In response to recent news media outlets which have misrepresented our field, the International Society for Neurofeedback and Research (ISNR) wishes to set the record straight.
February 02, 2017 (updated 02-06-2017)
Neurofeedback (NF), or EEG biofeedback, has been practiced for well over four decades. Hundreds of thousands of individuals and families impacted by various mental health and/or neurological conditions have benefited greatly from this powerful, effective, established, and proven intervention. NF is relatively non-invasive and creates lasting results in stark contrast from the outcomes derived from pharmaceutical treatment for a wide variety of conditions. We estimate over 15,000 clinicians, world-wide are using this technology. The represented professions are inclusive of: psychology, counseling, social work, marriage and family therapy, nursing, neurology, pediatrics, rehabilitation medicine, physical therapy, occupational therapy, naturopathic medicine, speech and language pathology, chiropractic, psychiatry, child and adolescent psychiatry, and family medicine.
Many practitioners of NF are certified through the Biofeedback Certification International Alliance (BCIA; bcia.org) which certifies individuals who meet specific education and training standards. NF certification requires a minimum of 36 hours of didactic training, passing a written exam, 25 hours of mentoring, 10 case reviews, performing 100 hours of client sessions, and 10 hours of personal NF. Further, BCIA certificants attest that they are either licensed clinicians or working under the supervision of a licensed clinician.
Contrary to claims that NF is insufficiently supported by research, here are links to a sample of just five rigorous scientific studies that provide solid evidence of the effectiveness and power of NF for attention-deficit/hyperactivity disorder (ADHD):
Arns, M., de Ridder, S., Strehl, U., Breteler, M., & Coenen, A. (2009). Efficacy of neurofeedback treatment in ADHD: The effects on inattention, impulsivity and hyperactivity: A meta-analysis. Clinical EEG and Neuroscience, 40(3), 180-189.
Coben, R., Wright, E. K., Decker, S. L., & Morgan, T. (2015). The impact of coherence neurofeedback on reading delays in learning disabled children: A Randomized controlled study. NeuroRegulation, 2(4), 168-178. doi:10.15540/nr.2.4.168
Micoulaud-Franchi, J-A., Geoffroy, P. A., Fond, G., Lopez, R., Bioulac, S., Philip, P. (2014). EEG neurofeedback treatments in children with ADHD: An update meta-analysis of randomized controlled trials. Frontiers in Human Neuroscience, 8(906), 1-7.
Steiner, N. J., Frenette, E. C., Rene K. M., Brennan, R. T., & Perrin, E. C. (2014). In-school neurofeedback training for ADHD: Sustained improvements from a randomized control trial. Pediatrics, 133(3), 483-492. doi: 10.1542/peds.2013-2059.
Wigton, N. L., & Krigbaum, G. (2015). Attention, executive function, behavior, and electrocortical function, significantly improved with 19-channel z-score neurofeedback in a clinical setting: A pilot study. Journal of Attention Disorders, [e-pub ahead of print].
Moreover, as can be found in the ISNR Comprehensive Bibliography (www.isnr.org/resources), ISNR’s official peer-reviewed scientific journal NeuroRegulation (www.neuroregulation.org), and the archives of ISNR’s Journal of Neurotherapy (www.isnr-jnt.org), the research literature is substantial. For example, 1,447 peer reviewed journal articles are cited in the National Library of Medicine when using the search terms: ‘EEG Biofeedback’, and in recent years there has been exponential growth in publications related to neurofeedback.
This literature documents the efficacy of NF for numerous conditions, inclusive of: ADHD, mood disorders, anxiety disorders, obsessive compulsive disorder, epilepsy, substance use disorders, PTSD, autism, learning disorders, brain injury, insomnia, and headaches. While there are a few randomized trials showing that NF is equivalent to a placebo, there are a larger number that demonstrate greater efficacy. Moreover, the number of randomized controlled trials showing efficacy are being published with growing frequency. For example, this study by Bessel van der Kolk, M.D. and colleagues was recently published in December 2016:
van der Kolk, B. A., Hodgdon, H., Gapen, M., Musicaro, R., Suvak, M. K., Hamlin, E., & Spinazzola, J. (2016) A Randomized Controlled Study of Neurofeedback for Chronic PTSD. PLoS ONE 11(12): e0166752.
Much of the research indicates that NF is frequently used as an adjunct to traditional treatments such as stimulants for ADHD, and it’s rare that NF is the only intervention. However, research and clinical evidence shows repeatedly that when NF is added to other therapies the outcomes are typically superior.
Further, there are established CPT codes for insurance reimbursement of biofeedback, as NF is a type of biofeedback, which have been in place for close to 40 years; for which many insurers do reimburse.
Our Resource List on the ISNR website (www.isnr.org/resources) provides a myriad of resources for professionals and the general public to learn more about NF and what it has to offer; such as an Overview of NF, a Toolkit for NF as an evidence-based treatment for ADHD, Practice Guidelines, and a recommended reading list.
The real fallout from inaccurate and erroneous coverage of NF is the lack of options provided to millions of Americans who suffer from the numerous conditions which NF can address, and aren’t even yet aware that research-based, effective neuroregulation techniques are available to reduce their suffering. Furthermore, it is important for the public to be accurately informed and discriminating when selecting their care. But equally important is the responsibility of our media sources to provide fair and balanced reporting so that we don’t limit choice and block access to legitimate interventions.
To learn more about Neurofeedback, visit our Overview of Neurofeedback page, where you will find a short video, an introduction to the equipment and process, and definitions of Neurofeedback and Biofeedack.
See the original article In Defense of Neurofeedback