Introduction to Neurofeedback and Frequently Asked Questions
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. It is painless and generally has no side effects.
How does neurofeedback work?
An overview of the process. Connecting electrodes to an amplifier, software, what the therapist sees, and what the client may see.
How is neurofeedback used clinically?
Think of it as regulating central nervous system-related problems or “dysregulation”. It’s commonly used for ADD, ADHD, depression, anxiety, attachment disorder, autism, panic attacks, peak performance, traumatic brain injury or concussions, seizures, and sleep problems. You often train differently for different problems.
How many sessions are needed?
That’s like asking how many times you need to go to the gym before you get in shape? The answer is different for everyone. It could be 10 visits, or it could be 40. Most people know within 6 sessions whether or not neurofeedback is going to work for them.
How long is each session?
Total session time is usually 30 minutes. There may be some variance depending on the type of equipment or software used, and 30 minutes is a safe average.
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 is standardly regarded as the minimum.
When do you stop the training?
We recommend not stopping training the minute symptoms get better. It takes some time for the brain to learn a new habit. By continuing to train a few sessions after you’ve noticed consistent and reliable improvement, you turn the healthier patterns into a new brain habit.
How long before I notice changes from the training?
Many people begin to notice changes within six sessions. Sometimes the client doesn’t notice changes, but people close to them do.
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?
Can it be used while a patient is on medication?
Clinicians report that more than half their neurofeedback clients start neurofeedback while taking one or more medications. After training for a while, it is often possible to reduce medication under appropriate supervision.
When doesn’t neurofeedback work?
Just as physicians and psychologists vary in their effectiveness based on their training, knowledge, and people-skills, the same is true of neurofeedback practitioners. Very few things help everyone. While neurofeedback helps, on average, 80% of people who try it, sometimes it just doesn’t work.
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 specific goal set for the 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.
Do insurance companies reimburse for neurofeedback?
There are ways to code neurofeedback that are both accurate and help increase the chances of it being accepted by insurance.
What’s the right name: neurofeedback, EEG biofeedback, neurotherapy?
No one in the field has agreed to a single name. Several 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 some info about the various models.
Is neurofeedback experimental?
Neurofeedback has been around for a long time, and the field is constantly evolving. Neurofeedback devices are FDA-approved.
Are there FDA guidelines for neurofeedback instrumentation?
Yes. This is an evolving question, and 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 their availability.
Can anyone do neurofeedback, or do you have to be licensed?
There are nonlicensed 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?
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 research in neurofeedback.
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.
Which professionals use neurofeedback?
An estimated 2500-3500 health professionals now use neurofeedback, including psychologists, doctors, licensed social workers, educational psychologists, marriage and family counselors, and registered nurses.
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 helps clients reduce the use of medications, as well.
What do clients and 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 doctors recommending or offering neurofeedback?
Neurofeedback works very well in a clinical setting, but few physicians 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 of long-term adverse effects.
Can training occur at home? Can a parent or individual do brain training at home with limited experience?
It was formerly very difficult to have good results with home training. With more tools available, newer technologies, and more demand, there are situations for which it is appropriate. It should be done with caution and in conjunction with a qualified neurofeedback provider.
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 and 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 their 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 less clear, and improvements can still occur.
How is brain imaging and cognitive neuroscience impacting neurofeedback?
What part of the brain do you train? As new data is published daily about imaging studies, we learn more important clues about how to best treat the brain.
Why is neurofeedback 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?