Mind Gym in a Philadelphia Correctional Facility
Executive Summary
A mind gym is an exercise room for the brain to promote fitness for the nervous system. A healthy brain is free of problems that lead to criminality. This proposal is for a staffed and equipped exercise room filled with a dozen types of biofeedback and related devices. Two Trainers will instruct and guide Inmates in using the equipment in an physical exercise room model.
All these devices are intended to generally improve well-being (see references). Relaxing and exercising the brain and nervous system promotes increased functionality, resilience, and flexibility. No device is used to diagnose or treat medical or psychiatric conditions. Anyone will obtain various benefits from using the devices in their standard modes. The experience is pleasant.
Groups of Ten Inmates at a time will receive 30 sessions over 10 or 15 weeks lasting 90-minutes. This will be a relaxed and quiet room with most Trainees wearing headphones for their auditory feedback or looking at computers or hand-held devices. Any non-disruptive inmate is a candidate for the brain gym program. The strongest results are expected with the most violent and dysfunctional inmates, simply because they have more room for improvement.
Research has shown that biofeedback and related devices significantly relieve disorders such as anxiety, depression, insomnia, addictions, ADHD, learning disabilities, epilepsy, alcohol & drug abuse, PTSD, and criminality (see references). Indeed, the 2776 felons at the Ontario Correctional facility between 1970 to 1995 had a 15% rate of recidivism after 3 years by using a combination of biofeedback and neurofeedback 7,8,9,10. We hope to replicate and exceed these results with more advanced technology. Several assessments will be performed.
The prison will provide a room suitable for 12 people with some furniture and adequate security. Gary Ames will supply and train 2 FTE staff of independent contractors for $120,400. Gary Ames will supply and install all equipment and personally manage all operations for between 60 and 90 days in the first year for $85,000. At maximum capacity 510 inmates will receive 45 hours of biofeedback for $8.98 per inmate hour. Total cost will be $200,000. Subsequent years will cost less.
Proposal for a Mind Gym
in a Philadelphia Correctional Facility
by Gary Ames
Purpose
To set up, equip and staff a mental exercise room for inmates with mind-body training equipment including biofeedback devices. A small staff will serve as Trainers. The first year will entail the initial costs of equipment and training. A maintenance and replacement budget will enable the brain gym to be sustained in operation after the first year at a lower cost.
Background
Decades of research and clinical experience have demonstrated and proven that biofeedback and related technologies are an effective treatment for many disorders. See the references at the end for studies on anxiety, depression, insomnia, ADHD, learning disabilities, epilepsy, alcohol & drug abuse, PTSD, and criminality. Overall, success rates range from 60-90% for the wide range of disorders commonly seen in prison populations.
From 1970 to 1995 a total of 2776 felons were treated at the Ontario Correctional Facility with peripheral biofeedback and brain wave biofeedback. No adverse effects were reported. This group averaged a recidivism rate after 3 years of just 15% 7,8,9,10. Because these were often violent felons with a normal recidivism rate of 65% the program is estimated to have saved thousands of lives.
Biofeedback 1,2,3
Biofeedback is mind-body training. Biofeedback begins with monitoring an aspect of the body’s functioning. Biofeedback consists of interacting with a display of your physiology. This is often with a goal of relaxation.
When an inmate holds a digital thermometer with his fingers, he sees his temperature. As he relaxes, the temperature goes up. Using trial and error learning he trains his nervous system to relax in such a way as to get more blood flow to his hands. Practicing relaxing in this way enhances the capacity to relax at any time both consciously and unconsciously.
What’s happening here is a learning process and exercise of the brain and nervous system in better habits of psycho-physiological performance. The goal is to enhance self-regulation. Each device fosters greater mind-body communication and empowers greater range and flexibility of function. This is often about expanding the capacity to relax. The training unconsciously generalizes well to the rest of life including sleep.
Goals
There are several expected benefits from calming, strengthening and balancing the nervous system:
- reduced recidivism;
- lower medical and psychological treatment costs;
- reduced number and dose of medications;
- reduced symptoms from stress related disorders;
- reduced symptoms from drug withdrawal and drug abstinence;
- safer environment for Corrections Officers and inmates;
- better sleep;
- enhance progress in other rehabilitation programs
- Fewer minor, major and critical incidents.
The goal for trainees is to enable released inmates to be more physically and mentally healthy, drug-free, employed, and compliant with their terms of release. The goal of the program is to drive the cost per inmate down while balancing effectiveness of the intervention.
Assessments:
Before training, after training, and follow up with a sample of inmates.
