EEG Biofeedback for PAIN AND HEADACHE

EEG Biofeedback for PAIN AND HEADACHE meets all of the criteria for Level 4: Efficacious 

EFFICACY LEVELS

Explanation of Efficacy Levels

Biofeedback and neurofeedback therapies have continued to develop over the last 40 years. Today there are myriad disorders for which is used. Large research grants have funded studies on neurofeedback therapy for a variety of disorders. These studies consistently report positive results.

In 2001, a Task Force of the Association for Applied Psychophysiology and Biofeedback and the Society for Neuronal Regulation developed guidelines for the evaluation of the clinical efficacy of psychophysiological interventions. The board of directors of both organizations subsequently approved these guidelines.

A low efficacy rating does not mindicate that neurofeedback is not effective for the disorder, only that an insufficient number of studies have been completed for conclusive results. 

Level 1: Not Empirically Supported

Supported only by anecdotal reports and/or case studies in nonpeer-reviewed venues. Not empirically supported.

Level 2: Possibly Efficacious

At least one study of sufficient statistical power with well-identified outcome measures but lacking randomized assignment to a control condition internal to the study.

Level 3: Probably Efficacious

 Multiple observational studies, clinical studies, wait-list controlled studies, and within-subject and intrasubject replication studies that demonstrate efficacy.

Level 4: Efficacious

a. In a comparison with a no-treatment control group, alternative treatment group, or sham (placebo) control utilizing randomized assignment, the investigational treatment is shown to be statistically significantly superior to the control condition, or the investigational treatment is equivalent to a treatment of established efficacy in a study with sufficient power to detect moderate differences, and

b. The studies have been conducted with a population treated for a specific problem, for whom inclusion criteria are delineated in a reliable, operationally defined manner, and

c. The study used valid and clearly specified outcome measures related to the problem being treated, and

d. The data are subjected to appropriate data analysis, and

e. The diagnostic and treatment variables and procedures are clearly defined in a manner that

permits replication of the study by independent researchers, and

f. The superiority or equivalence of the investigational treatment has been shown in at least two independent research settings.

Level 5: Efficacious and Specific

Evidence for Level 5 efficacy meets all of the criteria for Level 4. In addition, the investigational treatment has been shown to be statistically superior to credible sham therapy, pill, or alternative bonafide treatment in at least two independent research settings.

Disclaimer: All the articles, documents or publications mentioned by or linked on this site have been provided as a public service. There is absolutely no endorsement of any statement made in any of these documents, articles, or publications.

Research studies:

Bazanova, O.M., Aftanas, L.I. (2010).Individual EEG alpha activity analysis for enhancement neurofeedback efficiency: Two case studies.  Journal of Neurotherapy14(3), 244 – 253.

Coger, R., & Werbach, M. (1975). Attention, anxiety, and the effects of learned enhancement of EEG alpha in chronic pain: A pilot study in biofeedback. Chapter in B. L. Drue, Jr. (Ed.), Pain Research and Treatment. New York: Academic Press.

Gannon, L., & Sternbach, R. A. (1971). Alpha enhancement as a treatment for pain: A case study. Behavior Therapy & Experimental Psychiatry, 2, 209-213.

Ham, L. P., & Packard, R. C. (1996). A retrospective, follow-up study of biofeedback-assisted relaxation therapy in patients with posttraumatic headache. Biofeedback & Self-Regulation, 21(2), 93-104.

Jensen, M.P., Sherlin, L.H., Hakimian, S., Fregni, F. (2009). Neuromodulatory approaches for chronic pain management: Research findings and clinical implications.Journal of Neurotherapy 13(4), 196 – 213.

Jensen, M. P., Grierson, C., Tracy-Smith, V., Bacigalupi, S. C., Othmer, S. (2007).  Neurofeedback treatment for pain associated with complex regional pain syndrome. Journal of Neurotherapy, 11(1), 45-53. 

Lehmann, D., Lang, W., & Debruyne, P. (1976). Controlled EEG alpha feedback training in normals and headache patients. Archives of Psychiatry, 221, 331-343.

Matthew, A., Mishm, H., & Kumamiah, V. (1987). Alpha feedback in the treatment of tension headache. Journal of Personality & Clinical Studies, 3(1), 17-22.

McKenzie, R., Ehrisman, W., Montgomery, P. S., & Barnes, R. H. (1974). The treatment of headache by means of electroencephalographic biofeedback. Headache, 13, 164-172.

Pelletier, K. R., & Pepper, E. (1977). Developing a biofeedback model: Alpha EEG feedback as a means for pain control. International Journal of Clinical & Experimental Hypnosis, 25, 361-371.

Rosenfeld, J. P., Dowman, R., Heinricher, N., & Silvia, R. (1984). Operantly controlled somatosensory evoked potentials: Specific effects on pain processes. Chapter in B. Rockstroh, T. Elbert, W. Lutzenberger, & N. Birbaumer (Eds.), Self-Regulation of the Brain and Behavior. Berlin: Springer-Verlag, pp. 164-179.

Rosenfeld, J. P., Silvia, R.,Weitkunat, R., & Dowman, R. (1985). Operant control of human somatosensory evoked potentials alters experimental pain perception. Chapter in H. L. Fields, R. Dubner, & F. Cervero (Eds.), Advances in Pain Research and Therapy, Volume 9: Proceedings of the Fourth World Congress on Pain. New York: Raven Press, 343-349.

