What to expect during a program of Neurofeedback Training

At your initial consultation (2.5/3 hours)

When you come to us for a first assessment, three main elements will be involved:

  1. An EEG measurement of brain function

  2. An interview with a clinical psychologist

  3. A consultation with a member of our neuroscience team, who will be able to talk you through the assessment findings following the interview.

The first step is a baseline EEG recording. This is entirely painless and non-invasive (i.e., no injection, cut, etc. will be given to you). You will asked to wear an EEG cap (see What is EEG? to see a cap in use) and some conductive gel will be applied to each electrode.

The EEG assessment will give us information about your baseline (before treatment) brain function. We usually take two recordings, one with your eyes closed and one with your eyes open.

Please come with clean dry hair and no hair products, as this is key to get a clean recording. It is also advisable to bring a towel to dry your hair after session.

Once the baseline EEG recording has been completed, a clinical psychologist will interview you to confidentially identify history, symptoms, diagnoses etc. as well as your goals for neurofeedback training.

What happens next?

After this visit, we will work to link your symptoms and goals to your brain function. We can do this utilising the latest 3-D source localisation software (including LORETA and LORETA Progress Report Tools). These tools allow us to look at your brain activity in great detail and also compare it to a normative database (brain activity of other people your age and gender).

Our team will then analyse data and discuss with you the findings.

At your first session

Based on the recommendations made to you by our staff, and when you feel you have been given all the information you require, you may decide to begin neurofeedback training. 

However, before making a decision, we ask all prospective clients to take at least three days to consider all the information acquired during the consultation. A member of our team will call you during the week to assist you during the process answering all your questions.

At sessions 1 and 2, you will be given a number of resources , including a diary to keep a regular account of changes in your symptoms and behaviour. You will also asked to wear the EEG cap again (as you will do at every session) and learn how to engage with the training.

On the first day, we will take things slowly, taking breaks to ensure you answer all questions and understand the whole process. It is essential to neurofeedback training that you fully engage with the process. Neurofeedback training is not a passive experience and you are required to work hard during your sessions.

How many sessions will I need?

The number of sessions needed differs from person to person, and particularly from children to adults. Traditional neurofeedback training requires 60/80 sessions but, with our more advanced technology and improved protocols, we find that this number can be dramatically reduced.

In general, our clients require approximately 20 one-hour sessions, carried out over 12-20 weeks. Tapering sessions are then scheduled at 2 weeks, 1 month, 2 months and 3 months after the last session of the first block. 

A recent service evaluation carried out at Actualise found that clients who had 20 sessions or more tended to maintain benefits in the long term. We recommend a minimum of 12 sessions to begin, with timing varying from client to client although, for the first six weeks, some clients might need two sessions a week.

After this initial training, we will assess change and make a decision based on the evaluation of your progress using both behavioural and EEG data. This is accomplished running new interviews, taking new baseline EEG readings and re-analysing all data. If deemed necessary, our multi-disciplinary team will suggest updates and changes to your protocol.

It is important to note, that we do not want clients to view their 12th session as “the last one” as different conditions require different numbers of sessions. For instance, an adult person with depression or anxiety will generally require more sessions (20 and over) as compared to a child with ADHD.

Clients go to 15/20/25 sessions, so recommendations are made on a case by case basis, with reviews at regular intervals to guide your training sessions. We will never recommend unnecessary sessions and it is up to you if you wish to take our recommendations on board.

Neurofeedback training is learning a new skill. It is impossible to predict how many sessions an individual may require to make long lasting changes.

Adverse effects

Similar to most medical treatments, neurofeedback can have side effects. In some instances, some people have reported transient side effects associated with neurofeedback training.

These side effects may be non-specific (e.g., headaches, tiredness thought to associated with the neurofeedback training in general) or/and specific (e.g., nausea, emotional confusion and nightmares thought to be associated with the particular protocol used).

Should you notice any symptom worsening during your training, you are advised to inform us.

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Alkoby, O., A. Abu-Rmileh, O. Shriki and D. Todder (2018). "Can We Predict Who Will Respond to Neurofeedback? A Review of the Inefficacy Problem and Existing Predictors for Successful EEG Neurofeedback Learning." Neuroscience 378: 155-164.

Omejc, N., B. Rojc, P. P. Battaglini and U. Marusic (2018). "Review of the therapeutic neurofeedback method using electroencephalography: EEG Neurofeedback." Bosn J Basic Med Sci.

Rogel, A., J. Guez, N. Getter, E. Keha, T. Cohen, T. Amor and D. Todder (2015). "Transient Adverse Side Effects During Neurofeedback Training: A Randomized, Sham-Controlled, Double Blind Study." Appl Psychophysiol Biofeedback 40(3): 209-218.