· Symptom Checklist 90 (psychological distress)
· Sleep log
· Prison Social Worker assessment of General Adaptive Functioning score
· Correction Officer comments
· Grouped incident reports pre and post training. Incidents will be scored 1-minor, 3-major and 9-critical.
Post release:
· Probation Officer reports
· Results of drug tests
· Reported amount of earned income
· Homelessness
· Recidivism.
Biofeedback in a Mind Gym
A mind gym is designed for maximum use of both staff Trainers and the diverse equipment. Trainers are not therapists. After trainee equipment orientation, most Trainer conversations are about dealing with the experience: “How do you feel?” “Breathe even slower.” “Do you want stop now?” “That’s great, keep on going.” “It’s time to move to this device now.”
There are dozens of devices in a mind gym. Most are peripheral biofeedback devices to train self-regulation of the autonomic nervous system. The other category is generic brain exercisers or relaxers that work on the central nervous system.
Some of these exercise brain waves others train to concentrate blood flow within the brain. Some equipment is for independent use and some brain biofeedback equipment is operated by a Trainer. One Trainer can operate several brain biofeedback devices at the same time.
Training, not treatment
The interventions proposed here are not treatment devices, but training equipment. The difference is that a treatment must include a diagnosis of a condition and prescribed protocols. Training is done without regard to medical or psychological condition. Any customization of training is related to the performance of the training itself, not to differential therapeutic interventions.
Again, these exercise devices train the brain and nervous system to foster self-awareness and self-control at conscious and unconscious levels. These interventions relieve disorders in clinical populations in that context. However, they also enhance performance of the best singers and soldiers. The analogy is to aerobic cross training which boosts any other athletic activity and which reduces hypertension.
Adverse effects
Adverse reactions are rare, minor and avoidable by proceeding gently.
Biofeedback is remarkably safe and benign. Unwanted reactions to training are rare, minor and self-limiting. Unwanted reactions may take the form of a brief headache or minor feelings of discomfort. These dissipate quickly after stopping. Many experienced practitioners have never seen a bad session including the co-author of the large prison study-practicing daily since 1959. As in any gym program, the basic principle is to proceed gently and check in with the Inmate as you go. Some devices must be purchased by a licensed clinician. The FDA permits sale of many biofeedback devices by the public.
Introducing the devices to inmates
Biofeedback is pleasant and interesting. The problem of introduction is a small issue. In my trial run on January 11, 2007 at the PIC maximum security prison I had no difficulty running eager 4 inmates at a time on 4 kinds of devices – even a pair of devices simultaneously. All the reports the dozen inmates gave me suggest that positive word of mouth will flourish.
The initial group of inmates should be a small and easy to manage group in order to ramp up operations while we all become familiar with the training procedures and security logistics. As the system is perfected we can accommodate those who are more reactive or who have a lower frustration tolerance.
Features of Training
After inmates achieve competence in using all the equipment, a set of personal goals will be recommended with a custom training circuit and plan for progression. Trainee preferences can be accommodated to some extent.
Biofeedback is essentially a non-verbal modality. It is all about self-interaction. Self-disclosure to another is not a part of the process. There are brief conversations for direction and about how you are feeling to resolve training and equipment issues.
No clinical records will be kept of sessions. Attendance and administrative records will be kept to schedule the mix of devices on each day. Nobody is going to be impressed with proof that inmates brain waves are less abnormal. An improvement in the inmates’ life is the prime criterion of success.
Almost anyone is a candidate for participation in the brain gym program. All that is required is that inmate not be too disruptive. Neurofeedback has been shown to reduce the need for psychoactive medications. Some of the devices are proven effective for ameliorating the pains of drug withdrawal.
Weekly Schedule
A fully equipped brain gym will have multiple units of most of the devices. All training sessions last 90 minutes and will be composed of 3 30-minute blocks. Each trainee will rotate through a scheduled training circuit.
There will be 2 Trainers directing 10 inmates on the equipment. As shown in the chart below, each week there are 12 groups of 10 inmates each. There are 6 M-W-F Groups and 6 T-R Groups.
| Day of week | Monday | Tuesday | Wednesday | Thursday | Friday |
| 9 AM | Group A | Group G | Group A | Group G | Group A |
| 10:30 AM | Group B | Group H | Group B | Group H | Group B |
| 12 PM | Group C | Group I | Group C | Group I | Group C |
| 1:30 PM | Group D | Group J | Group D | Group J | Group D |
| 3:00 PM | Group E | Group K | Group E | Group K | Group E |
| 4:30-6 PM | Group F | Group L | Group F | Group L | Group F |
For one Inmate on one particular day the 90-minute personal circuit may look like the following: Start with light supervision for temperature biofeedback and HRV for ½ hour, then pRoshi for ½ hour, and finally a 30-minute pIR HEG neurofeedback session monitored more closely by the trainer.
