Introduction to Neurofeedback
The process of Neurofeedback is simple. It is a way to train the brain to be more relaxed, calm, alert, and focused. Sensors are placed on the scalp and they record brainwave activity. This information is transferred to the computer. When the software recognizes the client becoming more relaxed, calm, alert, and focused, the software plays video and sound. As soon as the client loses focus or becomes anxious, the video and sound stop playing. The client practices how to be more focused, calm and relaxed during the sessions.
The Neuros Centre in Barcelona has a great introduction video to Neurofeedback:
For a more detailed and technical explanation, please read the sections below.
What is Neurofeedback?
Neurofeedback (also known as EEG Biofeedback) is an evidence-based treatment to help regulate electrical brainwave activity to reduce the severity of symptoms that may result from an imbalance. The process of Neurofeedback is similar to how a speedometer works. A speedometer provides information about how fast a car is going at a given time. A driver uses this information to regulate their speed when they are traveling in different areas, such as a school zone or highway. The speedometer’s feedback can then be used by the driver to determine if they are going too fast or too slow, allowing them to regulate their speed accordingly.
Neurofeedback uses this same approach, but by giving the client information about their brainwave patterns. If their brainwave patterns are too fast or too slow, Neurofeedback provides information to help regulate this activity to achieve an optimal state for the demands of the situation. Remember, a speedometer does not increase or decrease the speed of a car. It’s merely a tool that enables the driver to regulate their speed. In the same way, Neurofeedback helps the client gain better control over their brainwave patterns and gives them a greater flexibility over their functioning.
How Does Neurofeedback Work?
Neurofeedback is based on the principles of operant conditioning. Operant conditioning is a type of learning where certain behaviours are rewarded to increase the chance of them occurring. For example, we may want to reward a calm, focused, mental state for a client who struggles with ADHD symptoms.
When the trainee enters this mental state, they are rewarded with visual and audial feedback through computer software. Participants are given instant feedback when they are no longer in the desired mental state, as the audial and visual feedback stops or is altered. Through practice, the desired mental state becomes easier to enter, maintain, and recognize.
As a result the trainee improves their ability to self-regulate their mental states. Clients learn to better understand themselves and what it means to be focused, calm, relaxed, and alert. Neurofeedback also takes advantage of the concept of neuroplasticity, the concept that the brain can restructure and reorganize itself in response to learning or other activities (for more information, we recommend reading The Brain That Changes Itself and The Brain’s Way of Healing). Neurofeedback is essentially a learning process. Information about the brain’s processing is displayed to the client and the brain adapts and improves as it learns to modify its functioning.
This method is very similar to the way we learn how to ride a bicycle. Riding a bicycle can be challenging because it is difficult to learn how to balance. No coaching or tips can significantly help you learn faster; you need to experience what being balanced feels like. The vestibular apparatus in our inner ear is responsible for our sense of balance, as it relays our body’s state of balance to our brain. This information allows us to modify our body position so that we can balance. Once we have learned to regulate our balance, riding a bike is easy.
Neurofeedback uses the same concept to teach the brain how to remain calm, focused, relaxed, and alert. Training provides clients an opportunity to exercise their ability to enter, recognize, and maintain the desired state. When enough training is done, the client improves their ability to self-regulate their brainwaves and mental state.
What does a Neurofeedback Session Look Like?
To be able to measure and evaluate your brainwave patterns, you’ll be connected to EEG leads that will transmit information related to brainwave patterns to the computer software used for training. Following a preliminary baseline assessment to evaluate your resting brainwave states, the software parameters are set to optimize your brain’s potential.
During a session, the software measures your brainwaves while providing audio and visual feedback via various animations and music to indicate when your optimal brainwave patterns are detected. Conversely, this feedback will stop when these brainwave patterns are suboptimal (potentially as a result of being distracted or daydreaming). Over the course of a one hour session twice a week, the client trains to improve their brainwave patterns and over time this causes the brain to shift into a healthier pattern of functioning.
Who is a good candidate for Neurofeedback?
Populations suffering from mental health conditions such as ADHD, Anxiety, Depression, and Stress may be good candidates for Neurofeedback. but could benefit from being more calm, focused, relaxed, and alert. This includes students, executives, and athletes.
Good candidates also include people who wish to improve their symptoms without the use of medications or in order to reduce their dosages. That is not to say that drug therapies should be avoided. Initially, drug therapies may be necessary as a short-term solution to reduce the severity of symptoms. Neurofeedback has been seen to produce long-lasting changes (See the Research section for more information). For those looking for a long-term solution without the constant use of medication, Neurofeedback training may be the best option for them.
Moreover, Neurofeedback gives the trainee an active role in managing their symptoms. This can be empowering for clients as they are not only developing self-regulation , but the brain is also learning to improve its function. Conversely, the role of medication is more passive, as no learning occurs during this process.
Frequently Asked Questions (F.A.Q)
1) Does Neurofeedback work?
