Biofeedback Therapy

Biofeedback therapy is more of a training process rather than a treatment, but it can be used as part of your overall treatment plan. A therapist may incorporate biofeedback techniques to treat a variety of conditions. However, research suggests it works better for some conditions than others.

Biofeedback is thought to be effective in treating ADHD, anxiety, chronic pain, constipation, headaches, epilepsy, motion sickness, hypertension, TMJ disorder, and Raynaud’s disease, among others. It may also be effective in the treatment of alcohol and substance abuse, arthritis, Type 2 diabetes, insomnia, and bowel incontinence. Although data is limited, biofeedback might be helpful with asthma, COPD, autism, cerebral or Bell’s palsy, depressive disorders, erectile dysfunction, fibromyalgia, IBS, stroke, tinnitus, and PTSD. There’s currently no supporting data that it’s effective for eating disorders, spinal cord injury, or immune function.

You may be encouraged to get biofeedback training as an alternative or supplemental therapy, especially if your current treatment plan isn’t producing a sufficient response or any response. If you have a medication intolerance or pharmacological treatment isn’t advised due to pregnancy, nursing, or other circumstances, biofeedback training may be suggested. If you’re currently getting psychotherapy and stress is a major part of your medical problems, you or your therapist may consider adding biofeedback training, especially if you value self-control.

Biofeedback may be combined with psychotherapy or medications, depending on your specific needs, but there aren’t any set treatment plans that go with biofeedback training. The benefits of biofeedback vary between individuals, but results may be more likely to occur when combined with cognitive behavioral therapy, physical therapy, and other relaxation techniques. Surface electromyography biofeedback and electroencephalography biofeedback are two specific types of biofeedback used for various disorders, including tension headaches, chronic pain, ADHD, and epilepsy.

Like any therapy, you want to ensure you choose a biofeedback therapist near you that you’re comfortable working with. This is especially true if your biofeedback therapist is doubling as your psychotherapist. It’s important to find a good fit. A therapist with the right mix of experience, compassionate care, and trustworthiness can put you at ease during your sessions.

When choosing a therapist, don’t overlook demographic factors that can play a part in how comfortable you may feel when working with a specific therapist. Factors like age, gender, sexuality focus, and faith focus can all potentially impact your comfort level, so keep these factors in mind when comparing biofeedback therapists near you.

A licensed mental health professional can administer biofeedback therapy if it’s within their scope of practice. Otherwise, a certified biofeedback technician may assist in the biofeedback treatment while your therapist provides psychotherapy. A mental health therapist who’s trained in biofeedback should have professional certification. The Biofeedback Certification International Alliance offers the Board Certified Biofeedback Practitioner credential and sets the minimum training standards for therapists wanting to provide biofeedback-based interventions. However, BCIA certification isn’t a license to practice. Some states require biofeedback therapists to be licensed, so check with your local licensing board.

Because biofeedback therapy requires specialized equipment and training, the cost for sessions may be higher than with other types of therapy. However, if biofeedback training is something you and your therapist think might help when other therapies haven’t, it’s worth the expense. Some medical insurance providers will cover biofeedback for certain conditions, so check with your provider and confirm if your therapist is in-network. You can also ask your biofeedback therapist if they offer a sliding fee schedule based on income.

Biofeedback may relieve specific symptoms and reduce medication consumption without significant side effects. Therapists incorporate biofeedback techniques into overall treatment plans for various conditions, including:

• Attention deficit hyperactivity disorder: EEG biofeedback/neurofeedback may help treat ADHD by teaching you how to self-regulate your brain activity and alter your control of cognition and behavior.
• Anxiety-related disorders: Biofeedback and neurofeedback may help with mood and anxiety-related disorders, such as generalized anxiety disorder, PTSD, and depressive disorders, by helping you alter brain activity and promote behavior changes.
• Substance use disorders: EEG biofeedback has been used for substance use disorders for decades, including drug and alcohol abuse. It may be combined with residential treatment programs and psychotherapy to aid in recovery.
• Headaches/migraines: Biofeedback is the most common non-pharmacological treatment for migraines and tension-type headaches, the two most prevalent and disabling types of headaches. It may help reduce your headache frequency and medication consumption.

