Additional DNF FAQs
Below are answers to some additional frequently asked questions about direct neurofeedback that might be helpful. If you have a question that is not answered below, please do not hesitate to connect with me, either by giving me a call or clicking on the Connect page to send me an email.
Does direct neurofeedback work?
While no guarantees can be made about the results, direct neurofeedback has been shown in clinical use to reduce symptoms in a wide range of conditions, including, but not limited to: anxiety, depression, post-traumatic stress disorder, ADD/ADHD, substance abuse, autism and traumatic brain injury. The percentage of patients that receive substantial benefit is upwards of 80%. Of those, the large majority experience initial improvement in the first session. Moreover, the positive changes last after completing a full treatment protocol, so treatment is not necessary on an ongoing basis.
Direct neurofeedback has also been found to result in improvements in athletics and other areas of performance.
Direct neurofeedback is not a specific treatment for any one disorder. It is an adjunct to mainstream medicine and is not meant to replace it.
Is direct neurofeedback safe?
Yes, neurofeedback is safe. While the long-term effects of electromagnetic feedback as used in direct neurofeedback are unknown, earlier versions of technologies similar to direct neurofeedback have been in existence since the early 1990s and there have been no reports of any recipient being in worse condition from having completed a course of treatment using direct neurofeedback.
Direct neurofeedback uses an extremely low frequency. As a point of reference, holding a AA battery against the head (as might be used in a pair of Bose headphones) is at least 1,000 times stronger than the direct neurofeedback signal.
How is direct neurofeedback different from Transcranial Magnetic Stimulation (TMS)?
Both are non-invasive, non-pharmaceutical treatments. Direct neurofeedback uses an extremely low-strength electromagnetic current that is too small to directly cause any stimulation or inhibition of neurons. However, by having a “disruptor” effect, the signal influences brainwaves.
TMS, on the other hand, uses magnetic pulses to alter neural activity and is typically reserved for someone that is suffering from severe, treatment-resistant depression.
Are there any side effects to direct neurofeedback?
Temporary side effects, especially early on, are not uncommon. In early sessions, it is common for the brain to be overly “reactive” or get overly stimulated. These side effects are usually mild and are always temporary. If one were to occur, future treatments are adjusted to reduce the incidence of such side effects.
The four most common side effects are:
- Feeling more tired
- Being wired (easily excitable)
- Lightheadedness or “spacey”
How many sessions of direct neurofeedback does it take before a positive change is noticed?
In direct neurofeedback, clients generally notice broad changes either immediately or within the first two or three sessions. Typically, after the first few sessions, people experience better focus, energy level, and mood.
Why is direct neurofeedback‘s full treatment 15-20 sessions?
Although many people experience rapid relief even after just one or two sessions, these initial improvements are temporary, lasting from a few hours to a few days. With additional treatment, these improvements typically last longer and longer until they are more “enduring”. The average number of sessions is between 15 and 20, at which point, people no longer feel the positive effects wearing off.
What might I anticipate during a direct neurofeedback session?
Typically sessions last for 30 minutes or less. The process begins with an evaluation of your particular nervous system as a whole. We will assess your mood, energy level, cognitive clarity, organizational ability, memory and sleep patterns. We will also determine your levels of sensitivity to external stimulation, such as light and noise, to determine the best treatment starting point for you.
Unlike traditional neurofeedback, in which you actively train your brainwaves, direct neurofeedback requires no effort on your part. As you sit in a chair, five sensors are placed on the scalp around the hairline. These sensors measure electrical activity of the brain and communicate the current status of your brainwaves to a computer that displays those brainwaves in the form of an electroencephalogram (EEG) to the direct neurofeedback provider. Based upon your evaluation and assessment, the direct neurofeedback provider will select the most appropriate protocol to administer.
The electrical activity of the brain as measured and displayed by the EEG determines the frequency of the signal that is going back to your brain. The signal influences your brainwaves and this change in brainwave frequencies then causes a change in the frequency of the signal going back to the brain. It is a direct feedback loop. You will not feel the signal being sent to our brain and you will receive only a few seconds to a few minutes of actual direct neurofeedback during each session.
The remaining time in the session will be spent assessing any symptoms, removing the sensors and observing responses to the treatment. The information gathered during each session is necessary to adjust future treatments in order to minimize side effects as maximum progress occurs when you have minimal side effects.
What is the research behind neurofeedback?
Neurofeedback is not new. If you would like to read more, please visit the International Society for Neurofeedback and Research (https://www.isnr.org/isnr-comprehensive-bibliography) where over 1000 published studies are listed, organized by symptom/condition.
Clarity Direct Neurofeedback® was developed based on LENS (Low Energy Neurofeedback System). If you are interested in reading more, please visit Cambridge Neurofeedback (http://www.cambridgeneurofeedback.net/research) where you will find a list of LENS studies and references.
For part of 2013 and most of 2014, The Dubin Clinic ran a formal, Independent Review Board (IRB) approved research study comparing the clinical status of 10 former NFL players with varying degrees of post-concussive syndrome both before and after treatment with direct neurofeedback. To read the promising, preliminary results, go to The Dubin Clinic’s website (http://thedubinclinics.com/nfl-post-concussive-syndrome-study/).
I’m currently on medications for my symptoms. Will this impact the direct neurofeedback treatment?
Being on medications does not necessarily influence the outcome of the direct neurofeedback treatments. In fact, you should avoid making changes in your medications during treatment in order to best assess response to the treatment. It is advised that you don’t stop or reduce your medication without consulting with your healthcare provider first. If your healthcare provider does approve a medication change based upon your treatment response, it will be important to let us know what those changes are, including a change in the medication and/or dosage, before your next direct neurofeedback session.
Will my insurance cover direct neurofeedback?
Some insurance providers may reimburse for such treatments. It is up to each individual to contact their insurance company and ask about such coverage. As neurofeedback is a form of biofeedback, some insurance companies will provide coverage under biofeedback, yet it might only be covered for medical services, not psychological services. Some additional questions you might ask your insurance company about such coverage include:
- Will you cover biofeedback/neurofeedback for (your symptom)?
- How many sessions will you cover (per year)?
- Is there a licensing requirement of the provider?
- Do I have “out-of-network” benefits for biofeedback?
Is it best to start with counseling or direct neurofeedback?
The answer to this question is it depends. Some of the signs of improvement from direct neurofeedback include calmness, clarity, mental energy, optimism and an overall sense of wellbeing. So, if you feel as though the symptoms you are currently experiencing might impede the counseling process, it might be best to start with direct neurofeedback. If you think it might be important to develop a connection with your therapist first, to ensure there is a good fit and a sense of trust before moving forward with direct neurofeedback, then it might be best to start with counseling. For a deeper dive into how these two modalities might be integrated or provided independently, you might want to read Why Add DNF to Body-based Psychotherapy?