Ethics for Biofeeedback Providers is a distance based course intended for clinicians, educators, and coaches who have incorporated or are interested in incorporating biofeedback (including neurofeedback) intervention and psychophysiological assessment techniques into their practices. It emphasizes issues in ethics and professional conduct which are of special interest to clinicians incorporating biofeedback - many of which are not clearly spelled out in typical codes of ethics and conduct promulgated by clinical organizations.

Course Concept and Description: Participants attend three audiovisual lectures (hear the instructor’s voice while watching slides), read text files, and interact with the instructor via e-mail. At the end of the course, participants answer a set of short essay questions covering key concepts in the course. No text is required for this course.

Most participants require about five hours to complete the course including answering the end of course questions and interacting with the instructor. Participants start the course whenever they wish to and proceed through the course at their convenience for up to one year. This course does not replace the standard 45 hour (3 credit) ethics courses usually required for licensure and does not cover all areas of ethics usually covered by such courses.

Five optional lectures are included in the course (introduction to biofeedback and for lectures on what you need to know to do biofeedback). Attending these lectures adds about an extra hour to the course.

CE Credit: This is a continuing education, not a college based, regionally accredited, course. Our program is accredited (approved) by and CE credits are approved by (1) the American Psychological Association, (2) the state of California’s Boards of Psychology and Behavioral Sciences (Approval # PCE1895), and (3) The National Board of Certified Counselors (Provider # 6270).

The Behavioral Medicine R&T Foundation is approved by the American Psychological Association to sponsor continuing education for psychologists. The BMR&T Foundation maintains responsibility for this program and its content.

• 1. Defining biofeedback and clinical psychophysiology – knowing what biofeedback actually is and what it is not. (Includes optional “introduction to BFB” lecture.)
• 2. Training required to ethically and knowledgeably provide biofeedback based services even in cases where a state license includes biofeedback as a practice modality. Includes a discussion of needing to understand how the equipment works, how the body works relative to the signals being fed back, and relationships between specific, diagnosable conditions, and the feedback signal. (Includes optional “what you need to know to do biofeedback” lecture.)
• 3. Ethical considerations in charging for non-validated biofeedback based interventions. This includes a discussion of standards for accepting an intervention as efficacious, FDA labels of biofeedback devices, etc.
• 4. Patient Rights. This topic includes (a) informed consent for biofeedback based interventions and psychophysiological assessments, (b) patient privacy, (c) abandonment, (d) duty to protect, & (e) record keeping.
• 5. The need to understand the effects of medications on symptoms treated with biofeedback and on the biofeedback signal.
• 6. Who can use biofeedback devices as part of therapy – the issue of FDA limitations on prescription of biofeedback devices, technicians running biofeedback sessions, billing issues, etc.
• 7. Applying the biofeedback sensors – can you touch the patient? When do you need a chaperone?
• 8. Conflicts of interest in charging for home practice aids as part of biofeedback therapy.
• 9. Issues in advertising biofeedback based services.
• 10. Ethical principles promulgated by the Biofeedback Certification Institute of America. The discussion includes overlap between and precedence of ethical principles promulgated by BCIA and profession based groups such as the APA.

Learning objectives: The course objective is to familiarize participants with the key ethical considerations and issues in professional conduct involved in providing biofeedback based interventions and clinical psychophysiological assessments which are frequently not covered adequately in traditional ethics courses.

This course is designed to help you (the student):

• 1. Apply an understanding what biofeedback and psychophysiological recording are to your interventions.
• 2. Recognize the training you will need to ethically and knowledgeably incorporate biofeedback based interventions and psychophysiological assessments into your practice.
• 3. Develop knowledge based decisions on incorporating validated and unvalidated interventions into your practice and charging for them.
• 4. Recognize the importance of understanding how medications (a) cause symptoms of the type commonly treated with biofeedback and (b) affect the signals.
• 5. Develop appropriate informed consent and treatment explanation documents.
• 6. Determine the extent to which you can apply sensors and when you need a chaperone.

Format: Home study supported by e-mail chats. The lecture portion of the course is presented through two audiovisual lectures in which you hear the instructor’s voice and watch power-point slides.

You will receive a CD containing three required and several optional audiovisual lectures as well as several texts files. Each lecture is about one hour long. It will take you about five hours to do the reading, attend the lectures, interact with the instructor (for a maximum of one hour total), and fill in the short essay questions at the end of the course.

The end of course short essay questions cover the key concepts covered during the course and must be answered correctly for you to receive credit for the course. When all questions are answered correctly, a course completion certificate will be e-mailed to you. There is no other “exam” for the course.

Accessibility: Hearing impaired people can view the slides only as virtually all of the material presented in the lectures is typed onto the slides. Visually impaired people can concentrate on the verbal lectures as the slide material is repeated in the lecture accompanying each slide.

Getting Started: Course schedule: The course CD will be mailed to you upon receipt of payment. You can begin at your convenience and progress through the course at your own pace for up to one year.

The course is presented by Dr. Richard Sherman, Ph.D. He is certified by BCIA (the Biofeedback Certification Institute of America), approved by BCIA to teach the general biofeedback certification and other courses, and currently teaches A&P, Pelvic floor disorders, pain, and other courses for the Behavioral Medicine R& T Foundation. Dr. Sherman was assistant chair of the Human Use Committees at several medical centers for many years so is very familiar with ethical issues. He is a professional psychophysiologist with extensive training (his Ph.D. is in biology / physiology), has nearly 30 years of experience in the field, and has published over 130 books, chapters, and articles (mostly in peer reviewed journals). Dr. Sherman is Dean of the psychophysiology doctoral program at the University of Natural Medicine and has held many positions within the Association for Applied Psychophysiology and Biofeedback including president. Full CV available upon request and on the course CD.