Academic journal article Journal of Mental Health Counseling

Developing a Specialty in Neurofeedback: Decision Points

Academic journal article Journal of Mental Health Counseling

Developing a Specialty in Neurofeedback: Decision Points

Article excerpt

This article reviews several important considerations in making the decision to develop a specialty in neurofeedback (NFB). These include: interest in expanding one's clinical expertise in neuroanatomy and neuroscience; aptitude for work with computers, software and equipment; and ethical considerations such as boundaries of practice, qualification, skillful practice, specialty supervision and continuing education. It also reviews important practical issues such as program design and focus, promotion, billing challenges and costs of training, supervision, equipment and supplies. The article then concludes with a brief discussion of the potential value of a NFB specialty to clients, counselors and the counseling profession.


Neurofeedback (NFB), a specialized form of biofeedback, has gained significant recognition as an effective method to change the brain wave patterns and reduce the symptoms associated with many cognitive, emotional, behavioral and physiological problems (Chapin & Russell-Chapin, 2014). Myers and Young (2012) outlined the benefits of integrating neurofeedback in counseling and suggested it has significant potential in counseling preparation, research and practice. It has been estimated that there are between 10,000 and 20,000 NFB practitioners in the United States (Crane, 2009) and these include a wide range of health care professionals: counselors, psychologists, marriage and family therapists, social workers, psychiatrists, physicians and registered nurses. A growing body of outcome research (Yucha & Montgomery, 2008), recent meta-analyses of NFB's effectiveness (Arns, de Ridder, Strehl, Breteler & Coenen, 2009) and functional imaging research (Russell-Chapin et al., 2013) have demonstrated the value of NFB in treating many conditions. Some of these include: attention deficit hyperactivity disorder, epilepsy, anxiety, depression, addiction, trauma, head injury, autism spectrum and personality disorders (Hammond, 2007). This research, combined with continued advances in neuroscience, increased understanding of the mind-body connection, and the astonishing capabilities of new computer software and electroencephalogram technology, has made NFB more accessible to clinicians and, therefore, more available for clients' potential therapeutic benefit. Still, clinicians must ask themselves, "Is adding a NFB specialty right for me and my practice?"

Implementing NFB into a counseling practice can be a challenging, time-consuming and expensive endeavor. There are many important preliminary considerations to take into account before making such a commitment. Once committed, there are also several practical issues to address in the design and implementation of a clinically sound NFB program. Finally, there are ethical issues to consider in assuring clinician competency, program quality and appropriate client treatment. The purpose of this article is to assist clinicians in making an informed decision about adding NFB to their practice. This will be done by reviewing some preliminary considerations, detailing key program design and implementation strategies, and highlighting the ethical principles involved in developing a NFB specialty.


There is much to consider before committing to the development of an NFB specialty. Some of these are academic and theoretical, such as the clinician's interest in neuroscience, neuroanatomy, physiology, the biological basis of behavior, neuroplasticity, biofeedback and the value of self-regulation in the process of change. Others involve professional issues, including qualifications, required training, supervision, certification and ethical considerations. Still more are personal, such as the clinician's motivation for adding NFB to their practice, comfort with computers, software and EEG technology, the necessary time and energy to get up and running and promote a new specialty, and the costs of equipment, training and supervision. …

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