<div><div><div><div id="page-content"><div><div><div id="region-main-box"><section id="region-main"><div role="main"><h3><a name="_Toc31009226" style="color: rgb(55, 71, 79); font-size: 2.143rem; background-color: rgb(255, 255, 255);">PREAMBLE</a></h3><div><div><p>This module covers all ethical and professional considerations for neurotherapy clinicians and technicians. The practice of neurotherapy is both an art and a science. It will vary in terms of approach, modality, method of delivery, and services provided. This chapter covers a code of ethics that neurotherapist need adhere to. When working with patients, may situations can arise; if a situation is not covered in this chapter on ethics, it does NOT mean that ethics do not apply. While the specific wording behind these standards is important, it is the spirit and intent of these standards which must be applied to situations. Violation of these standards by any BCN Certified Practitioner or neurotherapist ought to be brought to the attention of the BCIA, at jcrawford@bcia.org,&nbsp;<strong>(720) 502-5829.</strong></p><p>Neurotherapy members are encouraged to apply for membership to either the AAPB (Association of Applied Psychophysiology and Biofeedback) or ISNR (international Society for Neurofeedback and Regulation) for belonging to a larger board and for inclusion in a <img src="@@PLUGINFILE@@/ISNR.jfif" alt="ISNR" width="297" height="170" class="img-responsive atto_image_button_left">group of colleagues and professionals engaging in the same business. The professional standards adhered to by the professional organizations of neurofeedback professionals all maintain the highest ethics, values of competence, promotion of intellectual freedom, respect, integrity, honesty, fairness, and trustworthiness.</p><p><img src="@@PLUGINFILE@@/AAPB.png" alt="AAPB" width="288" height="175" class="img-responsive atto_image_button_right"></p><p>Because the trade organizations supporting and advocating for neurofeedback professionals are committed to the protection of human rights, they strive to maintain respect amongst other professional communities, fostered by professionalism, integrity and dignity.&nbsp; Clinicians must hold themselves accountable for their clients welfare as it pertains to the their neurotherapy regimens, and they mist limit their services only to those areas in which they have expertise and are competent.</p><p>The ISNR's Guidelines for the practice of Neurofeedback as as follows:</p><p></p><div><div><div><div><h2>ISNR's Guidelines For Practice</h2></div></div></div></div><div><div><div><div><h2><i>Purpose</i></h2><div><div><p><i>These guidelines are intended to provide a reference to both practitioners and the public with regard to basic methods for delivery of neurofeedback, also known as EEG Biofeedback. These guidelines are an extension of the Code of Ethical Principles and Professional Conduct of the International Society for Neurofeedback and Research (ISNR) which can be found on the ISNR.org website.</i></p></div></div></div></div></div></div><div><div><div><div><h2><i>The Practice of Neurofeedback</i></h2><div><div><p><i>Neurofeedback developed as a multidisciplinary treatment modality, and is now practiced by a wide variety of providers who may or may not be licensed healthcare professionals who treat mental or other illnesses. Its range of practice includes assessment and treatment for conditions diagnosed by licensed healthcare providers, training for optimal performance (e.g., among athletes, executives, students, performing artists, and other healthy individuals), and both clinical and applied scientific research.</i></p><p><i>In general, neurofeedback involves placing sensors on the scalp of the individual, and connecting the sensors to an amplifier and computer. Through these connections, the electrical activity of the brain is recorded, and then presented back to the individual on the computer screen in the form of a video game or soundtrack that changes depending on what state the brain is in. This is the “feedback” aspect of neurofeedback that enables the individual to change their brain function and keep the game or sound on more. The means by which this signal is displayed and controlled is the responsibility of the neurofeedback practitioner and should be done in accord with the guidelines below.