During your biofeedback sessions, electrical sensors are connected to different areas of your head and body to convert physical signals into visual and auditory cues about your body. You don’t need any special preparation before your biofeedback therapy. However, successful biofeedback training requires a great deal of participation and motivation, so bring an open mind and willingness to follow through with the instructions provided. If you’re just starting, write out the symptoms that are bothering you most, their frequency and duration, and anything that triggers symptoms so your therapist fully understands what needs to be addressed during biofeedback training.

Biofeedback is a non-pharmacological treatment with clinical applications covering a wide range of medical disorders. There are different types and models of biofeedback training, including:

Surface electromyography biofeedback

sEMG feedback measures muscle activity and allows direct access to muscle functioning. It helps you learn to “down-train” muscles that are overly active or “up-train” muscles that are weak or affected by partial paralysis. sEMG feedback may help with chronic pain, uncontrollable muscle spasms, TMJ dysfunction, and tension headaches.

Electroencephalography biofeedback

EEG feedback, also called neurofeedback, potentially helps improve cognitive deficits and has been shown to improve attention and working memory. It measures electrical activity in the brain and attempts to modify certain brain wave frequencies. EEG feedback has been used to treat ADHD, dyslexia, and epilepsy and evaluated for numerous other applications.

Thermal biofeedback

Thermal biofeedback involves measuring skin temperature to help you control blood flow. It has been used to alter blood vessel constriction in the fingers to improve slowed blood flow, which can help with Raynaud’s disease. Finger temperature is also an indicator of stress, so thermal biofeedback also has been used for hypertension and vascular headaches.

Biofeedback-based cognitive behavioral treatment

CBT-BF contains both biofeedback and cognitive behavioral treatment elements, which are used to educate you about a specific disorder and combine biofeedback training to improve maladaptive thoughts and behaviors. For example, when CBT for anxiety, stress, or depression is combined with biofeedback, you train your muscles to relax to help you release negative thoughts causing your anxiety, etc.

Like physical therapy, you must actively participate during your biofeedback therapy and practice between sessions. Your biofeedback therapist will teach you mental and relaxation exercises and deep breathing, muscle relaxation, and stress-coping techniques, which you should practice for at least five to 10 minutes each day at home. The overall success of your biofeedback therapy hinges on how frequently you use the techniques you learn during your therapy sessions in your everyday life.

The following sources were used throughout this guide. If you’d like more information about biofeedback and how it may help with various medical and mental health conditions, review these resources.

• AAPB | Evidence-Based Practice in Biofeedback and Neurofeedback: Provides details on why biofeedback is used and research data on its effectiveness. | Last accessed June 2021.
• NCBI | Biofeedback in medicine: who, when, why, and how: Provides details on how biofeedback works and the conditions it may help treat.
• NCBI | Biofeedback: Outlines the basic components of biofeedback and conditions it helps treat. | Last accessed June 2021.
• AAPB | Standards for Performing Biofeedback: Includes In-depth information on the training required to provide biofeedback-based services. | Last accessed June 2021.
• NCBI | Neurofeedback as a Treatment Intervention in ADHD: Discuss how EEG biofeedback helps with ADHD. | Last accessed June 2021.
• NCBI | Neurofeedback and Biofeedback for Mood and Anxiety Disorders: Covers the effectiveness of neurofeedback on anxiety and mood disorders. | Last accessed June 2021.
• NCBI | EEG Biofeedback as a Treatment for Substance Use Disorders: Reviews the effectiveness of EEG biofeedback for substance abuse. | Last accessed June 2021.
• AAPB | Biofeedback Treatment for Headache Disorders: Provides details on how biofeedback helps relieve headaches and migraines. | Last accessed June 2021.
• NCBI | Surface Electromyographic (SEMG) Biofeedback for Chronic Low Back Pain: Discusses the benefits of sEMG for chronic pain. | Last accessed June 2021.
• NCBI | Effectiveness of EEG-Biofeedback on Attentiveness, Working Memory and Quantitative Electroencephalography on Reading Disorder: Studies the effectiveness of EEG biofeedback in children with attention, reading, and memory issues. | Last accessed June 2021.
• NCBI | Biofeedback in Medical Practice: Discusses the different types of biofeedback and what they’re used for. | Last accessed June 2021.