<h4>Client Preparation for Neurofeedback</h4><p>It behooves the clinician to have a well-worked out approach to meeting clients, introducing them to the neurotherapy process, and addressing any concerns they might have. Some of the commonly asked questions are things like:</p><p><span><b>Q: What is neurofeedback?</b></span></p><p>A:&nbsp;Neurofeedback, also called EEG biofeedback, is a way of training the behavior of the brain (in terms of the amplitudes of certain brainwaves, or the connectivity dynamics of the brain). The tools used are EEG equipment (electrodes, differential amplifiers) and any kind of feedback (usually tones or video feedback). It is used for a variety of psychopathologies and physical pathologies.<br><br>Once the clinician determines how the problem manifests in the brainwave, using EEG measurement equipment, they can then encourage or discourage different behaviors from the brain by rewarding or punishing different EEG behaviors. After a certain number of sessions (typically between 20 and 40) the brain has learned to operate differently, leading to different behaviors and experiences of life.</p><p><span><b>Q; How long does it take?&nbsp;</b></span><b style="font-size: 1rem;">Will it address my condition?&nbsp;</b></p><p>A: While it's wise to not make promises or guarantees for how long the therapy will take or whether it will address the client's concern, anecdotal and academic evidence are compelling and often adequate for answering these kinds of questions. Depending on the experience of the practitioner and the types of modalities used, answering the client's concerns with general answers is possible.&nbsp; Some modalities take longer than others. In the field of neuromodulation (i.e. tDCS, tACS, Pink noise, etc.) 25 sessions is an average amount for conditions that are more common (e.g. neuroses, such as anxiety, stress, panic, etc., or ADHD), while some modalities can take 60-80 sessions or more.&nbsp;</p><h4>Some other Frequently Asked Questions and Answers</h4><p><b>Q: Is Neurotherapy dangerous? Can it hurt me?&nbsp;</b></p><p>A; Short answer: no. Neurofeedback is an operant conditioning method, meaning we are using your brain’s own system of conditioning to create changes in the way your brain behaves. Typically, the worst outcome of a bad neurofeedback session is feeling overly wired or overly tired.<br><br>A: The long answer: it is possible. If the person administering neurofeedback is not experienced or credentialed and has not taken an appropriate assessment, such as a brain map and an intake, they are essentially flying blind. Many pathologies show up with various profiles and presentations in the EEG. It is imperative that the patient researches the competency of their clinician and ensures they have the minimal credentials in the field of neurotherapy before allowing them to do brain work.<b><br></b></p><p><b>Q: Does Neurofeedback Work?</b></p><p>Short answer: Yes. Neurofeedback, which is a means of rewarding the desired brainwave activity or inhibiting problematic brainwave activity with auditory or visual feedback works. How well it works is contingent upon the competency of the practitioner, as well as the tools they have at their disposal. Imagine going to a doctor who hadn’t updated any of his equipment in 30 years, and was practicing with old techniques and assumptions. This would be troublesome and possibly dangerous for the patient. The same goes for neurofeedback. The field of neurofeedback has been around since the 1970s, and many clinicians received their training in the early 1990s with simplistic modalities. The patient ought to expect their clinician regularly attends trainings and keep his/her equipment up to date, as well as his/her clinical perspectives.<br><br>Neurofeedback abetted by neurostimulation is a faster, and cutting-edge method wherein the clinician first shows the brain what it ought to do (i.e. make theta frequencies), then follows up later with neurofeedback, as a conditioning tool. This one-two approach is a solid and reliable way to impact change in the brain.<br></p><p><b>Q: How does neurofeedback work?</b></p><p><span>A: First, the clinician gets an assessment of the client’s brainwave patterns, through a brain map. They also assess the patient through an intake process. Then, they determine what patterns and behaviors in the brain are creating the problem. A classic example is a traditional Attention Deficit Disorder case, where there is too much theta (daydream, hypnogogia, trance-like) and not enough beta (active, conscious thinking). This client has a high theta / beta ratio. The clinician would then determine the source and location of the excess theta and would downtrain (encourage suppression) of the excessive theta brainwaves, while uptraining (encouraging greater amplitudes) of beta brainwaves. This is done using electrodes or a full 19-channel EEG cap. By programing their software for this particular patient, the clinician can reward (via visual or auditory feedback) the optimal state of low amplitude theta brainwaves and high amplitude beta brainwaves, which will lead to a permanent state where the brain knows how to produce more beta and less theta, on a consistent basis. The result, in this example, is a decrease in the attention deficit symptoms due to excess theta, allowing the individual greater focus, clarity, and presence in their functioning.<br></span></p><p><span><b>Q: Does neurofeedback last?</b></span></p><p><span><span>Short answer: yes. Neurofeedback lasts if the duration of training was long enough and if the training was frequent enough. Neurofeedback training is similar to going to the gym. You are trying to alter the functioning of your brain permanently. If you are seeking change, multiple times at the gym, per week, is recommended.<br><br>We typically train our clients anywhere from 3-5 times per week in the beginning of their training (once per week is akin to going to the gym once per week and expecting change). Once we have a few weeks of intensive work under our belts and we are seeing changes, we can begin to titrate back the training regimen to twice per week, then once per week, and eventually once per every other week, until the client’s training has completed.<br><br>After the initial course of training, the occasional neurofeedback tune-up may be desired, but is typically not necessary.<br></span></span></p><p><span><span><b>Q: How does neurostimulation work? Does it work with neurofeedback?</b></span></span></p><p><span><span>If neurotherapy is like going to the gym, then neurofeedback is like weight training and neurostimulation is like cardio vascular exercise. We often begin our clients with cardio for the first few sessions. This primes their system and has an immediate, noticeable effect for most. It is a way to show the brain what we want it to do on its own.<br><br>Once we have a few sessions of neurostimulation, we begin adding in neurofeedback. Neurofeedback is the strength training that conditions the brain. The combination of neurostimulation and neuromodulation is a complete training regimen that speeds up the progress and the duration of treatment.<br></span></span></p><p><span><span><b>Q: Is there any research to support neurofeedback?</b></span></span></p><p><span><span><span>Yes. There is a frequently updated bibliography that is maintained by the International Society for Neurofeedback Research. <a href="https://www.isnr.org/isnr-comprehensive-bibliography" style="">See link here.</a><br><br>One difficulty with neurofeedback research is that nearly all pathologies have different profiles. There is no thing as a one size fits all treatment approach. In addition, it takes a trained clinician to determine the appropriate treatment for each individual.<br></span></span></span></p>