</i></p></div></div></div></div></div></div><div><div><div><div><h2><i>Training and Credentials for Neurofeedback Practitioners</i></h2><div><div><p><i>Membership in ISNR and certification by the Biofeedback Certification International Alliance (BCIA) are voluntary and help demonstrate to the public that a neurofeedback provider is able to provide ethical and competent training. When training objectives include the treatment of a diagnosed mental or other health condition and the delivery of a regulated assessment or intervention, it helps demonstrate to the public that the provider is able to deliver ethical and competent neurofeedback training when the provider is licensed by a government-recognized health profession board, and the provider’s scope of practice with their professional board includes assessment and intervention for that diagnosed condition. Regulations regarding licensure and scope of practice are determined and enforced by various governmental agencies, depending on state, country, or province. Consumers should ascertain that the practitioner has appropriate credentials, training, experience, and licensure to treat their problem, or is supervised by someone who does.</i></p></div></div></div></div></div></div><div><div><div><div><h2><i>Guidelines</i></h2><div><div><p><i>The following guidelines are applicable to neurofeedback practitioners regardless of client background or training objective.</i></p><p><i>ISNR members:</i></p><ul><li><p><i>Follow the ethical principles of the International Society for Neurofeedback and Research and any other professional organization to which s/he might belong.</i></p></li><li><p><i>Accurately represent their training and any professional qualifications and/or licenses they have achieved, and disclose relevant limitations.</i></p></li><li><p><i>Provide neurofeedback training only for those problems or goals for which they are competent, as demonstrated by their training, experience, licensure, or supervision.</i></p></li><li><p><i>Provide neurofeedback training for the treatment of diagnosed mental or other health conditions only if they are regulated healthcare practitioners whose scope of practice includes the diagnosis and treatment of the specific client population, and who are further trained or supervised in the application of neurofeedback for those clients.</i></p></li><li><p><i>When an unlicensed neurofeedback provider is assessing a client and the severity or complexity of the problem suggests that a diagnosable mental health problem or medical illness may be related to the goal being addressed by neurofeedback, then it is prudent for the provider to discuss this possibility with the client, review the limits of their practice, encourage the client to consult with their family physician or licensed healthcare providers, and document the discussion.</i></p></li><li><p><i>Maintain their competency through continuing education.</i></p></li><li><p><i>Regularly seek consultation and supervision for cases in order to assure themselves and the client that training is in keeping with current knowledge and practice.</i></p></li><li><p><i>Document their client’s consent to the specifics of training, including where and how the client will be touched, acknowledgment of training benefits, risks, and costs.</i></p></li><li><p><i>Accurately represent the degree of scientific support reported in peer- reviewed publications for assessment and training methods for the various problems to which neurofeedback training may be applied.</i></p></li><li><p><i>If technicians are used, document the client understanding of the technician’s qualifications, role, and degree of supervision.</i></p></li><li><p><i>Document the client’s consent for their data to be used for research and/or educational purposes, if applicable.</i></p></li><li><p><i>Document their client’s acknowledgement of the limits of confidentiality.</i></p></li><li><p><i>Document their client’s acknowledgment that training will not necessarily achieve agreed upon goals, either completely or at all.</i></p></li><li><p><i>Further document the client’s acknowledgment that unexpected changes in the client’s experience or behavior may occur during&nbsp;the course of training which may or may not be related to the training itself, and that in those cases it is important for the client to inform the neurofeedback provider so that the training methods can be either adjusted or discontinued, if necessary, and the unexpected changes can be appropriately addressed.</i></p></li><li><p><i>Provide training regardless of race, creed, color, nationality, gender, sexual orientation, religion, or social affiliation.</i></p></li><li><p><i>Collaborate with their clients to develop measurable training goals, a clear plan for training, and methods for measuring progress toward those goals. This collaboration includes regular review of progress with the client with the objective of asking for their decision regarding whether the benefit of continuing training merits the cost.</i></p></li><li><p><i>Carry out effective practices for maintaining good hygiene, applying electrodes and establishing an adequate electrical connection, and maintaining software and hardware in good and up-to-date condition.</i></p></li><li><p><i>Use hardware and software that is safe, accurate, and effective for the purpose to which it is applied. Equipment which meets the IEEE (Institute of Electrical and Electronics Engineers) standards or has been FDA registered is recommended for clinical use.