Neurofeedback has demonstrated efficacy for multiple conditions. The most research in the literature has been conducted for ADHD and Seizure Disorders. An increasing amount of research is being published for Neurofeedback in the treatment of Anxiety, Depression, Concussions and Traumatic Brain Injury (TBI), Post-Traumatic Stress Disorder (PTSD) and Trauma, and Optimal Performance clients. See the Research section for more information.
2) Will this treatment work for me?
It depends on your current situation, diagnosis, and training goals. After a detailed assessment and clinical interview, we can decide if you are a good candidate for training. We would then move forward and design a personalized program to help you achieve your training goals.
3) How many sessions will it take for changes to occur?
This depends on your training goals. Generally, clients observe changes between the 10th to 20th session. We have to remember that Neurofeedback is a learning experience. Everyone learns at a different pace and have different criteria for change.
4) How many sessions must I complete in total?
Trainees usually complete 40 sessions though more may be required depending on their training goals. Certain optimal performance clients (executives, athletes, and students without a diagnosis) may meet their goals at the end of 20 sessions. More complex cases may take more than 40 sessions of training. After specific training goals are achieved, new training goals can be defined, and a new training program can be created.
5) Can I continue to take medication while completing Neurofeedback training?
Yes. We only ask that the trainee stops taking medication during assessments as it does affect their EEG recordings. As the client progresses through the training, the dosage of medication may need to be reduced.
6) Is Neurofeedback training covered by insurance or extended health care benefits?
Psychological assessments and reassessments are covered by most insurance companies. Biofeedback and Neurofeedback training may be covered by certain insurance companies for certain conditions. Insurance companies may cover treatments plans approved by a clinical psychologist. Please inquire with your extended health care benefits company and we will do our best to work with them.
7) If Neurofeedback training works so well, why haven’t I heard of it?
The most common form of intervention for mental health conditions is medication. The pharmaceutical industry has the money and power to advertise where Neurofeedback does not. This is changing as more research is being published to advocate for the efficacy of Neurofeedback. See http://www.isnr.org/ and http://www.aapb.org/ for more information.
8) Are there an risks/side effects associated with training?
Neurofeedback is a non-invasive treatment modality that focuses on teaching individuals to regulate their electrical brainwave activity. No research to date has reported any negative side-effects from Neurofeedback training. Neurofeedback training programs are designed so that only positive, optimal brainwave patterns are reinforced. No negative or unwanted brainwave patterns can be created in this way. As the training progresses, the trainee may notice that the side-effects of their medication are becoming more prevalent (if they are on medications). This indicates that their brain functioning is becoming optimal.
9) Can Neurofeedback training help me if I don’t have a diagnosed condition?
Neurofeedback and Biofeedback techniques are also used in Peak Performance settings to help improve an individual’s level of calm, focus, relax, and alert. This type of training is used for athletes, executives, and students who aim to achieve greater success in their respective disciplines.
10) What age ranges are the best candidates for Neurofeedback Training?
Neurofeedback relies on concept of neuroplasticity, which states that the brain can alter its function and reorganize itself in response to learning and other events. Neuroplasticity tends to decrease as you age, so younger clients tend to progress the quickest. This is why it is easier to learn a language or skill early in life as opposed to when you are older. The most common age ranges for training are 8-24 years old. Older clients (55 years of age and over) may need a few more sessions to achieve certain training goals.
11) Why not use medication?
Initially, drug therapies may be necessary as a short-term solution to reduce the severity of symptoms. Medication may not be a viable long-term solution for some. If medication is discontinued, symptoms reappear because no learning has occurred. Due to the numerous side-effects associated with the medication, non-pharmacological options may be a better option. As training progresses and symptomatology improves, medication may need to be reduced or removed completely.
12) Are the results from Neurofeedback Training permanent?
Follow-up studies have been conducted for children who received Neurofeedback training and they indicate that their training progress was sustained years after training was completed in most cases. Please visit our Research Section for more information.
13) Does Neurofeedback training hurt?
Neurofeedback training is a non-invasive treatment modality and does not hurt. Electrodes are placed on to the head and ears in a comfortable manner. Clients may feel fatigued at the end of a session because Neurofeedback is essentially a workout for your brain. The trainee is practicing self-regulation, and they may feel tired after a session.
14) What does a client do during a Neurofeedback training session?
Each of our clients is paired with a Neurofeedback mentor who works with the client on a one-on-one basis. After a baseline recording of the trainee’s brainwave patterns is taken, the client begins training their focus and concentration. Complex Neurofeedback software is used to give the client feedback when they are relaxed, alert, and focused. The client gets multiple chances to practice achieving this state. After each round, the mentor gives the client feedback and explains their scores related to their brainwave patterns. This is reviewed at the end of the session with the parents as well. The clients also complete tasks related to their training goals during the session. This can take the form educational games, puzzles, reading comprehension, or other metacognitive strategies to test the client and help them grow.
Please note that services are not covered under OHIP, but may be covered by insurance or extended health care benefits.