BASIC CONCEPTS
What is neurofeedback?
Neurofeedback is biofeedback for the brain. The training tends to improve cognitive function, attention, mood, anxiety, and behavior. It helps quiet the mind.
How does neurofeedback work?
An overview of the process. Connecting electrodes to an amplifier, to software, to what the therapist sees, to what the client may see.
How is neurofeedback used clinically?
Think of it as regulating CNS (central nervous system) related problems or "dysregulation". It's commonly used for ADD, ADHD, depression, anxiety, panic attacks, traumatic brain injury, sleep problems. But you often train differently for different problems.
How many sessions are needed?
How many times do you need to go to the gym before you get in shape? The answer is different for everyone. It could be 10, it could be 40 visits. But you'll know much more quickly whether neurofeedback is working for you.
How long is each session?
Total session time usually runs 30 minutes.
How often do you need to come for training? Twice a week is typical. Three to four times a week can be helpful. Once a week minimum.
When do you stop the training?
Don't stop training the minute your symptoms get better. Turn them into a new brain habit.
How long before I notice changes from the training?
Should you notice change in the first session? By the fifth? What's realistic? Many people get inpatient if there's no change within 10 sessions.
Do symptoms ever get worse with neurofeedback training?
If something can produce positive changes relatively rapidly, is it possible to make symptoms worse, even if just for a short time?
How long does the effect of training last?
In an interview with Dr. Joel Lubar, he reported following up with patients up to 20 years later. Do the effects of training always hold like that?
Can it be used while a patient is on medication?
Clinicians report that more than half their neurofeedback clients start on one or more medications. After training for a while, it is often possible to reduce the medication under appropriate supervision.
When doesn’t neurofeedback work?
Just as MD's and psychologists vary in effectiveness based on training and knowledge, the same is true of neurofeedback practitioners.
How does training transfer to everyday situations?
In neurofeedback training, the “beep” is the sound you hear to remind your brain to return to the goal (to relax, to focus, or a goal for a specific client). The experience generalizes - so when you're not training, you can be more focused, less anxious, sleep better, be in a better mood, etc.
COSTS, REIMBURSEMENT
Do insurance companies reimburse for neurofeedback?
Neurofeedback is biofeedback. Some insurance companies will pay directly for biofeedback. Many will not. Here are more details for professionals and consumers.
ABOUT THE FIELD
What’s the right name: neurofeedback, EEG biofeedback, neurotherapy?
No one in the field has agreed to a single name. Any of the following names can be used, and are interchangeable.
Is there more than one way to do neurofeedback?
There are multiple approaches to doing neurofeedback. All of them have value. Is there a best one - or at least a best one to get started with? Some clinicians use multiple models. Here's a bit about the various models.
Is neurofeedback experimental?
No. Since neurofeedback devices are required to carry an FDA label, their use by licensed health providers is completely permissible.
Are there FDA guidelines for neurofeedback instrumentation?
Yes. This is an evolving question, but there are several companies that clearly are registered with the FDA under FDA guidelines. There are others who have chosen not to register and some controversy exists about that.
Can anyone do neurofeedback, or do you have to be licensed?
There are non-licensed professionals obtaining equipment, then offering services to others. Professionals in the field are very concerned that they are treating without a license. What's the controversy?
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BACKGROUND
Is there enough research?
A recent child and adolescent psychiatric journal devoted much of a special issue to research in neurofeedback. . . There are over 1000 publications supporting the field. . .
A brief history
How did science and cats discover SMR EEG training? In 1968, a neuroscientist at UCLA proved that cats could be trained to change their EEG. He used the same cats in an experiment for NASA .
Are there differences in neurofeedback and biofeedback?
Neurofeedback is EEG biofeedback.
It's just a specialized form of biofeedback. But there are differences in traditional biofeedback and neurofeedback.
ABOUT ITS USE
Which professionals use neurofeedback?
It's estimated 2500-3500 health professionals now use neurofeedback, including psychologists, MD's, LCSW's, educational psychologists, marriage and family counselors, RN's.
What do health professionals say it does for their clients?
In a survey, clinicians who use neurofeedback reported that it improves symptoms for a large percentage of clients. It often reduces the use of medications.
What do clients/patients say about neurofeedback?
An example of some comments from clients with ADD, autism, depression who've used neurofeedback. What are some of the challenges clients face in understanding the impact of neurofeedback?
Why aren't more MD's recommending or offering neurofeedback?
Neurofeedback works very well in a clinical setting. But few MD's are really educated about it, which is probably the biggest obstacle to acceptance. Why is there such a lack of education? Does insurance coverage play a role in slowing adoption? Is it a problem with research?
Are there adverse effects?
There are 30 years of clinical experience with neurofeedback, and hundreds of thousands of training sessions. There are no known situations where a long-term adverse effect has been identified.
HOME TRAINING
Can training occur at home?
Should a parent or individual do training at home with limited experience?
Even if you're supervised at home by a trained professional (many won't do it), it's harder and the chances of failure are higher. There are situations it is appropriate, but it should be done very cautiously.
MORE ON HOW IT WORKS
How can training change sleep quickly?
Sleep is one of the first symptoms to respond. Here's a quick example of how to change someone's sleep.
What EEG frequencies are typically trained? What do the frequencies mean?
Beta frequencies (13-20 Hz) are associated with an alert, awake, attentive state. Alpha-theta training (rewarding 8-11 or 8-12 Hz for alpha and 4-8 Hz for theta) guides people to deep quiet states. Excessive theta and delta (slow wave activity) can be associated with distractibility, inattentiveness or not focusing.
Excessive high beta is associated with anxiety, tension. It can interfere with attention.
When you see the EEG change, is the brain actually changing?
Yes. The EEG is a physiological measure. Neurofeedback trains you to change the EEG. When someone changes their EEG, by definition, they are changing their brain - and how neurons are firing. If the EEG is changing, what does that represent?
Does the EEG always change after training?
It's not unusual to see a clear change in the EEG's behavior. Sometimes, the change is much less clear, but improvements occur.
How is brain imaging and cognitive neuroscience impacting neurofeedback?
What part of the brain do you train? As more is published daily about imaging studies, its providing important clues.
OTHER QUESTIONS
Why is NF not in all the schools?
It should be. Here's a list of challenges and some ideas about how to achieve it.
When does anecdotal information become common clinical knowledge?
There's a lot of well known common knowledge in neurofeedback. Is it simply anecdotal?
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