</i></p></li><li><p><i>Carefully assess and document the benefits, risks, and the abilities of the person who may conduct remote or home training, before such training is begun. In general, home training should be discouraged for conditions with a clinical diagnosis. Where it is chosen, careful attention must be given to the training and supervision of the person who will be responsible for performing the neurofeedback sessions at the home. Additional full disclosure and informed consent of potential problems, how and when to report them, and methods to resolve them should be discussed, and the client’s understanding of these documented with their signature. Steps to prevent or limit the use of neurofeedback software and hardware beyond their intended purpose should be documented. The issue of performing services outside of one’s&nbsp;geographic region of license or certification must be taken into consideration.</i></p></li><li><p><i>Plan and carry out neurofeedback training that is based on scientifically validated principles and methods.</i></p></li><li><p><i>Plan and carry out an organized course of neurofeedback that is based on an initial assessment that is adequate for the presenting problem and goal, including a pre-training EEG assessment.</i></p></li><li><p><i>Provide therapeutic support, coaching, and direct supervision during client neurofeedback training that is sufficient to achieve the agreed- upon goals of the client’s training. Document the client’s understanding of the degree to which the individual who is responsible for training will be present during training.</i></p></li></ul></div></div></div></div></div></div><br><p></p><h3>Education Necessary for BCIA - Certification</h3><p></p><p><strong>To qualify for the BCN,</strong>&nbsp;you must demonstrate a Bachelor’s level degree in a health care related field. Approved health care fields include: psychotherapy, psychology, nursing, (including 2-year registered nurses with license; not including LVNs or LPNs), physical therapy, occupational therapy, rehabilitation, social work, counseling, chiropractic, exercise physiology, recreational therapy, speech pathology, physician’s assistant (proof of certification or license needed), and sports medicine.</p><p><strong>The following fields require a master’s degree:</strong>&nbsp;music therapy and counseling education (M.Ed. in counseling). Appropriately credentialed doctors of medicine are also accepted. Degrees in health care fields other than those listed above must be submitted to the Certification Review Committee. BCIA will consider requests for special review for the demonstration of equivalency for most of our requirements, including prerequisite education. For answers to eligibility questions, please contact:&nbsp;<a href="mailto:info@bcia.org" target="_blank" rel="noopener">info@bcia.org</a>.</p><p>The BCIA's Professional Standards and Ethical Principles of Biofeedback can be found <a href="https://bcia.memberclicks.net/assets/docs/ProfessionalStandardsAndEthicalPrinciplesofBiofeedback.pdf">here</a>.</p><p></p><h3><a name="_Toc31009227">RESPONSIBILITY TO PATIENT WELFARE</a></h3><p>The goal of the neurotherapist is to advance the patient’s well being and maintain their best interests at all times.</p><p><span style="color: rgb(55, 71, 79); font-family: &quot;Open Sans&quot;; font-size: 1.715rem;">Licensure</span></p><p>Anyone practicing neurofeedback ought to be under the supervision of a licensed health-care provider, unless they themselves are licensed. Approved health care licenses include RN, Psychologist, PsyD, Psychotherapist (LMFT, LPCC), MD, OD, Chiropractic Doctor, OT, LCSW, PT, and others. If you are unsure if your license will allow you to practice neurofeedback without a supervisor, contact: info@bcia.org.&nbsp;</p><p>If you choose to practice neurofeedback without a healthcare license, you cannot legally treat any medical pathology or psychopathology. If someone comes to you for the treatment of any diagnosis (i.e. depression, anxiety, ADHD, etc., you must refer out). It is mandatory that you disclose to your clients, before beginning any work with them, that you are unlicensed and cannot legally treat any medical or psychological disorder. This disclosure ought be made in written format, where the client signs their acknowledgement. Many people who are unlicensed practice Peak Performance neurofeedback, or neurofeedback on healthy individuals.</p><p><span style="color: rgb(55, 71, 79); font-family: &quot;Open Sans&quot;; font-size: 1.715rem;">Equal Access Health Care</span><br></p><p>A principle of equal access to health care demands that every person who&nbsp;<b>shares the same type and degree of health need</b>&nbsp;must be given an equally effective chance of receiving appropriate treatment of equal quality so long as that treatment is available to anyone. This means that regardless of sex, race, gender, weight, income bracket, etc., all are afforded the same level of health care.