Sime, A. (2004). Case study of trigeminal neuralgia using neurofeedback and peripheral biofeedback. Journal of Neurotherapy, 8(1), 59-71.

Siniatchkin, M., Hierundar, A., Kropp, P., Kuhnert, R., Gerber, W-D., & Stephani, U. (2000). Self-regulation of slow cortical potentials in children with migraine: An exploratory study. Applied Psychophysiology & Biofeedback, 25(1), 13-32.

Tansey, M. A. (1991). A neurobiological treatment for migraine: The response of four cases of migraine to EEG biofeedback training. Headache Quarterly: Current Treatment & Research, 90-96.

Source: http://www.brainworksneurotherapy.com/efficacy-levels

Our Services on Newspaper Headline (29 August 2014)

Nanyang Siang Pau Newspaper Headline 南洋商报头条新闻 (29 August 2014), 

旅游与文化部长纳兹里正坐在我的临床催眠疗法沙发上检查他的脑电波。

Tourism and Culture Minister Datuk Seri Nazri Aziz was sitting on my clinical hypnotherapy chair and checking his brainwaves. 

China Press Newspaper  中国报(29 August 2014)

旅游与文化部长纳兹里正坐在我的临床催眠疗法沙发上检查他的脑电波。

Tourism and Culture Minister Datuk Seri Nazri Aziz was sitting on my clinical hypnotherapy chair and checking his brainwaves. 

 Harian Metro (29 August 2014)

Tourism and Culture Minister Datuk Seri Nazri Aziz was sitting on my clinical hypnotherapy chair and checking his brainwaves. 

Success Story (Depression and Insomnia - Miss T)

If you think you may have insomnia, ask yourself the following questions:

• Do you wake up during the night and find that you cannot fall back asleep? 
• Do you lie in bed, tossing and turning for hours each night? 
• Do you dread going to bed because you feel like you never get a good night’s sleep? 
• Do you wake up feeling unrefreshed after sleeping? 
• Does the problem occur even though you have the opportunity and the time to get a good night’s sleep? 
• You are suffering from depression?
• It takes you more than 30 mins to fall asleep?

If you answered “yes” to any of the above questions, then you may have insomnia. If you’ve had insomnia for more than three weeks (chronic insomnia), consider booking an appointment with a therapist.
Let's me share a testimonial that I get from my clients, this real story tell you how she improve her insomnia problem after doing her clinical hypnotherapy and EEG biofeedback therapy with me.

.................................................................................................................................................................

My client: T (22 years old), primarily came to see me for her stress issues. She has been diagnosed with depression and was prescribed with the antidepressants as well as sleeping pill by her Psychiatrist. However, She stopped her anti depressant and sleeping pill after using them for 3 weeks as she felt that she could not sleep even with the sleeping pills and she feels a lot more blur and slow in response after the antidepressants.
Her problem has influenced her life since she was young until to the extend that she had to stop herself from continuing her study due to her lack in  focus and emotional issues.
Upon analyzing her unique brainwave patterns and her response toward clinical hypnotherapy, I found that most of her brainwaves pattern (especially those brain locations which associated with focus, logical thinking, verbal expression and attention span) is under-arousal/weak.

Her brainwaves pattern is the reason why she was having problem as below:

1. Depression symptoms
2. Self harmful thoughts
3. Insomnia
4. Bad sleeping quality
5. Negative thoughts
6. Inability to express confidently
7. Poor focus and attention span

Treatment Plan:
A customized self-hypnosis method was planned for her; She was guided on how to do self hypnosis effectively while her brainwaves was monitored. For the first session, 2 hours was spent with her to deal with her depression symptoms, negative thinking and self harmful thoughts issues.

Following is the result obtained:

After the first session, she confessed that it was the first time ever that she felt so calm and relaxed. She complied to practice her customized self hypnosis technique for positive thinking once a day until her next visit.
Two weeks later, the follow up session was carried out.
Following are the changes that she experiences after the 2 weeks practice of self hypnosis:

1. Positive thinking
2. More optimistic
3. More confident to speak
4. Ability to let go of past event
5. Begin to look forward for a better future
6. Less self harmful thoughts
7. Become less anxious and stressful
8. Become relax and calm 
9. Response speed increased

For her 3rd session, her objective is to improve her sleep quality and deal with her insomnia problem so that she can improve her overall life quality as well as her health condition. I guided her to do a customized self hypnosis technique for sleep and following is the result obtained:

During the session, she was able to fall asleep by doing her customized self hypnosis technique for sleep alone! As you can notice her Delta brainwaves for sleep increased after she did her self hypnosis technique (See the red cursor on the graph above) and her Hibeta was decreasing further too.

Upon the completion of the clinical hypnotherapy session, she came back to do EEG biofeedback therapy to improve her attention span and focus issue.
She shared her joy and improvement on the relevant issue. She found the following positive changes in her life after the therapy session:

1. Feel more motivated to live better
2. Easy to wake up in the morning, feeling refreshed
3. More alert 
4. Increase in the respond speed
5. Improvement in sleep quality (Able to sleep by doing customized self hypnosis and without the use of sleeping pill)

Remark:

Before she started the clinical hypnotherapy session, her depression screening test showed a score of 29 (Category: moderate to severe depression). After 3 sessions of clinical hypnotherapy, she now had a score of 9 (Category: none to mild depression).

Remark: Our client's information will be kept strictly confidential all the time. All reviews have been acknowledged and provided by past and current clients of (Clinical Hypnotherapist Koo). Clients names have been changed to protect their identity.