On another day the 90-minute this Inmate’s circuit may start with 1 hour of brain wave biofeedback monitored by a Trainer and finish with a simultaneous combination of GSR & HRV with CES for ½ hour.
Maximum Program Capacity
Each Training group consists of 10 Trainees staying for 90 minutes. There are 6 groups per day. Every inmate who completes all sessions, will graduate with a total of 45 hours of training.
The 6 Mon.-Wed.-Fri. group will graduate in 10 weeks with 5 groups a year.
This is a sub-total of 60 Trainees x 5 groups = 300 Trainees.
The 6 Tuesday-Thursday groups will graduate 60 trainees every 15 weeks.
This is a sub-total of 60 Trainees x 3.5 groups a year = 210 Trainees/year.
This program can graduate a total of 510 Trainees per year.
| I propose to deliver a program that offers 45 hours of training for up to 510 inmates per year. That is 22,950 training hours annually. |
| The total first year cost is $206,120. The cost per graduate is $404.16 per inmate or $8.98 per hour of training. |
Subsequent years will cost less in equipment and program administration.
Prison provides:
· Facility: large room for 10 trainees at a time with tables and chairs.
· Escort 10 trainees every 90 minutes to and from the room.
· Security for staff and equipment. May include locked storage cabinets.
Staffing:
Gary Ames will provide 2 independent contractors as Training staff for 8 hours a day for 250 days a year. At for $30/hour the 2 full time equivalent contractors will cost $60,000/year each. Or 4000 hours x $30 is $120,000.
All Mind Gym Trainers will receive at least one full day of orientation in the use and instruction of the devices including coaching strategies. Each device has specific and technical issues regarding the sensor, signal processing, and display as well as expected responses.
Cost of Equipment and Management
All Equipment and Gary Ames Management will cost $85,000 in the first year. Subsequent equipment expense may cost $10-20,000 per year for replacements upgrades, technical support, and consumables. Amount of program management required in subsequent years is less but unknown.
The time for Gary Ames provision of equipment, supervision of staff, oversight and management of the project is estimated at 60 to 90 days. Most of that will be on site at the prison. Any time required over 90 days will be billed to the prison at $1200/day with authorization by Deputy Commissioner Hammond.
This $85,000 price includes all assessments, the equipment list below with all biofeedback and related devices including 3 neurofeedback stations (hardware, software, peripherals & annual support and consumables.) Gary Ames plans to spend an intensive amount of time in the beginning with staff training and consulting. After the launch is stabilized, he will spend less time overseeing operations. Mr. Ames will train, consult and oversee on fewer days later in the year as needed, but no less than once every month.
Equipment Budget
All the devices below have been shown to produce extraordinary benefits in various clinical and non-clinical populations. These benefits are pervasive and enduring, indeed some of the benefits have been shown to last a lifetime. Below is the entire equipment list that will make up the mind gym.
Biofeedback:
Thermometer: hand or toe warming for autonomic relaxation.
10 @ $30 = $300
Heart Rate Variability (HRV): Train for synchronization of breathing and heart rate oscillations5. Builds stress resilience. Two kinds of hand held devices.
1 Freeze Framer computer system @$300 = $300.
2 EmWaves @$200 = $400
3 StressErasers @ $300 = $900
Wild Divine: Structured computer game and hardware with HRV and GSR (Galvanic Skin Response, sweat rate).
3 @ $200 = $600
Inner Tube: Flexible computer environments software with HRV and GSR monitoring. Can be combined with free images designed to desensitize reactive emotions. This was a key feature in the work of Doug Quirk in Ontario7,8.
2 @ $85 = $190
4 desktop computers to run the above software @600 = $2400.
Neurofeedback:
Brain wave Biofeedback: – Advanced software with EEG. Relaxes turbulence of all brain waves using brief pauses in music as feedback promoting a quiet mind.
Includes laptop computers, EEG, NeuroCarePro software, consumables, reclining chairs, paste, etc.
2 @ $9,475 = $18,950
pIR HEG – Trains for activation of the prefrontal cortex via greater blood perfusion. With an infrared thermometer sensor on the forehead, Trainees work to keep the movie playing as temperature thresholds are increased.
1 @ $3400 with DVD player.
nIR HEG – Trains to increase oxygenation at a site in the brain.