&nbsp;<br></p><p><span style="color: rgb(55, 71, 79); font-family: &quot;Open Sans&quot;; font-size: 1.715rem;">Scope of Practice</span><br></p><p>Neurotherapy services should be limited to the practice standards and guidelines of one's license or the license of their supervisor. If a neurotherapist has sufficient training in a modality of treatment (demonstrating certification or courses attended for the treatment of a condition or modality of treatment) and familiarity with a client population, they may practice neurofeedback as long as the treatment of the condition is within the limit of their license. For instance, the use of alpha/theta neurofeedback is helpful in peak performance, meditation enhancement, and stress regulation. For these demographics, a BCN-certified neurotherapist can work with&nbsp; individuals using alpha-theta neurofeedback.&nbsp;</p><p><a name="_Toc31009228" style="color: rgb(55, 71, 79); font-family: &quot;Open Sans&quot;; font-size: 1.715rem; background-color: rgb(255, 255, 255);">Non Discrimination</a><br></p><p>Neurotherapists will not discriminate or deny services to anyone based upon religion, gender identity,&nbsp; sexual orientation, ethic or national origin, race, socioeconomic status, or disability. Within reason, neurotherapists make accommodations to treat all individuals within their scope of practice. If a neurotherapist believes someone is outside of their scope of practice (e.g. an infant), they will do their best to find a suitable referral for those seeking help.</p><p><a name="_Toc31009229" style="color: rgb(55, 71, 79); font-family: &quot;Open Sans&quot;; font-size: 1.715rem; background-color: rgb(255, 255, 255);">Dual Relationships</a><br></p><p><img src="@@PLUGINFILE@@/Dual%20Relationships.jpg" alt="Dual Relationships" width="400" height="262" class="atto_image_button_right"><span style="font-size: 1rem;">A dual relationship is one that occurs outside of the neurotherapy clinic as a separate and distinct relationship during or after the termination of the neurotherapeutic relationship. Neurotherapists avoid dual relationships with patients that are able to impair professional judgment, as they are aware of their influential position in the patient-therapist dynamic. Not all dual relationships are unethical and some dual relationships cannot be avoided.</span></p><p><a name="_Toc31009230">Unethical dual relationships</a>&nbsp;are those wherein a neurotherapist borrows money from a patient, hires a patient, engages in business ventures with a patent, or enters a close personal relationship with a patient (this applies to patient’s spouses, partners and family members, as well). Sexual contact, intimacy or intercourse with a patient <u>during the therapeutic relationship or two years following the relationship</u> is unethical and strictly prohibited. If a neurotherapist engages in intimacy with a former patient or their spouse or partner, or immediate family member, within two years of the termination of the patient-therapist relationship, the neurotherapist risks the revocation of their quantitative EEG diplomacy and/or their board certification in neurotherapy. This type of conduct is considered harmful and potentially exploitative to the patient.&nbsp;</p><p><span style="color: rgb(55, 71, 79); font-family: &quot;Open Sans&quot;; font-size: 1.715rem;">Treatment Disruption, Abandonment or Termination&nbsp;</span><br></p><p>It is a neurotherapists professional and clinical responsibility to maintain practices and procedures that assure undisrupted care. This may include providing contact information in case an emergency situation arises while the neurotherapist is away. It is important that a neurotherapist uses clinical judgment when terminating a relationship, as termination must be done in an appropriate manner and based upon sound reason (e.g. the patient is not benefitting from treatment, continuing treatment is no longer beneficial or appropriate, the neurotherapist can no longer provide treatment due to extenuating circumstances, or in order to avoid an ethical conflict or problem). It is unethical to abandon&nbsp; to neglect a patient in treatment; if a neurotherapist is unable to continue providing treatment, they must attempt to provide their patient an alternative health care professional for their accommodation.</p><p><a name="_Toc31009231" style="color: rgb(55, 71, 79); font-family: &quot;Open Sans&quot;; font-size: 1.715rem; background-color: rgb(255, 255, 255);">Hygiene</a><br></p><p><img src="@@PLUGINFILE@@/hygiene.jpg" alt="hygiene" width="200" height="201" class="img-responsive atto_image_button_left">It is imperative that the neurotherapist maintains a clean and hygienic office for the protection of both clients and staff. This includes all equipment, sensors, pastes and gels used, preventing for cross contamination or any human byproduct (i.e. sweat, saliva, blood, etc.). In a post-pandemic world, this is of paramount importance.