Due to the rapid development over the last two decades of numerous brain-based technologies, healthcare professionals now have access to powerful tools that allow direct observation of the human brain’s functioning. But unlike CAT, PET, SPECT scans or fMRIs, neurotherapy is both a powerful yet cost-effective clinical tool for assessing and modifying human brain activity. In contrast to psychotropic medication which impacts chemical activity throughout the human brain, evidence-based neurotherapy approaches can identify specific brain structures and determine whether their functioning, alone or in conjunction with other brain areas, exhibit atypical patterns of activity that have been associated with emotional, behavioral, or psychological disorders. Once specific areas or patterns of dysfunctional brain activity are identified, neurotherapy can effectively modify the atypical activity creating positive and lasting results.
Neurotherapy has its foundations in basic and applied neuroscience as well as data-based clinical practice. It takes into account the behavioral, cognitive, and subjective aspects of an individual as well as their brain activity. The brain wave frequencies that are targeted during sessions are specific to each individual. There are no medications used and the procedure is completely painless and non-invasive.
Neurotherapy (also referred to as ‘neurofeedback’ or ‘EEG biofeedback’) uses monitoring devices to provide moment-to-moment information to an individual on the state of their physiological functioning, in particular, the central nervous system and the brain. Because the electrical activity in the brain is responsible for the control of our attention, thoughts, behaviors and the regulation of all of our bodily systems, any changes in brain function can have a broad impact. Brain mapping with quantitative EEG (qEEG) actually lets us see what specific brainwave irregularities are behind these and other disorders. Neurotherapy then allows us to train the brain to correct the irregularities as the brain learns about itself, strengthens neural networks, and develops better self-regulation.
In a typical neurotherapy session, sensors are placed on the head which begin to read the electrical brainwave patterns of the individual (or ‘trainee’). This information is then fed back to the trainee virtually instantaneously on a computer monitor whenever the trainee is able to generate the targeted brainwave frequency or pattern selected by the neurotherapy clinician. Due to the principles of learning, and after repeated training sessions, the trainee is able to change the specific brain patterns associated with their reported emotional and behavioral problem(s). Typical outcomes include positive changes in cognitive function, behavior, and mood, and decreased frequency of events related to brain irritability – fewer seizures, headaches, and panic attacks.
As of January 2011 there were 708 peer-reviewed scientific studies cited by the National Library of Medicine for neurofeedback (or EEG biofeedback). This body of research reflected the successful use of neurofeedback to treat symptoms associated with a multitude of psychiatric and medical disorders. An abbreviated list of disorders for which use of neurofeedback is supported by empirical research includes the following:
- Age-related Cognitive Decline
- Learning Disabilities
- Anger problems
- Medical & Neurological Conditions
- Posttraumatic Stress Disorder
- Autism & Asperger’s Disorder
- Sleep Disorders
- Behavioral Disorders
- Substance Use
- Traumatic Brain Injury (TBI)
- Developmental Disorders
- and many more…
For individuals who do not experience difficulties associated with psychological or medical conditions but do seek to improve their functioning in specific work or recreational activities (e.g., business executives, athletes, artists, etc.), these same brain-based technologies can be utilized to enhance one’s performance in a chosen life domain. More specifically, when no particular clinical problem exists, neurotherapy can still help to optimize health by increasing the brain’s ability to self-regulate, focus, relax and become resilient. Neurotherapy approaches have been used to improve the performance of NASA astronauts, Canadian Olympic athletes, Metropolitan opera singers, members of the Italian 2006 World Cup Champion team, numerous professional musicians, elite military units and many others.
Thorough assessment always precedes treatment at the BAND Center. Just as you wouldn’t allow a doctor to put a cast on your leg without first taking an x-ray, effective evidence-based neurotherapy must be preceded by an objective assessment of brain activity and psychological status. In addition to a clinical interview and completion of standard paper-and-pencil assessments and/or a computerized battery of neurocognitive tests, all individuals receiving neurotherapy services at the BAND Center receive a quantitative electroencephalography (qEEG) assessment. The qEEG is a powerful tool for measuring the elical activity within the brain and identifying whether the brain evidences specific types of atypical activity as compared to a large database of same-age, well-functioning individuals. The results of the qEEG assessment are then used to inform the creation of a carefully tailored, individualized treatment plan. The treatment plan identifies the specific targets of treatment unique to that individual’s brain. In addition, the qEEG will inform the choice of neurotherapy approaches necessary to assist the individual in modifying their atypical brainwave patterns so that problem symptoms are reduced and/or eliminated.
