The Science Behind Neurofeedback
The Evidence Base for Neurofeedback ( From www.neurofeedbackadvocacyproject.com )
On matters of the science of neurofeedback, I am guided by the extensive experience of Dr. Matt Fleischman, Director at the Neurofeedback Advocacy Project. In his blog at www.neurofeedbackadvocacyproject.com he writes:
“When we approach agencies about joining the Neurofeedback Advocacy Project, I, am often asked about the evidence base for neurofeedback, and about the ILF Neurofeedback, the type of feedback we use in the project. This is my answer:
First, to get a sense of the breadth and depth of research on neurofeedback, I actually recommend folks at least scan for the term "neurofeedback" and then any other modifier you want to add at https://pubmed.ncbi.nlm.nih.gov/. There should be over a 1000 published studies.
Going at it another way, I recommend reading the current NY Times bestseller, The Body Keeps Score by Dr. Bessel van der Kolk, one of the recognized experts on trauma and its treatment as Dr. van der Kolk includes a chapter on neurofeedback as an invaluable tool. To those interested in the underlying science of trauma and how that relates to neurofeedback, I strongly recommend Sebern F. Fisher’s Neurofeedback in the Treatment of Developmental Trauma.
Outside the field of trauma, I recommend Neurofeedback and Attention‐Deficit/Hyperactivity‐Disorder (ADHD) in Children: Rating the Evidence and Proposed Guidelines (2020) which concludes based on two meta-analyses that neurofeedback fits on the continuum of empirically supported treatments, using standard protocols. For a good summary of the underlying science, we recommend Closed-loop brain training: the science of neurofeedback in the distinguished journal Nature Review: Neuroscience.
In regards to the specific neurofeedback modality I use in my work, I direct folks to articles by Dr. Sigfried Othmer. Dr. Othmer and his wife Susan Othmer are responsible for what is now termed Infra Low Frequency (ILF) Neurofeedback. From these pages, you can find links to studies in all areas.
Besides sending folks to these other sources, I feel it is appropriate to mention my own professional history including over 30 years using neurofeedback. In my doctoral program at the University of Oregon, my field of interest was behavior disorders in children. Upon graduating I was a Principal Investigator for an NIMH funded field study on the treatment of aggressive children. Later I was the Director of the Center for Attention & Learning in Eugene, Oregon and soon incorporated neurofeedback into my clinical work treating ADD/ADHD and behavior disorders. I have taught seminars and courses in the US and abroad in this area, and have stayed current with many approaches to neurofeedback including ones based on quantitative electroencephalography (QEEG).
However, I have never been convinced that this approach could be widely implemented, especially in public and non-profit settings that served the most difficult and underserved cliental. And while there is a proliferation of inexpensive neurofeedback-like devices on the Internet, none have had the scrutiny to assure they were safe and/or effective.
For the Neurofeedback Advocacy Project, I opted for the use of ILF Neurofeedback because I saw how effective it was, especially with clients who also had a history of trauma or co-occurring such as addictions and mental health issues. Furthermore, the Othmer's EEG Institute has developed a training model where new practitioners could be trained in as little as 5 days and with a model he developed for supervision at a distance, and which could provide safe, competent treatment to real-world clients immediately after the training. Furthermore, their Cygnet system of hardware and software has turned out to be nearly bullet-proof, even in the hands of the most technologically phobic clinicians.”
Dr, Fleischman has been a primary force in guiding me in my development of my understanding of neurofeedback. Over the years, Dr. Fleischman has introduced many practitioners to this model of neurofeedback and in the course of our work in the Neurofeedback Advocacy Project I have seen how successfully newly trained neurofeedback clinicians were able to implement it with populations not usually seen in private practice. This led me to join Dr. Fleischman to launch the Neurofeedback Advocacy Project, where we initially implemented ILF neurofeedback in three agencies in Oregon and collected data to assess its impact. This data showed significant improvements in what everyone would agree are very difficult client populations. Furthermore, seeing their results, each agency chose to expand their use of neurofeedback. The program is now active in nine agency sites, with discussions underway with many more in several States.
The project continues to expand its data collection. Our goal is to provide our own evidence base for our work. We believe strongly that such evidence, collected in real world settings, and using meaningful measures of results, is the best way to promote the wide spread use of neurofeedback .