How to squeeze the magic from biofeedback
In earlier articles we have looked at what can be achieved with the diligent application of biofeedback and neurofeedback. We have expalined why biofeedback therapy is a misnomer to us. In this article we spell out what we see as the requirements for effective biofeedback and neurofeedback.
As a relatively new field it is not always clear what the limitations are or the advantages are. Also there are a variations in equipment quality and in the level of training and expertise of practitioners. That being the case what are the foundations?
Biofeedback and neurofeedback can have some major advantages over the traditional use of pharmaceuticals. Methods and product in the neurofeedback field are unfortunately not always consistent in their level of quality and good scientific evidence is not always available.
Among the promoted methodologies, there are some EEG training methods, based on controversial ideas and promoted by a single person or company, without at present good evidence to support the approach.
In other cases low cost biofeedback hardware has appeared on the market, where the signals are mostly poor and contain a lot of measurement artifact. These systems are like toys and do not have any medical certification so should not be relied upon for clinical applications.
It is no surprise surely that the best foundations for a good biofeeback/neurofeedback practice are based on well trained personnel and high quality equipment. Here are our recommendations.
Recommendations for biofeedback practice
- Biofeedback and neurofeedback require a well-trained clinician or coach (depending on the intended application). Unlike most medication, which can be used without the supervision of a medical professional, a biofeedback or neurofeedback session won't be successful when the clinician does not know how to use the equipment or how to analyze and interpret the data. Clinicians should follow a (BCIA) certified training process so they can offer their clients the full potential of this approach.
- Biofeedback and neurofeedback require the dedication and motivation of the client. Some clients may not be motivated to go through the 'effort' of working on their own health; remember this is a training process that requires participation.
- Biofeedback and neurofeedback training take time. In order to be truly effective, a good number of sessions (5-10 for biofeedback and 20-40 sessions for neurofeedback training) may be required;
- Buy high quality equipment that is medically certified (CE Marked in Europe). Don't economize on the equipment. It might be tempting to get the cheapest system, but the quality of the equipment determines the quality of the treatment;
- Buy the equipment that meets the broadest requirement. The NeXus systems have ultra-wide band DC amplifiers, which means that they can be used for DC-EEG, ULF, SCP and classical frequency band based neurofeedback. This enables the clinician to measure and feedback brain activity from slow cortical potentials to Alpha, Beta, Gamma, Delta, Theta and SMR frequencies up to 100 Hz;
- Be selective. Only offer neurofeedback to clients for applications that are indicated with good scientific evidence of results; even though it is generally a safe approach, inappropriate application leads to disappointment, damages credibility of the field and damages the client's pocket
- Take one step at a time. We would suggest clinicians to start with biofeedback which is powerful in it's own right, rather than with neurofeedback since the latter is more complicated;
- Think multi-modal. We believe that the true power of this approach lies in combining neurofeedback with biofeedback. All NeXus systems are fully multi-modal and offer a full spectrum of neurofeedback and biofeedback functions.