Neurofeedback Therapy

Dr. Nicolette Natale
Brittany Ferri
Written by Dr. Nicolette Natale on 03 February 2025
Medically reviewed by Brittany Ferri on 06 February 2025

Neurofeedback therapy, also known as electroencephalogram (EEG) biofeedback or neurotherapy, is a non-invasive treatment designed to train the brain to regulate its activity. It provides real-time auditory or visual feedback to help individuals adjust their brainwaves, promoting mental states such as focus, calmness, and better emotional regulation.

Neurofeedback is used to treat conditions like ADHD, anxiety, depression, and sleep disorders, as well as addiction, by promoting healthier brainwave patterns.

Key takeaways:
  • Neurofeedback therapy is a non-invasive treatment that trains the brain to regulate its activity using real-time EEG feedback; it is commonly used for ADHD, anxiety, depression, sleep disorders, and addiction, among other conditions.
  • Neurofeedback is a promising treatment for addiction because it addresses brain imbalances linked to cravings and impulsivity, potentially supporting long-term recovery and complementing traditional treatments.
  • While neurofeedback shows potential, it should be used as an adjunct to traditional treatments due to current evidence gaps. There is ongoing research to optimize the use of neurofeedback and to help integrate it more effectively into a comprehensive treatment plan.
a close up photo of a person hooked up with wires of on their head for an EEG or neurofeedback therapy

Understanding Neurofeedback

Neurofeedback is a method of training the brain designed to improve cognitive function. This therapy is considered a type of biofeedback in that it gives the provider and the client greater awareness of physiological functions–in the case of neurofeedback, brain activity–to help control how the client thinks and feels.

Despite its current limitations, neurofeedback is steadily gaining recognition as a promising tool in mental health and brain wellness. While it is primarily used today as an adjunct to traditional therapeutic approaches, its potential applications continue to expand. Professional devices have been developed and marketed for professional providers, and consumer-grade devices for home usage are employed, proving its recent prominence.

Many individuals who seek neurofeedback are already engaged in conventional treatments, such as psychotherapy or medication management, and use it as a complementary method to enhance their progress or address specific challenges.

Is neurofeedback therapy a legitimate method?

The field’s growing legitimacy is reflected in actions taken by organizations like the International Society for Neurofeedback & Research, which rebranded in 2019 due to additional brain-based technologies and methods. This shift signals a recognition of research within a larger movement toward integrative approaches to mental health and cognitive optimization. As research continues to explore its effectiveness and accessibility improves, neurofeedback could move from being an adjunctive therapy to a more mainstream intervention.

How it works: The science behind neurofeedback

Neurofeedback is a type of biofeedback that provides real-time feedback on brain activity. By monitoring brainwave activity through EEG sensors placed on the scalp, individuals can see how their brain behaves and learn to modify it. This process utilizes the brain’s neuroplasticity, or its ability to reorganize itself and adapt to environmental changes, to improve the way the brain functions. Over time, individuals can reduce impulsivity and enhance focus, which can help with addressing behavior disorders like addiction.

Neurofeedback works by teaching the brain through rewards. A common reward in neurofeedback is a visual or auditory cue, like a video playing smoothly or a pleasant tone. If your brain drifts from the target activity, the video might pause or become fuzzy. This immediate feedback trains the brain to stay in the desired state. Over time, this training helps the brain find a better balance, making it easier to control impulses and reduce cravings.

Neurofeedback in substance abuse treatment

The integration of neurofeedback into addiction treatment started because of the need for alternatives to traditional therapies, which often face high relapse rates. By providing real-time feedback on brain activity, neurofeedback enables individuals to self-regulate and adjust dysfunctional patterns linked to addiction, enhancing the potential for long-term recovery.

During a neurofeedback session, sensors are placed on the scalp, and individuals receive visual or auditory feedback based on their brainwave patterns. This allows them to change their brainwave activity to support more stable mental states that help reduce cravings and impulsivity, which are key factors in addiction recovery.

Despite its potential, neurofeedback is generally considered a supplementary therapy rather than a stand-alone treatment. Studies indicate that it may work best when combined with other forms of therapy, such as cognitive behavioral therapy or medication management, to improve the overall treatment outcomes for addiction.

What to expect in a neurofeedback session

Neurofeedback sessions typically last between 30 to 60 minutes, and the number of sessions required varies by individual. Some people require fewer sessions, while others need more depending on their progress.