&nbsp;</p><p><br></p><h3><a name="_Toc31009232"><br></a></h3><h3><a name="_Toc31009232" style="color: rgb(55, 71, 79); font-size: 1.715rem; background-color: rgb(255, 255, 255);"><br></a></h3><h3><a name="_Toc31009232" style="color: rgb(55, 71, 79); font-size: 1.715rem; background-color: rgb(255, 255, 255);">Financial Concerns</a><br></h3><p>It is unethical for a neurotherapist to maintain a client relationship solely for financial gain, nor is it ethical to terminate a patient relationship for non-payment of fees, unless the termination is handled in a clinically appropriate manner. All services billed by the practitioner must be for clinical services provided directly by the clinician or by their technician.&nbsp;</p><p><a name="_Toc31009233" style="color: rgb(55, 71, 79); font-family: &quot;Open Sans&quot;; font-size: 1.715rem; background-color: rgb(255, 255, 255);">At Home Training</a><br></p><p>Neurotherapists recommending and enacting at home training are responsible for the patient’s (or patient’s care-takers) education and application of all neurofeedback modalities and their use. Since at home systems involve the neurotherapist not being present, the neurotherapist must take extra precautions to meet their responsibility to their patients.</p><p>Before implementing at home system use, a neurotherapist must consider the competence and capability of a patient or patient’s caretaker to administer treatments from an at home setting, and must be present via an online screen share for the initial training sessions to ensure the equipment and the set-up is appropriate. When at home training occurs, a neurotherapist must inform patients of the risk of at home training, consequences, limitations, and appropriate emergency responses, should a situation emerge. It is the neuerotherapist’s responsibility to ensure the patient signs all appropriate paperwork regarding at home training, its risks, consequences, and potential adverse effects before engaging in at home use.</p><p><a name="_Toc31009234" style="color: rgb(55, 71, 79); font-family: &quot;Open Sans&quot;; font-size: 1.715rem; background-color: rgb(255, 255, 255);">Intake</a><br></p><p>During the initial intake, a neurotherapist will get written informed consent from their patients and clients when providing clinical<img src="@@PLUGINFILE@@/Intake%20Form.jfif" alt="Intake Form" width="299" height="168" class="img-responsive atto_image_button_right"> services, including a form indicating the patient is aware of the QEEG procedure (if being done) as well as the neurotherapy procedures at hand. During this initial session, the neurotherapist is to give the client enough information about the neurotherapy process so the client adequately understands what their involvement entails.</p><p><br></p><h3><a name="_Toc31009235" style="color: rgb(55, 71, 79); font-size: 1.715rem; background-color: rgb(255, 255, 255);">Disclosures and Informed Consent</a><br></h3><p>A neurotherapist ought to provide clear information about the neurotherapy modalities used in easy to understand language so the patient can make an educated decision about partaking in neurotherapy. It is of paramount importance that the neurotherapist informs their patients of potential risks and benefits of therapy and any common side effects that occur from the treatment modalities they utilize. This ought to be done in written form at the beginning of neurotherapy under an "informed consent" form the client signs. This ought to be signed by the patient before they begin neuro-work with the neurotherapist. On the same form, i<span style="font-size: 1rem;">t is strongly recommended that the neurotherapist informs their patient of their background, theoretical and professional orientation, education, and training.</span></p><p><a name="_Toc31009236" style="color: rgb(55, 71, 79); font-family: &quot;Open Sans&quot;; font-size: 1.715rem; background-color: rgb(255, 255, 255);">Non-Neurotherapist Roles</a><br></p><p>When a neurotherapist acts in a professional role other than the role of a neurotherapy provider (be it psychologist, psychotherapist, nurse, nutritionist, acupuncturist, chiropractor) they are acting solely within that role and may clarify, when necessary, which role they are acting in in order to prevent confusion.</p><p><span style="color: rgb(55, 71, 79); font-family: &quot;Open Sans&quot;; font-size: 1.715rem;">Supervisor, Supervisee, Educator and Student Responsibilities</span><br></p>Neurotherapists maintain professional roles and boundaries when in the role of student or supervisor/educator. The supervisor/educator takes seriously their impact on their students and supervisees and, thus, do not exploit the trust and dependency of their supervisees. A neurotherapist does not engage in romantic or sexual relationships with supervisees/students (over whom they exercise professional authority).