Short answer: no. Neurofeedback is an operant conditioning method, meaning we are using your brain’s own system of conditioning to create changes in the way your brain behaves. Typically, the worst outcome of a bad neurofeedback session is feeling overly wired or overly tired.
The long answer: it is possible. If the person administering neurofeedback is not experienced or credentialed and has not taken an appropriate assessment, such as a brain map and an intake, they are essentially flying blind. Many pathologies show up with various profiles and presentations in the EEG. It is imperative that the patient researches the competency of their clinician and ensures they have the minimal credentials in the field of neurotherapy before allowing them to do brain work.
Short answer: Yes. Neurofeedback, which is a means of rewarding the desired brainwave activity or inhibiting problematic brainwave activity with auditory or visual feedback works. How well it works is contingent upon the competency of the practitioner, as well as the tools they have at their disposal. Imagine going to a doctor who hadn’t updated any of his equipment in 30 years, and was practicing with old techniques and assumptions. This would be troublesome and possibly dangerous for the patient. The same goes for neurofeedback. The field of neurofeedback has been around since the 1970s, and many clinicians received their training in the early 1990s with simplistic modalities. The patient ought to expect their clinician regularly attends trainings and keep his/her equipment up to date, as well as his/her clinical perspectives.
Neurofeedback abetted by neurostimulation is a faster, and cutting-edge method wherein the clinician first shows the brain what it ought to do (i.e. make theta frequencies), then follows up later with neurofeedback, as a conditioning tool. This one-two approach is a solid and reliable way to impact change in the brain.
First, the clinician gets an assessment of the client’s brainwave patterns, through a brain map. They also assess the patient through an intake process. Then, they determine what patterns and behaviors in the brain are creating the problem. A classic example is a traditional Attention Deficit Disorder case, where there is too much theta (daydream, hypnogogia, trance-like) and not enough beta (active, conscious thinking). This client has a high theta / beta ratio. The clinician would then determine the source and location of the excess theta and would downtrain (encourage suppression) of the excessive theta brainwaves, while uptraining (encouraging greater amplitudes) of beta brainwaves. This is done using electrodes or a full 19-channel EEG cap. By programing their software for this particular patient, the clinician can reward (via visual or auditory feedback) the optimal state of low amplitude theta brainwaves and high amplitude beta brainwaves, which will lead to a permanent state where the brain knows how to produce more beta and less theta, on a consistent basis. The result, in this example, is a decrease in the attention deficit symptoms due to excess theta, allowing the individual greater focus, clarity, and presence in their functioning.
Short answer: yes. Neurofeedback lasts if the duration of training was long enough and if the training was frequent enough. Neurofeedback training is similar to going to the gym. You are trying to alter the functioning of your brain permanently. If you are seeking change, multiple times at the gym, per week, is recommended.
We typically train our clients anywhere from 3-5 times per week in the beginning of their training (once per week is akin to going to the gym once per week and expecting change). Once we have a few weeks of intensive work under our belts and we are seeing changes, we can begin to titrate back the training regimen to twice per week, then once per week, and eventually once per every other week, until the client’s training has completed.
After the initial course of training, the occasional neurofeedback tune-up may be desired, but is typically not necessary.
If neurotherapy is like going to the gym, then neurofeedback is like weight training and neurostimulation is like cardio vascular exercise. We often begin our clients with cardio for the first few sessions. This primes their system and has an immediate, noticeable effect for most. It is a way to show the brain what we want it to do on its own.
Once we have a few sessions of neurostimulation, we begin adding in neurofeedback. Neurofeedback is the strength training that conditions the brain. The combination of neurostimulation and neuromodulation is a complete training regimen that speeds up the progress and the duration of treatment.
Yes. There is a frequently updated bibliography that is maintained by the International Society for Neurofeedback Research. https://www.isnr.org/isnr-comprehensive-bibliography
One difficulty with neurofeedback research is that nearly all pathologies have different profiles. There is no thing as a one size fits all treatment approach. In addition, it takes a trained clinician to determine the appropriate treatment for each individual.
Neurofeedback, also called EEG biofeedback, is a way of training the behavior of the brain (in terms of the amplitudes of certain brainwaves, or the connectivity dynamics of the brain). The tools used are EEG equipment (electrodes, differential amplifiers) and any kind of feedback (usually tones or video feedback). It is used for a variety of psychopathologies and physical pathologies.
