZACEEG Brain Biofeedback
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
Sta
ndar
d 10
/20
Sys
tem
-Voi
ce B
ox, H
eart
Rat
e, a
nd G
SR Abnormal Normal
Brain Activity During
ZAC Long Coast Subtest
The red shows increased frontal activity
Activity is in a slow Delta Wave Range(8 to 12 cycles a second)
The results suggest that individuals can:
Improve information processing and functional behaviorZAC charts from three trials of 12 responses on a single day.
The subject is focused and is able to engaged in the treatmentprocess
Improve psychophysiological functioningEEG Record
As frontal lobe circuits are activated, hallucinations and circular negative thoughts are diminished by the process of reciprocal inhibition
Caveat
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.
Hopewell – a nurturing residential environment
Miran’s Neuropsychological TreatmentImproves 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
In Conclusion:
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CONTACT INFORMATION
HOPEWELL THEAPEUTIC COMMUNITYCandace Carlton9637 State Route 534PO Box 193Mesopotamia, OH 44439-0193(440) 693-4074 [email protected]
MIRAN APPROACHEsta Miran272 Sylvan Rd.Rochester, NY 14618(585) 473-3558 [email protected]