During a typical session:

  1. A practitioner conducts an initial assessment to identify specific symptoms and establish training goals.
  2. Sensors are placed on the scalp to monitor brainwave activity.
  3. Individuals receive real-time visual or auditory feedback based on their brainwave patterns.
  4. Through repeated sessions, individuals learn to modify their brainwave activity to achieve desired mental states.

This process uses the brain’s neuroplasticity to promote long-term mental health and cognitive function improvements by encouraging more balanced brainwave activity. Through repeated sessions, individuals can train their brains to respond more effectively to stressors, reduce impulsivity, and improve emotional regulation. The long-term goal of neurofeedback is skill-building, as this modality aims to teach someone to manage their emotions and behaviors without the use of a machine.

Who can benefit from neurofeedback therapy?

Neurofeedback therapy is versatile and can benefit individuals with various conditions, including:

  • Individuals with mental health conditions: Neurofeedback has been shown to help those dealing with anxiety, depression, and PTSD by promoting balance in brainwave activity. It encourages relaxation and emotional regulation, addressing excessive worry, low mood, or hypervigilance.
  • People with neurological disorders: Conditions such as ADHD, epilepsy, and migraines are linked to dysregulated brain activity, and have all been proven to be improved through neurofeedback. Neurofeedback helps improve focus, impulse control, and reduce episodes by training the brain to maintain healthier patterns.
  • Individuals with substance dependence: Neurofeedback can support recovery in individuals with opioid or other substance dependencies. It addresses underlying imbalances in brain activity, reduces cravings, and complements traditional treatments.
  • Those seeking improved cognitive and physical performance: Athletes, professionals, and students use neurofeedback to enhance concentration, reaction time, and mental clarity. It’s also a popular tool for peak performance training.
  • Children and adults with behavioral or developmental challenges: Neurofeedback benefits children with autism, sensory processing issues, or learning disabilities. It helps improve focus, reduce behavioral outbursts, and support emotional regulation.
  • Anyone experiencing sleep disorders: Neurofeedback can help people struggling with insomnia or other sleep disturbances by retraining the brain to enter calmer states to support rest.
  • Patients in chronic pain or recovery: Chronic pain sufferers and those recovering from brain injuries often find relief through neurofeedback, which helps retrain the brain to reduce pain perception and restore functionality. According to a 2020 review, although results are promising further research is required into the exact protocols and methods of administration are most effective.  

By addressing the root causes of dysregulation in brainwave patterns, neurofeedback is a promising tool for individuals of all ages looking to improve mental, emotional, and physical well-being.

Challenges and limitations of neurofeedback

Several challenges and limitations of neurofeedback emphasize the need for careful consideration when implementing or studying this therapy.

Certain studies have had low completion rates. This challenge in participant engagement indicates logistical and motivational barriers in outpatient settings.

Neurofeedback often requires multiple sessions over weeks or months to achieve lasting results. This can deter individuals who are looking for more rapid results or have demanding schedules.

Patients need to engage actively and consistently with the process. This can be challenging for individuals with severe attention or motivation issues, such as those with addiction or ADHD.

It can also be difficult for patients to access neurofeedback because there isn’t a clear standard for how to use it, and there’s not enough solid evidence to prove how well it works for all conditions.

Combining neurofeedback with traditional treatments

Neurofeedback has shown promise when combined with traditional treatments, such as medication management and psychotherapy, for substance abuse disorders.

In particular, it can help to address brain imbalances that contribute to impulsivity, enhancing the effectiveness of medications like methadone and buprenorphine.  

Research has also shown that combining neurofeedback with conventional psychotherapy, particularly in individuals with co-occurring substance abuse and PTSD, may help reduce relapse rates.  

More studies are needed to establish exactly how neurofeedback works best as an adjunct therapy, but it shows potential to improve long-term recovery outcomes, making it a valuable addition to addiction treatment programs.

How to access neurofeedback for addiction treatment

Accessing neurofeedback therapy for addiction treatment has become more convenient as the therapy gains popularity. To get started, look for providers certified by reputable organizations such as the Biofeedback Certification International Alliance (BCIA) or similar associations. Ensure the practitioner has experience treating addiction and offers neurofeedback methods tailored to your needs.

Research-affiliated clinics, often connected to universities or medical centers, may provide access to cutting-edge evidence-based technologies. Scheduling a consultation can help you understand the practitioner’s approach, set goals, and clarify costs or expected outcomes.