&nbsp;&nbsp;Other unethical acts include: borrowing money from students, engaging in a close personal relationship with a supervisee, engaging in a businesses venture with a supervisee, barter with supervisees, or engaging in any of the aforementioned with the student’s spouse. It is mandatory that a supervisor maintain their professional skills with recurring courses and trainings.</div><div><h3><br></h3><h3>Competence of Supervisee</h3><p><img src="@@PLUGINFILE@@/Teacher%20Student.jpg" alt="Teacher and student" width="300" height="264" class="img-responsive atto_image_button_left">Neurotherapists make sure their supervisees are addressed and taught at the level of their competence and are not providing services before they are clinically capable. It is the responsibility of both the supervisor and supervisee to ensure the supervisee understands and can apply the material and neurofeedback techniques appropriately. The appropriate consultation and supervision in neurofeedback mandates that the supervisee passes all client cases by the mentor while earning their certification, in order to accurately assess the patient's EEG and and QEEG, in order to appropriately apply neurotherapy modalities for optimal success. The supervisor shall oversee the supervisee until they have earned their BCIA accreditation.&nbsp;</p><p>It is strongly recommended that the student continue to learn through mentorship with various individuals. The field of neurotherapy is diverse and there are many perspectives, softwares, hardwares, and applications. Typically, a neurotherapy professional builds a practice that is an amalgam of approaches and techniques. It is paramount to stay atop the latest trends and findings of the field in order to keep one's practice and neurotherapy applications relevant.&nbsp;</p><p><a name="_Toc31009237" style="color: rgb(55, 71, 79); font-family: &quot;Open Sans&quot;; font-size: 1.715rem; background-color: rgb(255, 255, 255);"><br></a></p><p><a name="_Toc31009237" style="color: rgb(55, 71, 79); font-family: &quot;Open Sans&quot;; font-size: 1.715rem; background-color: rgb(255, 255, 255);">Consultation with Outside Parties and Referrals</a><br></p><p>It is important that neurotherapists have access to professional communities of other clinicians doing similar work in the cases that they need to consult, collaborate with, and refer patients out to other professionals, physicians, and community resources. In cases where neurotherapy is not leading to desired results, neurotherapists ought to offer treatment alternatives that are appropriate for the patient’s symptoms. It is of paramount importance that neurotherapists do not violate HIPAA in these interactions, it is well-advised that neurotherapists provide patients with a form to sign, allowing them to disclose their case information to mentors, if they see fit.</p><p><a name="_Toc31009238" style="color: rgb(55, 71, 79); font-family: &quot;Open Sans&quot;; font-size: 1.715rem; background-color: rgb(255, 255, 255);">Treatment Decisions and Case Notes</a><br></p><p>All mental health care practitioners keep notes of their patient sessions, including the patients subjective state, their demeanor and reported changes or challenges since the last neurotherapy session, as well as the protocol given at the time of the appointment in as much detail as is necessary. This latter form of note keeping may be kept in electronic format, but it is paramount that the neurotherapist maintains a backup copy of the treatments undertaken in the case of computer failure. This will involve the monitoring of medication and medical condition. It is not within the scope of the neurotherapist to alter the medication regimen of a patient, unless they have an MD and the consent of the prescribing physician to do so. If the neurotherapists does not have an MD, it is recommended that they connect with any prescribing physician to inform them of the treatment plan if the neurotherapy treatment&nbsp; is going to alter the patient's reception of the medication.</p><p><a name="_Toc31009239" style="color: rgb(55, 71, 79); font-family: &quot;Open Sans&quot;; font-size: 1.715rem; background-color: rgb(255, 255, 255);">Confidentiality &amp; Privacy</a></p><p>A neurotherapist is held to the same levels of confidentiality as other mental health care practitioners. It is paramount that they disclose to clients and other interested parties at the outset of services the nature of confidentiality and possible limitations of the clients’ right to confidentiality. They ought to review with clients the circumstances where confidential information may be requested and where disclosure of confidential information may be legally required (most often this would be if the patient is using health<img src="@@PLUGINFILE@@/confidential.jpeg" alt="confidential" width="300" height="168" class="img-responsive atto_image_button_right"> insurance and their health insurance company requests records).