1 @ $2000 plus computer $600 = $2600.
HEG stands for Hemoencephalography (blood-brain-image). pIR Passive infrared is different from near infrared nIR HEG.
Accessories:
$850 – Headphones, batteries, electronics, and a small library of CDs & DVDs.
Neurotechnologies:
Cranial Electrical Stimulator (CES) – Approved by the FDA for anxiety, depression and insomnia4. Also effective to reduce symptoms of drug withdrawal. Two ear clips carry a subliminal amount of current through the brain.
3 @ $300 = $900
pRoshi – Glasses with flashing lights for photic and magnetic stimulation6. A kind of brain exercise that seems to develop neural infrastructure.
2 @ $1900 = $3800.
Equipment total: $35,590
Personnel Budget
| Staff Person | Time Frame | Hr rate | Year Cost |
| Trainer #1 | 1 year | $30 | $ 60,000 |
| Trainer #2 | 1 year | $30 | $ 60,000 |
| Gary Ames | Management | $120 | $ 49,410 |
| Total year one | $169,410 |
Total Budget
35,590 Equipment
169,410 Personnel
205,000 Total
Payment schedule
Since the project is front loaded with capital costs, 1/2 of the contract amount is due at signing and ¼ of the contract amount at each of 2 milestones:
1) After 11 weeks and when the second MWF group completes their first week of training.
2) After 21 weeks and when the fourth group begins training.
Scale of Operations
To double the staff and equipment would double the capacity for Trainees. But to halve the budget would reduce the program throughput by much more than half and greatly increase the cost per hour of training.
Operational adjustments are to be expected. The freedom to expand and explore is needed. The goal is to refine the mix of equipment to bring down the price per Trainee while keeping results high.
The path for expansion is to either increase staff and equipment or set up Mind Gyms of this same size or larger in different locations. Expansion of the program can also include more assessments. This project cries out for proper scientific research, but that degree of rigor should not be the initial step.
This is meant to be a demonstration project. A brain gym has not been done before, quite like this, in a prison setting. However, all of these devices have been used in a variety of clinical environments. Hospitals and prisons have proven to be ideal settings.
Prison inmates are an ideal population for this venture because biofeedback tends to de-abnormalize people. Biofeedback does not make people normal, but it does make them less abnormal. The more abnormal they are the further they have to go and the more likely they are to make large strides towards recovery and rehabilitation.
References:
1) www.aapb.org Association of Applied Psychophysiology and Biofeedback.
Largest association for biofeedback professionals.
2) www.isnr.org International Society for Neurofeedback and Research.
Association specializing in neurofeedback. Features extensive bibliography http://isnr.org/uploads/compbiblio.pdf.
The bibliography contains outcome studies and case reports and is divided by into these problem areas: Epilepsy; ADD/ADHD, Learning Disabilities, & Academic-Cognitive Enhancement; Anxiety Disorders, PTSD, & Sleep Disorders; Depression, Hemispheric Asymmetry, & Anger; Addictive Disorders; Brain Injury, Stroke, Coma, & Spasticity; Chronic Fatigue Syndrome, Fibromyalgia, & Autoimmune Dysfunction; Pain & Headache; Schizophrenia; Obsessive Compulsive Disorder; Parkinson’s Dystonia; Tourette’s Syndrome; Autism; Cognitive Decline with Aging; Asthma; Hypertension; Dissociative Disorders; Creativity & Optimal Functioning; Criminals.
It lists 2 new articles on neurofeedback with juvinile offenders.
3) http://www.eeginfo.com/research/ More scientific support for neurofeedback.
4) www.Alpha-Stim.com Most comprehensive site about Cranial Electrical Stimulation.
5) www.HeartMath.org Heart rate variability.
6) www.roshi.com Photic simulation and magnetic stimulation device.
7) http://www.alertfocus.com/relieve/violence/ch19.php
Chapter 19 Prisons, Drugs, and Special Education in No Child Left Behind Goals (and more) are Attainable with the Neurocognitive Approach, Vol. 1
8) http://www.behavior-analyst-today.com/BAT%207-4.PDF Page 492: The Origins of EEG biofeedback for Remediating Misbehavior. Most recent and complete article on reducing recidivism with biofeedback.
9) http://www.hyperactivekids.com/sections/library/articles/incorrigible.html Correcting the Incorrigible – The original article about reducing recidivism with biofeedback by a co-author.
10) http://www.alertfocus.com/relieve/violence/index.php
Gary Ames’ web site with short version of large biofeedback study in prison.
