In order to practise neurofeedback, a practitioner needs Neurofeedback equipment, as well as specific training to be a Neurofeedback practitioner. While the industry is not currently regulated in Australia, neurofeedback professionals are encouraged to meet and maintain minimum standards of training and to be assessed and accredited to deliver NFB services. Please visit the BCIA-A website to access minimum training requirements.
Neurofeedback equipment involves sensors, which attach to the scalp, an amplifier that filters and amplifies the signal, and computerised EEG software that analyses the EEG and feeds back the critical information from it to the client. The feedback is most usually in the form of a video game, with both a visual display and sounds that are driven by the client's EEG. Most modern computers are capable of handling Neurofeedback software.
Any person interested in purchasing equipment would be advised to speak to practitioners already in the field. The Neurofeedback equipment (software and hardware) advertised on the internet is of variable quality. Amplifiers differ in their fidelity and software varies in its flexibility and user friendliness. Also, the issues of technical support, software and hardware upgrades need to be considered.
Training in Neurofeedback focuses on two issues: First is the technical issue. Practitioners have to learn how to operate the software and hardware they purchase. They also have to learn how to prepare clients for training, that is, how to attach the EEG sensors to the scalp, and how to make sure the best possible EEG readings can be taken. Usually, this practical training can be achieved in two days.
The more difficult issue involves learning the theoretical underpinnings of Neurofeedback, the particular aspects of Neurophysiology, Neuropharmacology and Neurochemistry necessary to practise successfully. Neurofeedback also has its own special testing. There are diagnostic assessments which are standard in the field of Psychology, such as interviews, history taking, intellectual and personality assessments, and neurological screening instruments, which are also used by Neurofeedback practitioners. There are also assessment tools that belong more specifically within the field of Neurofeedback. There are continuous performance tests which give real time data on the ability of clients to maintain focus and control impulsivity.¹
There are more general computerised neurological tests², and lastly, there is QEEG (Quantitative EEG assessment). QEEG takes what would otherwise be a Clinical EEG assessment, and compares the EEG with a normal database. In clinical practice, a QEEG will typically measure electrical activity at 19 or 26 points on the scalp simultaneously. Not only are the voltages at the scalp measured and compared to normative data, but also measures of the level of connectivity (sometimes called coherence or comodulation) between each pair of points is measured, and also given as standard deviations from the normative mean. These data have diagnostic significance (see John R. Hughes, M.D., Ph.D. and E. Roy John, Ph.D. Conventional and Quantitative Electroencephalography in Psychiatry. Journal of Neuropsychiatry & Clinical Neuroscience 11:190-208, May 1999 © 1999 American Psychiatric Press, Inc.).
All or part of the above mentioned testing and interview data informs the neurofeedback practitioner as to where to place the training sensors, and which EEG frequency bands to train up (reward), and which to train down (inhibit).
There are a variety of training courses in Neurofeedback available in Australia, as well as overseas. Those interested are advised to contact members of the Neurofeedback and Psychology interest group for specific details.
Beyond the initial training in Neurofeedback, practitioners are strongly advised to continue to attend more advanced trainings in Neurofeedback, which are available both in Australia and overseas, to seek supervision and mentorship in Neurofeedback, and to practise only in those areas where they are already knowledgeable, and where their professional training permits them to practise.
Moshe Perl, PhD, MAPS
Member Clinical and Forensic Colleges
¹Such as the TOVA - Test of Variables of Attention and the IVA - Integrated Visual Auditory Continuous Performance Test
²Integ Neuro - from the Brain Resources Company