Neurofeedback is direct training of brain function, by which the brain learns to function more efficiently. We observe the brain in action from moment to moment. We show that information back to the person. And we reward the brain for changing its own activity to more appropriate patterns. This is a gradual learning process. It applies to any aspect of brain function that we can measure. Neurofeedback is also called EEG Biofeedback, because it is based on electrical brain activity, the electroencephalogram, or EEG. Neurofeedback is training in self-regulation. It is simply biofeedback applied to the brain directly. Self-regulation is a necessary part of good brain function. Self-regulation training allows the system (the central nervous system) to function better.
Neurofeedback addresses problems of brain disregulation. These happen to be numerous. They include the anxiety-depression spectrum, attention deficits, behavior disorders, various sleep disorders, headaches and migraines, PMS and emotional disturbances. It is also useful for organic brain conditions such as seizures, the autism spectrum, and cerebral palsy.
How Does Neurofeedback Work?
We apply electrodes to the scalp to listen in on brainwave activity. We process the signal by computer, and we extract information about certain key brainwave frequencies. (All brainwave frequencies are equal, but some are more equal than others...) We show the ebb and flow of this activity back to the person, who attempts to change the activity level. Some frequencies we wish to promote. Others we wish to diminish. We present this information to the person in the form of a video game. The person is effectively playing the video game with his or her brain. Eventually the brainwave activity is "shaped" toward more desirable, more regulated performance. The frequencies we target, and the specific locations on the scalp where we listen in on the brain, are specific to the conditions we are trying to address, and specific to the individual.
Who Provides Neurofeedback?
Neurofeedback (EEG Biofeedback) is typically provided by mental health professionals such as psychologists, family therapists, and counselors. These professions usually work with clients one-on-one. The training may also be provided by nurses, clinical social workers, rehabilitation specialists, and educators. MDs also provide the service, but with the exception of psychiatrists will usually have the service provided by a trained staff person.
The EEG Directory is a great place to find a provider. You may search by zip code to locate a provider in your local area.
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Is Training Unique?
Over the years, certain neurofeedback (EEG Biofeedback) training protocols have been developed that are helpful with certain classes of problems such as attention, anxiety and depression, seizures and migraines, as well as cognitive function. There are a number of assessment tools we use to help us decide which protocols to use. These are simple neurodiagnostic and neuropsychological tests.
Is Neurofeedback a Cure?
In the case of organic brain disorders, it can only be a matter of getting the brain to function better rather than of curing the condition. When it comes to problems of disregulation, we would say that there is not a disease to be cured. Where disregulation is the problem, self-regulation may very well be the remedy. But again the word cure would not apply.
What Conditions Can it Help?
We are especially concerned with the more "intractable" brain-based problems of childhood whose needs are not currently being met. This includes, Seizures and sub-clinical seizure activity, Severely disruptive behavior disorders such as Conduct Disorder and Bipolar Disorder, Autistic spectrum and pervasive developmental delay, Cerebral palsy, Acquired brain injury, Birth trauma.
Many children have sleep problems that can be helped such as Bed wetting, Sleep walking, sleep talking, Teeth grinding, Nightmares, Night terrors.
We can also be helpful with many of the problems of adolescence including Drug abuse, Suicidal behavior, Anxiety and depression.
We can also help to maintain good brain function as people get older. The good news is that almost any brain, regardless of its level of function, can be trained to function better.
Do Training Effects Last?
If the problem being addressed is one of brain disregulation, then the answer is yes, and that covers a lot of ground. Neurofeedback involves learning by the brain and if that brings order out of disorder, the brain will continue to use its new capabilities, and thus reinforce them.
Matters are different when we are dealing with degenerative conditions like Parkinson's or the dementias, or when we are working against continuing insults to the system, as may be the case in the autism spectrum. In such cases the training needs to be continued at some level over time. Allergic susceptibilities and food intolerances make it more difficult to hold the gains. Poor digestive function will pose a problem, as does poor nutrition. A child living in a toxic environment (in either the physical or the psychological sense) will have more difficulty retaining good function.
What is the Success Rate of Neurofeedback?
Through our twenty years of experience with neurofeedback, we have reached the point of having very high expectations for success in training. When such success is not forthcoming, or if the gains cannot hold, then there is usually a reason for that which needs to be pursued. In the normal course of events, neurofeedback ought to work with everybody. That is to say, nearly everyone should make gains that they themselves would judge to be worthwhile. Our brains are made for learning and skill-acquisition. On the other hand, we are working with many families whose expectations have been lowered by their past experience. And they need to see progress before they will share our optimism. We understand that.
It turns out that among the vast majority of clients (>95% in one clinician's experience) the actual outcome exceeds the prior expectations. Against such low expectations, the changes that can be produced with neurofeedback may even appear miraculous. One EEG Biofeedback office has a sign on its front desk: "We expect miracles. If none occur, something has gone wrong." What appears miraculous in all of this is really nothing more than the incredible capacity of our brains to recover function when given a chance.
What about Medications?
With successful neurofeedback training, the medications targeting brain function may very well no longer be needed, or they may be needed at lower dosages, as the brain takes over more of the role of regulating itself. This decrease in medications is particularly striking when the medications play a supportive role in any event, as is often the case for the more severe disorders that we are targeting with our work. It is important for clients to communicate with their prescribing physician regarding neurofeedback and medications.
Is Neurofeedback Covered by Insurance?
There is an insurance code for biofeedback, under which neurofeedback is covered. And there are codes for combining psychotherapy with biofeedback / neurofeedback. However, coverage for chronic mental health concerns is rarely adequate in the United States, so parents may have to advocate strongly with their insurance company for reimbursement.
This, more than anything else, makes it necessary for the Brian Othmer Foundation to exist.
What about Home Training?
Many of the conditions we address with neurofeedback involve long-term training, as the brain's capacity to function is gradually enhanced. For some children, neurofeedback may remain a useful challenge over their life span. To make this economically viable, remote training is an available option for parents. Remote training refers to home training under the (remote) supervision of a clinician. After parents have had their child trained with a clinician for at least twenty sessions, they may transition to remote training and continue on that basis, consulting with the clinician regularly to monitor progress and determine changes in protocol. Then training can be done frequently and consistently, on an affordable basis.