Neurofeedback therapy gives real-time feedback about brain activity from a computer-based program. For example, one form of neurofeedback uses an electroencephalography (EEG) machine to do this. Here, small metal discs (electrodes) are placed on the scalp, and the EEG machine records brainwaves (i.e., brain activity). This brain activity is then displayed in real-time through a feedback signal.

During neurofeedback training, the individual may be in a neutral resting state (i.e., similar to meditation practices) or given controlled trauma reminders as sounds or pictures. Brain activity is monitored as participants try to self-regulate.

Feedback about this brain activity is given immediately in the form of auditory or visual signals. This way, the participant becomes aware of the automatic responses the brain is having and that can cause symptoms of PTSD.

Over the course of neurofeedback therapy, individuals learn to train their brain to re-focus or regulate brainwaves in more balanced and helpful ways when triggers happen in the moment. That way, the triggers don’t result in unhelpful thoughts, emotions, moods and behaviours.

Neurofeedback doesn’t just treat responses to specific triggers – it can also help to improve functioning in day-to-day life.

At the start of the first neurofeedback session, a service provider will clearly explain the equipment and machinery being used, as well as the process.

Example of an EEG-based neurofeedback treatment:

• Clients are comfortably seated throughout the 20 to 60 minute session (although a variety of neurofeedback protocols exist, which can be tailored to benefit personalized needs).
• EEG sensors are placed on the client’s scalp using gel or a headband. The sensors only measure brain waves. They don’t have an electrical current so there won’t be a sensation of an electrical shock.
• Depending on needs and the particular treatment plan, clients view a video or animation (using a screen or headset) or listen to sounds or music that is streamed into the room or on headphones. This is usually related to the feedback signal, and changes over the treatment. Depending on the treatment needs, sometimes individuals will be shown words or pictures that are associated with their specific trauma experience (akin to exposure therapies for PTSD).
• The EEG sensors will measure brain activity as the client watches or listens.
  • Visual or auditory feedback (i.e., a video or gentle beep) is given to the client when their brainwaves are within (or outside of) a goal range or “baseline.” For example, if the brain is reacting to a trigger and the EEG shows that the client is able to regulate it in the moment, the video may change slightly or they may hear a beeping sound to reward their brain for responding in a helpful way.
• This is repeated on a loop throughout individual sessions and for the course of treatment to train the brain to respond in more helpful ways when triggered.

As a non-invasive therapy, neurofeedback:

• Doesn’t hurt
• Does not require sedation or medications
• Does not always require exposure to trauma reminders.

After a neurofeedback session it is safe to return to regular daily routines. Some people may feel tired or mentally exhausted after the session.

Sometimes, individuals will have a pre-therapy session where they work with a trained service provider to “map their trauma.” In this process, individuals are asked to share the unique circumstances of the trauma they experienced, the particular symptoms they have and potential management strategies. The parts of the brain that show too much, or too little, activity that triggers PTSD symptoms may be identified, along with the particular cues that trigger those responses.

• Each session can last between 20 and 60 minutes.
• Sessions can be weekly or more frequent, based on needs.
• The duration of therapy varies for individual needs and is determined collaboratively by the service provider and the person receiving therapy.
• Importantly, more research is still needed to identify effective duration and dosing of neurofeedback treatments. This research is currently being conducted by the Atlas Institute.

Neurofeedback is safe, non-invasive and doesn’t have any known significant long-term side effects.

A service provider who is covered through VAC/Medavie Blue will need to be certified by the Biofeedback Certification International Alliance, which offers a searchable database of clinicians here.

Service providers administering neurofeedback should have the appropriate training and be certified by the Biofeedback Certification International Alliance (BCIA). Only BCIA certified clinicians are covered under VAC/Medavie Blue Cross benefits.

Service providers should also have background and experience that is relevant to a client’s specific needs. For example, if the individual has a diagnosis of PTSD and/or another mental health concern, it will be important the neurofeedback service provider has knowledge and expertise in this area.

When considering working with a service provider, questions to ask include:

• What their educational background and credentials are.
• If they have experience working with Veterans and/or people with a diagnosis or symptoms like yours.
• What their process is like and what will happen during the sessions.
• How they will modify the treatment protocol if any side effects occur.

The Biofeedback Certification International Alliance offers a searchable database of clinicians here.

Neurofeedback/EEG Biofeedback therapy is covered under mental health services through VAC/Medavie Blue Cross for Veterans who qualify.

A recommendation from a primary doctor/mental health professional (e.g., psychiatrist, psychologist or GP) is required.

Learn more about how to qualify for neurofeedback coverage here.

Neurofeedback is covered by some private health insurance companies.