Your healthcare provider may also refer you to a specialist, or you can use directories from the International Society for Neurofeedback and Research (ISNR) or the Association for Applied Psychophysiology and Biofeedback (AAPB) to find certified professionals in your area.

FAQs

Common Questions About Neurofeedback Therapy

What is neurofeedback therapy?

Neurofeedback therapy is a type of biofeedback that trains individuals to regulate brainwave activity using real-time feedback from EEG measurements.

How many neurofeedback sessions are needed for addiction treatment?

Typically, 20-40 sessions are needed for addiction treatment, though the number can vary.

Are there risks or side effects of neurofeedback?

Risks or side effects are generally minimal but can include headaches, irritability, or fatigue in some individuals.

Is neurofeedback approved by the FDA?

Neurofeedback is not FDA-approved as a treatment for addiction, but it is FDA-cleared for use as a medical device for EEG monitoring.

Is neurofeedback therapy covered by insurance?

Neurofeedback therapy (particularly for substance abuse) is not commonly covered by insurance. Coverage may vary depending on the provider and treatment specifics. Be sure to check with your insurance before starting neurofeedback therapy.

Was this page helpful?

Your feedback allows us to continually improve our information

Resources:

  1. Hammond D. Journal of Neurotherapy: Investigations in Neuromodulation, Neurofeedback and Applied Neuroscience What is Neurofeedback: An Update. Journal of Neurotherapy. 2011;15(4).
  2. Marzbani H, Marateb H, Mansourian M. Neurofeedback: A Comprehensive Review on System design, Methodology and Clinical Applications. Basic and Clinical Neuroscience Journal. 2016;7(2).
  3. Ross SM. Neurofeedback. Holistic Nursing Practice. 2013;27(4):246-250.
  4. Dehghani-Arani F, Rostami R, Nadali H. Neurofeedback Training for Opiate Addiction: Improvement of Mental Health and Craving. Applied Psychophysiology and Biofeedback. 2013;38(2):133-141.
  5. Chiba T, Kanazawa T, Koizumi A, et al. Current Status of Neurofeedback for Post-traumatic Stress Disorder: A Systematic Review and the Possibility of Decoded Neurofeedback. Frontiers in Human Neuroscience. 2019;13.
  6. Srabani Banerjee, Argáez C. Neurofeedback and Biofeedback for Mood and Anxiety Disorders: A Review of Clinical Effectiveness and Guidelines. NIH.gov. Published November 13, 2017.
  7. Enriquez-Geppert S, Smit D, Pimenta MG, Arns M. Neurofeedback as a Treatment Intervention in ADHD: Current Evidence and Practice. Current Psychiatry Reports. 2019;21(6).
  8. Marchi A, Guex R, Denis M, et al. Neurofeedback and Epilepsy: Renaissance of an Old Self-Regulation Method? Revue Neurologique. 2024;180(4):314-325.
  9. Golshan F, Lysenko R, Nabi Zade M, et al. Study Protocol for a Randomized Controlled Trial of Neurofeedback Mindfulness in Chronic Migraines. Contemporary Clinical Trials Communications. 2024;41:101362.
  10. Graczyk M, Pąchalska M, Ziółkowski A, et al. Neurofeedback Training for Peak Performance. Annals of Agricultural and Environmental Medicine. 2014;21(4):871-875.
  11. Landes JK, Reid CL, Arns M, et al. EEG Neurofeedback for Executive Functions in Children with Neurodevelopmental Challenges. Cochrane Database of Systematic Reviews. Published online December 7, 2017.
  12. Lambert-Beaudet F, Journault WG, Rudziavic Provençal A, Bastien CH. Neurofeedback for Insomnia: Current State of Research. World Journal of Psychiatry. 2021;11(10):897-914.
  13. Roy R, de la Vega R, Jensen MP, Miró J. Neurofeedback for Pain Management: A Systematic Review. Frontiers in Neuroscience. 2020;14.

Activity History - Last updated: 06 February 2025, Published date:


Reviewer

Brittany Ferri

PhD, OTR/L

Brittany Ferri, PhD, OTR/L is an occupational therapist, health writer, medical reviewer, and book author.

Activity History - Medically Reviewed on 03 February 2025 and last checked on 06 February 2025

Related guides

Experiential Therapy

6 minutes read