VINCENT J. MONASTRA
The purposes of this chapter are to provide an overview of the primary types of electroencephalographic (EEG) biofeedback, describe the most common clinical applications of each of these treatment protocols, summarize research investigating the application of these treatment protocols in the context of American Psychological Association (APA) guidelines, and present a perspective on directions for future clinical research and practice. Although a substantial number of scientific papers examining the application of EEG biofeedback (neurofeedback) have been published (see Byers, 1995, for a comprehensive overview), a much more restricted number of papers are available for review via Medline and PsycSCAN searches. Overall, a sufficient number of positive outcomes have been noted in the treatment of attention-deficit/ hyperactivity disorder (ADHD), anxiety disorders, mood disorders, seizure disorders, traumatic brain injury (TBI), and addictions to prompt reviewers like Duffy (2000) to comment that "if any medication had demonstrated such a wide spectrum of efficacy, it would be universally accepted and widely used" (p. v).
However, as noted by Duffy (2000), progress in the clinical application of EEG biofeedback appears to have been limited not so much by the lack of research as by the kind of scientific provincialism that is evident when new treatment paradigms are introduced. Duffy (2000) has summarized this issue as follows: "On one hand, some proponents may be overly and uncritically enthusiastic, whereas on the other hand many critics may be quite ignorant of the real data and/or theoretical underpinnings of EEG biofeedback therapy and overly sensitive to self-perpetuating common wisdom" (p. vi). My review of the literature indicates that certain essential questions remain unanswered with respect to neurophysiological models of psychopathology and the identification of specific biofeedback treatment protocols that optimize the therapeutic process and yield enduring improvement in health status. However, as will be illustrated in this chapter, several clinical applications of EEG biofeedback meet established scientific criteria to be considered at least "probably efficacious" in the treatment of a number of psychological and neurological conditions.