Once the clinician determines how the problem manifests in the brainwave, using EEG measurement equipment, they can then encourage or discourage different behaviors from the brain by rewarding or punishing different EEG behaviors. After a certain number of sessions (typically between 20 and 40) the brain has learned to operate differently, leading to different behaviors and experiences of life.
tACS is transcranial alternating current stimulation. It is a form of electrical stimulation that uses two electrodes (a positive electrode called an anode and a negative electrode, the cathode) to pass current back and forth through either the brain or the body. This technology is engineered, developed, and sold through Neurofield, Inc.. Clinicians in our clinic, as well as in clinics all over the world use this stimulation device to help their patients heal, recover, and change the behavior of the brain and their bodies.
tDCS is transcranial direct current stimulation. It is a form of electrical stimulation that is used to treat many conditions and pathologies, both in the brain and in the body. The technology uses a positive and a negative electrode (called the anode and the cathode, respectively). Direct current passes a one-way current through the brain or the body. In the brain, a surge in calcium ions and in sodium ions creates a condition of neuroplasticity, which makes the brain more susceptible to neurofeedback and pEMF conditioning.
tRNS is transcranial random noise stimulation. It is a form of electrical stimulation that is used to treat many conditions and pathologies, both in the brain and in the body. The technology uses a positive and a negative electrode (called the anode and the cathode, respectively). Alternating current similar to white noise (like the fuzz of a television screen) passes back and forth at the desired frequency through the brain or the body.
pEMF is pulsed eletromagnetic field therapy.
A Quantitative EEG is a brain map. A brain map uses your brain waves (EEG) to determine how you vary from the normal population of men or women your own age. After the EEG technician gets your eyes open and eyes closed EEG data, they then process it through a normative database. This database of healthy individuals, without pathology of any kind, is used as a basis of relativity for your brainwaves. A brain map will assess the activity of your brain by assessing measures of power (read in amplitude of brainwaves) and connectivity (read in measures of coherence and phase relationships). Your clinician will then read the QEEG brain map and determine how your symptoms are present in the brain map. It is important you work with a credentialed clinician, who is certified in neurotherapy (Board Certified in Neurotherapy) and brain map interpretation (Quantitative EEG Diplomate).
Short answer: no.
Longer answer: You’re wise to seek a credentialed provider (this means they already have a health care license). If you’re looking to become a neurofeedback provider, you’re advised to become credentialed for the safety of your clients, as well as yourself. The clinicians in our clinic are not only Board Certified in Neurotherapy and Neurofeedback, but they are also Quantitative EEG Diplomates (meaning their interpretation of brain maps is valid and legitimate). Furthermore, they are all licensed health care practitioners in the field of psychology at the doctoral level.
To become credentialed as a neurofeedback clinician, you must first have a health care license for independent practice (if you are going to work on medical or psychological disorders). If you do not have a licensed, you have to work under a supervisor.
The following fields are approved by the credentialing board (the BCIA): medical doctors, nursing, psychology, physical therapy, social work, rehabilitation, chiropractic, occupational therapy, counseling, physician’s assistant, speech pathology, sports medicine, exercise physiology, music therapy, and counseling education.
To be a neurofeedback clinician you must have a degree in a health care related field. These include: nursing (not LVNs or LPNs), psychology, physical therapy, social work, occupational therapy, counseling, rehabilitation, chiropractic, exercise physiology, sports medicine, speech pathology, physician’s assistant (with certification or license), recreational therapy, sports medicine. Appropriately credentialed MDs are accepted, too. For more information, visit the Biofeedback Certification International Alliance at www.bcia.org.
You need to have a health care license or credential to independently practice neurofeedback. Without a license or credential, you must agree to work under the supervision of a health care professional who is appropriately credentialed to practice neurofeedback. This is mandatory when working with a medical or psychological disorder. Your supervisor should have training and experience with neurotherapy.
Neurotherapy is a combination of neurofeedback and other modalities. In its most commonly used sense, neurotherapy is a combination of neurofeedback and neurostimulation, such as pulsed electromagnetic field therapy (pEMF), Transcranial Direct Current Stimulation (tDCS), Transcranial Alternating Current Stimulation (tACS), and repetitive Transcranial Magnetic Stimulation (rTMS).
Stimulation, as well as training the brain (via neurofeedback) changes functional connectivity, as well as the emergent properties of the brain (DeRidder, 2014). The integration of stimulation and neurofeedback is currently (as of 2016) new in the field, and a minority of practitioners are using these modalities blended. Quantum physicist and EEG neurodiagnostician Juri Kropotov dubbed these combined technologies “neurotherapy,” given that feedback is not involved in stimulation technology.
The neurotherapist is a clinician who uses psychophysiological measures, such as quantitative EEG, to assess the client, and later treats the client with applied psychophysiology (i.e. neurofeedback, neurotherapy, and biofeedback).