Imagine a simple procedure versatile enough to treat epilepsy, autism, and attention deficit disorder, addictions, and depression without drugs, surgery, or side effects. These are only some of the capabilities of neurofeedback.
--Jim Robbins (2008, inside cover)
The Association for Applied Psychophysiology and Biofeedback (AAPB) and the International Society for Neurofeedback and Research (ISNR) defined biofeedback as "a process that enables an individual to learn how to change physiological activity for the purposes of improving health and performance" (AAPB, 2008, "What Is Biofeedback," para. 2). Biofeedback allows individuals to be actively involved in the control of their own physiological and emotional processes (i.e., self-regulate), first aided by equipment that measures physiological activity and later without the use of such instruments (Wheat & Larkin, 2010). Neurofeedback (NFB), a subset of biofeedback, allows clients to monitor and change their brain wave patterns, which leads to changes in behavior (Heinrich, Gevensleben, & Strehl, 2007). Recent meta-analyses and reviews of outcome research have established the effectiveness of NFB in improving the quality of life through symptom reduction for persons with attention-deficit/hyperactivity disorder (ADHD; Ares, de Ridder, Strehl, Breteler, & Coenen, 2009; Williams, 2010), autism spectrum disorder (Cohen, Linden, & Myers, 2010), Asperger's syndrome (L. Thompson, Thompson, & Reid, 2010), sexual behavior problems (Longo, 2010), drug addiction (Sokhadze, Stewart, & Hollifield, 2007), and epilepsy (Walker, 2010), among other conditions. In a recent position paper, Sherlin, Arns, Lubar, and Sokhadzke (2010) provided evidence to support the designation of NFB as a safe and efficacious treatment for ADHD, meeting the criteria for a Level 5 treatment system using the ISNR and AAPB five-level rating system (La Vaque et al., 2002).
NFB has been shown in multiple studies to improve autonomic regulation, promote brain competencies, help remediate brain-based functional disorders through both symptom reduction and the amelioration of underlying conditions, and enhance optimum performance (Arns et al., 2009; Vernon, 2005). NFB reduces the need for psychoactive medications and has been shown to be as effective as medications in the treatment of ADHD (Vernon, Frick, & Gruzelier, 2004). Experienced clinicians have reported that NFB has success rates of 60% to 80% (Evans & Rubi, 2009; Gunkleman & Johnstone, 2005) with virtually no side effects (S. Othmer, 2009). Relatedly, functional imaging studies using techniques such as positron emission tomography (PET) and functional magnetic resonance imaging (fMRI) have begun to demonstrate that counseling and psychotherapy actually change how the brain functions (Linden, 2006). On the basis of these findings, it is timely to consider how NFB, as well as neuroscience, can be integrated into counseling practice, preparation, and research.
The 2009 Standards of the Council for Accreditation of Counseling and Related Educational Programs (CACREP) require all counselors to have curricular experiences to promote an understanding of the "nature and needs of persons at all developmental levels, ... theories of learning and personality development, including current understandings about neurobiological behavior" (CACREP, 2009, p. 10). Neurobiological behavior is further defined as "the relationship among brain anatomy, function, biochemistry, and learning and behavior" (CACREP, 2009, p. 60). The intent of the 2009 Standards clearly is not to add courses in neuroscience, neuroanatomy, or brain functioning to the knowledge base for counseling, but rather to help counselors integrate important concepts from neuroscience into counseling work (Ivey, Ivey, Zalaquett, & Quirk, 2009). We propose NFB as the foundation for this integration because it not only incorporates an understanding of neuroscience, the study of the brain and nervous system, but also offers an applied means of intervention that counselors can implement to promote and evaluate positive client change. …