Using QEEG-guided neurotherapy is relatively new. Most practitioners have not gone through the extensive training to perform the EEG or QEEG. It is technologically intensive, and the equipment is expensive. Some practitioners use types of neurofeedback that are not QEEG-guided; however, the results usually are not as successful as those guided by the QEEG.
The QEEG (Brain Map), is more objective than other tests, and unlike many other tests, can identify a problem that might be hidden or masked by another issue. Also other problems may exist and a Qeeg can identify all these issues. Then the brain training can then address all or selected problems during the course of the treatment.
Research studies published in well-respected peer reviewed journals have consistently shown neurotherapy treatment approaches to produce positive and clinically significant results for a wide range of conditions. Given the fact that neurotherapy was first utilized in the 1970’s as a treatment for ADHD in youth as well as for individuals with seizure disorders, the cumulative research in these applications are more robust than for other applications.
With regard to ADHD, several recently published meta-analyses (Arns et al., 2009; Sherlin et al., 2010) of well-designed research studies have described neurofeedback as a “safe and efficacious treatment intervention for ADHD,” meeting the American Psychological Association’s rating of “Level 5: Efficacious and Specific.” These meta-analyses included reviews of studies using large, multi-site, randomized and controlled research designs. Consistently, the effects of neurotherapy were similar to that of stimulant medication, particularly for problems with inattention and impulsivity. More specifically, these studies consistently demonstrated that over 80% of youth exhibiting home and school-based behaviors that warranted a diagnosed with ADHD, no longer met the criteria for ADHD nor required medication after completing neurotherapy treatment.
In contrast to current treatments such as medication management and multi-component behavior therapy (Molina et al., 2009), there is substantial data indicating that the positive clinical effects of neurofeedback remain stable after completing treatment and may even improve further over time. Neurotherapy in the treatment of ADHD has been demonstrated to have positive effects lasting from 3 to 6 months (Heinrich et al, 2004; Leins et al., 2007), over 2 years (Gani et al., 2009; Gevensleben et al., 2009), and even 10 years after neurotherapy treatment had ended (Lubar, 2003).
With regard to the added benefit of conducting a qEEG assessment prior to commencing neurotherapy with youth diagnosed with ADHD, research studies have shown that qEEG-informed neurotherapy can further improve the therapeutic outcome by over 2.5 times that of neurotherapy conducted without a qEEG assessment or standard treatment with stimulant medication (Monastra et al., 2002).
(Please see the Additional Resources section for information regarding the research cited above.)
It is difficult to predict in advance how many sessions will be needed to attain the specific goals sought by our clients. Generally speaking, the results of neurotherapy will vary depending on the specific condition being addressed; that is, the severity of a client’s problems will typically dictate the length of treatment required. Treatment might range from as few as twenty sessions for less severe difficulties (e.g., mood or anxiety problems) to over forty sessions for more severe difficulties (e.g., autistic spectrum disorders). As such, we ask all individuals considering our neurofeedback services to commit to a minimum of twenty sessions. By twenty sessions, the vast majority of individuals receiving neurotherapy services should report experiencing a noticeable change in function.
Since neurotherapy is typically viewed as ‘training’ for one’s brain, like most training endeavors, consistent repetition is necessary to be effective. As a result, we recommend twice weekly sessions whenever possible. Although progress does seem to be more rapid with twice weekly sessions, many of our clients can make good progress with weekly visits. BAND Center staff will be happy to assist you in creating a schedule that best fits your goals and lifestyle.
Training sessions typically take about 45 minutes, with actual feedback time varying based on what is best tolerated and most effective.
While qEEG assessment and any subsequent neurotherapy treatment is often reimbursed by insurance plans in many other states, reimbursement from Massachusetts insurance carriers is not guaranteed. As a result, individuals receiving neurotherapy services at the BAND Center are asked to talk directly with our staff to determine if your specific insurance plan will cover these treatments. We will talk with your insurance company and get back to you with in a few days.
Neurotherapy is non-invasive, holistic, and there are no significant side effects. The effect is usually permanent. The process is painless and non-invasive. Neurotherpy resolves problems instead of masking the symptoms of the problem. Drug therapy does not “cure” problems, and may have harmful side effects such as decreased appetite, insomnia, lethargy, or depression.