Affective Neurosciences PLLC

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Overview Of the Neurofeedback Training Process


Sessions generally take approximately 45 minutes, with 30 minutes of actual training time. Occasionally we will train for a longer period, when time permits. The first session is always only 15 to 20 minutes, to assess how each person responds.

Please do your best to arrive on time. Our schedule can be quite tight. In order to be able to take trainees at the scheduled time, it is important that we stay on schedule for the afternoon. If you are not able to arrive on time, we will do our best to get to you as soon as possible, but will need to work within the constraints of the rest of the scheduled sessions.

Please arrange all scheduling changes with your therapist.

Information on the effects of training:

The neurofeedback equipment provides feedback to the trainee about brain activity to allow for change. But we need feedback from you about what you experienced after the training to assess the effects of the training and fine tune and optimize the training process.

We will always assume that changes seen after a session, whether positive or negative, are a result of training. If there is any reason to think that another factor may account for the change you observed, please let us know.

After every session, we will ask you to complete a checklist of changes you noticed after the session. You do not need to check the item if there was no change. Please rate these items for changes observed comparing behavior in the time prior to the last session to the time after the session. We are looking for your observations of the changes due to EACH session, not change from the beginning.

For the first four or five sessions, we do not expect that changes will be long lasting. Please make your observations based on changes for the rest of the day after the session. After sufficient learning has occurred, the changes will last longer and you can include observations on the following day or days.

Consider all of the items on the list, not just those that are your primary concern. Use the bottom of the form or the back for any additional observations.

We have this checklist available online, and we ask you to complete the checklist the evening before your next session. This will allow us more time to consider how best to change and fine tune the training before your session.

Please raise any questions or concerns directly with Dr. Lonsberry. She will always be available to talk to you before sessions. However, when we are busy, she will need to limit herself to shorter discussions with you at this time. If you have concerns or issues to discuss that will require more than a few minutes of her time, please call before your session to talk with her. She is usually available between 12 and 2.

Should you have any urgent concerns between sessions, please call us immediately!

Training effects:

We expect to see some training effects within four or five sessions, usually before then. Occasionally it may take longer for change to be evident. Change is usually subtle at first and becomes stronger and more apparent over time.

We do see short lived negative effects from the training. We use these as indications on how to adjust and optimize the training over time. There are no reports known to me of lasting negative outcomes from neurofeedback. But we do need to know of any negative outcomes you observe.

Individuals vary a great deal in how long training effects endure. Usually they are short lived at the beginning of the training and begin to last longer over time. Please let us know if they do not appear to be lasting after the initial six or seven sessions.

Occasionally it happens that there is no change immediately after a session, but then a delayed change seems to occur. If you think you are seeing this, please let us know. It also occasionally happens that there is a period of unsettled or disrupted behavior immediately after the session, and then behavior settles afterward. The initial disruption tends to recede over time and then disappear as one gets used to the training.

It may also happen that a person has an especially strong response to the very first session. For this reason, we conduct only 15 minutes of training on the first session. Should this happen to you, please be aware that we usually see that the size or strength of the effect from subsequent training sessions does not remain as strong as on the first session, although the gains accumulate over time.

Psychoactive medication:

Many trainees are taking medication when they begin training. Many have the goal of reducing or eliminating medication. However, we do not want to begin doing neurofeedback training when you are in the middle of a medication change. We have no way of knowing whether any effects seen are due to the medication change or to neurofeedback. If you and your physician are considering a medication change, please let us know. We will then plan to wait until your medication has been stabilized before beginning neurofeedback.

If medication change is needed during the course of your neurofeedback training, please let us know in advance. It is often necessary to reduce medication, as the training takes effect. This is particularly true of stimulant medication. If you are seeing good progress with neurofeedback, and then symptoms and/or behavior worsens, it may be that the previously adequate medication dose is now too much, due to the neurofeedback training effect. Some physicians will mistakenly interpret this as a need for MORE medication, worsening the situation. Please let us know if you see this pattern of worsening behavior after a period of improvement.

Dr. Lonsberry is always happy to speak with your prescribing physician if there are any questions about possible interactions of medication and neurofeedback training.

Other considerations:

If you are getting sick, or still recovering from being sick, do not come in for training. We usually see excess slow wave activity with illness, and it does not make sense to attempt to alter this temporary illness-related EEG pattern. Call to let us know that you are sick and will return to training when you are healthy.

Scientific evidence is accumulating that shows a relationship between nutrition/diet and a variety of psychological and neurodevelopmental factors including mood, attention, and learning. The same is true of exercise, sleep, and time spent in videogame play and watching TV. We urge you strongly to take small, consistent, and cumulative steps to improve your nutrition, get regular exercise, and regulate sleep based on the need for sleep at each developmental stage. In addition, videogame play and TV watching should be monitored and kept within reasonable limits, for example, no more than one hour daily.

Although we do not always provide neurofeedback together with family therapy, parent guidance, or other forms of therapy, we often do so. If you believe that you and/or your family are in need of additional forms of intervention, please discuss this with Dr. Lonsberry.

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