</p><p>When consulting with colleagues or referral sources, a neurotherapist does not share confidential information that could reasonably lead to the identification of a client, with whom they have a confidential relationship, unless they have obtained the prior written consent of the client. Information may be shared only to the extent necessary to achieve the purposes of the consultation.</p><p>It is paramount that neurotherapists do not disclose client confidences, except by written authorization or waiver, or where mandated or permitted by law. Verbal authorization will not be sufficient except in emergency situations, unless prohibited by law. When providing couple, family or group treatment, the neurotherapist does not disclose information outside the treatment context without a written authorization from each individual competent to execute a waiver. In the context of couple, family or group treatment, the neurotherapist may not reveal any individual’s confidences to others in the client unit without the prior written permission of that individual.<br></p><p>All information exchanged by the patient is confidential with these exceptions:</p><p></p><ol><li>If the patient is suicidal, the neurotherapist has the obligation of staying with the patient until they can ensure their safety. The therapist may reach out to an emergency contact and ensure the patient is in the care of a close friend, spouse, or relative. If the patient seems unstable, it is the professional obligation of the neurotherapist to see that the patient is taken to the hospital, even if by an involuntary hold (a 5150 code). This may involve the police or calling 911 if the patient is resistant</li><li>If the patient is abusing or knows of someone abusing an elderly person or a child (in which case it is the neurotherapists duty to reach out to the proper authorities (e.g. child protective services or the police)</li><li>If the patient is homicidal or threatening acting against another violently, in which case it is the neurotherapists duty to make sure all endangered parties are informed, by contacting the police</li></ol><p></p><p><br></p><p></p><h3>HIPAA Compliance</h3><p><img src="@@PLUGINFILE@@/HIPAA.png" alt="HIPAA" width="338" height="149"></p><p>HIPAA stands for&nbsp;&nbsp;Health Insurance Portability and Accountability Act. This Act was established for the protection of patients' confidential information. Neurotherapists, like all health professionals, are expected to adhere to the principles of HIPAA. More information on HIPAA can be found here:&nbsp;https://www.hhs.gov/hipaa/for-professionals/index.html</p><p><br></p><p>Here are some of the basic coverages of the Act:</p><p></p><span style="font-size: 1rem;">1) Creation and implementation of policies, procedures, and standards of conduct</span><br><span style="font-size: 1rem;">2) Enabling technical protections: including encryption of patient data and password protection</span><br><span style="font-size: 1rem;">3) Exercising privacy and confidentiality practices everywhere (i.e. using aliases instead of patient names)</span><br><span style="font-size: 1rem;">4) Display privacy notices in office and on website</span><br><span style="font-size: 1rem;">5) Exercise caution in the use and communication of Protected Health Information (PHI), PHI includes:<br></span><span style="font-size: 1rem;">Identifying information, such as</span><ul><li>Names,&nbsp;</li><li>DOB,&nbsp;</li><li>Pictures,&nbsp;</li><li>Patient numbers,&nbsp;</li><li>Payment information,&nbsp;</li><li>Emails,&nbsp;</li><li>Social security numbers,&nbsp;</li><li>Biometric identities</li><li>Website links and other URLs</li><li>Telephone numbers</li><li>Vehicle Identifiers</li></ul><p></p><h3><span>Client Access to Records&nbsp;</span></h3><p><span>Neurotherapists must provide clients with reasonable access to records concerning the clients. Neurotherapists can limit client’s access to their records only in exceptional circumstances when they are concerned, based on compelling evidence, that such access could cause serious harm to the client.&nbsp; The client’s request and the rationale for withholding some or all of the record should be documented in the client’s file.&nbsp;</span></p><p><a name="_Toc31009240" style="color: rgb(55, 71, 79); font-family: &quot;Open Sans&quot;; font-size: 1.715rem; background-color: rgb(255, 255, 255);">Limits of Neurotherapist’s Role and Contact</a><br></p><p>A neurotherapists will act solely within the provision of their role as a neurotherapist and within the role of their professional license, if applicable. A chiropractor is free to do chiropractic work, an acupuncturist is free to do acupuncture, a psychotherapist is free to do psychotherapy, etc., but no neurotherapist is allowed to reach beyond the bounds of the professional license with any neurotherapy client. For example, it would be unethical for someone without a license in mental health care to conduct psychotherapy with a patient while doing neurotherapy. The therapist will also purchase liability insurance that covers the extent of their neurotherapeutic work, including all forms of neurostimulation and neurofeedback.