What is Biofeedback and Neurotherapy ?
Neurofeedback is a specialized form of biofeedback, with which many people are already familiar. Biofeedback methods such as EMG (muscle relaxation), GSR (galvanic skin response), HRV ( Heart Rate Variability), temperature and respiration training have been in use by health professionals for many years. In the last few years, however, EEG (electroencephalogram) neurofeedback has become the fastest growing segment of the biofeedback field. While neurofeedback reduces stress and is relaxing, as are other modes of biofeedback, this method provides a more direct and lasting impact on brain regulation along with central nervous system function.
Neurofeedback uses computerized feedback to allow individuals to "teach" their brains to increase certain brainwaves that are helpful for improved function. With training, people can train their brains to decrease excessive fast or slow brainwaves that interfere with optimal functioning. For example, if someone has excessive amounts of certain EEG frequencies (e.g., theta or alpha) in the frontal lobes of his/her brain, he/she might experience depression or obsessive-compulsive symptoms. By training the brain to reduce slower brainwaves and increase faster brainwave activity, symptoms are often reduced in severity and frequency and, over time, the new brain behavior is "learned." Too much of the faster brainwaves (beta) in the frontal part of the brain can result in increase in anxiety and panic. Neurofeedback can be quite helpful in reducing these conditions.
How is Neurofeedback being used clinically ?
Neurofeedback, psychotherapy, and medications work hand-in-hand, and training can be used for people on or off medications. Of considerable significance is that, after 30 years of research and clinical use, no lasting negative side effects of this procedure have been documented. While the training does not directly change sleep or other problems, it does help the brain regulate sleep, emotions, thinking, and behavior more effectively. When the brain is given information about itself, it has an enormous capacity for change. Neurofeedback makes the information available to the brain almost instantly, and asks it to make adjustments, a process which gives the brain an improved ability to self-manage or regulate.
The most common problems for which neurofeedback is being used clinically include ADD/ADHD, depression, bipolar disorder, anxiety, panic attacks, PTSD, anger and rage, dissociative disorders, and conduct disorder. Neurofeedback is also being used to reduce the impact of cognitive impairment suffered by people with traumatic brain injury and stroke, reduce the incidence and intensity of migraine headaches, improve sleep, improve the functioning of patients with autism and other pervasive developmental disorders and reactive attachment disorder, decrease alcohol and drug abuse, and treat epilepsy. Over 2000 health professionals are using Neurofeedback in their practices, the majority being mental health care providers, although increasing numbers of physicians, licensed nurses, and other medical professionals are using the procedure as well.
How does the process work ?
The neurofeedback procedure uses a special EEG (brainwave) monitor and software set up with a computer. Electrodes are placed on the scalp (a completely painless process) to record the client’s brainwave activity, and the client is then given visual and/or auditory feedback, such as that provided by a specially designed computer game. As certain brainwave frequencies increase or decrease, the client gets increased or decreased feedback, including auditory, visual, and tactile feedback.
The clinician undertakes a comprehensive assessment of reported symptoms, often combined with standardized testing. This assessment data is used to identify sites and frequencies at which to train, based on models that correlate assessment data with brain function. After this data is obtained and analyzed, electrodes are placed over specific sites in the brain, and training may include increasing certain brainwave frequencies and/or decreasing others at specific sites. Auditory and/or video feedback rewards the client when he/she meets training goals (i.e., produces more or less of a specific EEG frequency) determined by the clinician.
Training sessions are 50 minutes in length. The therapist tracks client outcome and makes training adjustments accordingly. The training, which produces more effective brain regulation, is a generalized effect, meaning that the client doesn’t have to "think about" the training to get the effect. The client’s brain simply responds better to demands when it is in a demanding situation.
While noticeable effects typically occur between the first and tenth sessions, in most cases therapists recommend a minimum of 25 sessions, the goal being to complete enough training to insure consistent and lasting benefits. Initially,one or two sessions a week may be recommended, although the frequency depends upon the individual being treated. In general, therapists report that the benefits of training hold long after training is completed. New research on the duration of treatment effects is being carried out regularly, and published research on ADD/ADHD shows the effects on behavior and attention hold well as long as 12 months and longer post training.
Do health insurance companies reimburse for biofeedback and neurotherapy ?
Most insurance companies, HMO’s, and PPO’s pay directly for neurofeedback, if it is done as a part of a comprehensive therapy program.
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