</p><p><a name="_Toc31009241" style="color: rgb(55, 71, 79); font-family: &quot;Open Sans&quot;; font-size: 1.715rem; background-color: rgb(255, 255, 255);">Competence</a><br></p><p>A neurotherapist is expected to practice within the limits of their professional competence, based upon their experience, their education, and their training.&nbsp; It is also the therapist’s role to inform their patients about particular procedures and possible negative effects. A clinician who received the QEEG-D designation ought to have the competence of an intermediate practitioner and it is advised that they pursue their BCIA (Biofeedback Certification International Alliance) certificate before pursuing the QEEG-D or QEEG-T.</p><p>If a professional is serving in the role of a biofeedback or neurofeedback technician or assistant, they will engage in the practice only under the supervision of a qualified professional.&nbsp; Misrepresentation of one’s credentials, training, experience, degrees, or specialty is a violation of ethics and a violation of law in certain circumstances.</p><p><a name="_Toc31009242" style="color: rgb(55, 71, 79); font-family: &quot;Open Sans&quot;; font-size: 1.715rem; background-color: rgb(255, 255, 255);">Treatment Alternatives and Referring Out</a><br></p><p>Sometimes a client will seek neurotherapy who would be much better suited by another form of treatment. Sometimes a patient will seek neurotherapy who has a condition that is more severe than the neurotherapist can address or is foreign to the neurotherapist. In other situations a patient may come to a neurotherapist without knowing what is wrong with them. In these situations it is the ethical duty of the neurotherapist to consider the client’s best interests and either refer to an appropriate specialist for a more suitable treatment or appropriate assessment and diagnosis. In cases where the neurotherapist does not know who to refer out to, it is best to receive consultation with a supervisor or other professional who is licensed and can give educated advice as to how to proceed.</p><p><a name="_Toc31009243" style="color: rgb(55, 71, 79); font-family: &quot;Open Sans&quot;; font-size: 1.715rem; background-color: rgb(255, 255, 255);">Complaints</a><br></p><p>If a neurotherapist receives a filed complaint from a client, the board to which the complaint must first be presented is to the clinician’s professional licensure board. The professional boards for the practice of neurotherapy, including the International Quantitative EEG Certification Board, The Biofeedback Certification International Alliance (BCIA) Board of Directors, and the Association of Applied Biofeedback and Psychophysiology (AAPB) will be the secondary board to determine whether or not the member failed to comply with either ethical and/or legal requisites. If the neurotherapist does not have a license, these credentialing boards are the first to be notified.&nbsp;</p><p>If a neurotherapy employee or the licensed clinician receives a consumer complaint, or has been&nbsp; accused of unethical behavior, it is paramount to consult with other licensed individuals as to the best course of action for the given complaint. If it is appropriate, attempts to resolve the client's complaint with the client (i.e. refund of money or explanation of behavior) may be the best course of action. In cases where a complaint is formalized, or further contact with the patient would be damaging to them, consultation with the trade organization responsible for advocacy and support of the license (or, if only a board certified neurotherapist, contact with ISNR, AAPB, or BCIA) in order to determine the best course of action.</p><p><a name="_Toc31009244" style="color: rgb(55, 71, 79); font-family: &quot;Open Sans&quot;; font-size: 1.715rem; background-color: rgb(255, 255, 255);">Core Professional Values of Neurofeedback Professionals</a><br></p><p>&nbsp;<span style="font-size: 1rem;">These core professional values are borrowed from the AAPB Code of Ethics:</span></p><p></p><ul><li>Enhancing human development and improvement through the life span</li><li>Honoring diversity and embracing a multicultural approach in support of the worth, dignity, and uniqueness of people within their social and cultural context</li><li>Promoting social justice</li><li>Safeguarding the integrity of the provider/client relationship</li><li>Practicing in a competent and ethical manner</li></ul><p></p></div></div></div></section></div></div></div></div></div></div></div><footer><div><br>

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