NEUROFEEDBACK - FAQ

How often and for how long do I come for Neurofeedback sessions and how long are the training sessions?

The frequency of sessions depends on your program phase and how your brain is responding to the training. Your brain is gradually learning a new set of skills (ie. regulation). It will first need to learn those skills, then practice them, and then consolidate or integrate them as the new “baseline” in your nervous system. During the initial learning phase, 1-2 sessions per week is recommended for a minimum of 10 sessions. Once your brain has started to shift and these changes are remaining consistent in between sessions, the frequency of training can be reduced to once per week or bi-weekly. Completing a minimum of 20 training sessions is recommended as the baseline number of sessions to experience more lasting shifts. The actual Neuroptimal® training sessions run for 33 minutes. We typically allot an hour for Neurofeedback sessions to provide us time to set up, check in and debrief afterwards.

What if I miss a session or need to miss multiple sessions in a row? How important is it to come consistently?

Training consistency is extremely important in maximizing the benefits of Neurofeedback, particularly in the beginning. It is not uncommon for people to notice when they miss a few weeks or multiple sessions in a row. We are very understanding of the unpredictability of life and how missing sessions can happen at times. We strongly encourage people to try their best to be consistent with participation and in particular, to get through the first phase of training with no missed sessions as the brain is actively learning something new.

What happens in a typical session?

During a Neuroptimal® Neurofeedback session, two sensors will be placed on each side of your scalp in the central regions to pick up surface brain activity on both sides. You will also have two ear clips placed on your right ear and one on your left ear as reference and ground electrodes. The sensors on your head are picking up your brain activity in real time at a sampling rate of 256 times per second. That information is then sent to the amplifier which converts it to digital data and further sends it to the software program on the attached computer. The training program then reads and calculates the activity and provides information or feedback to the brain through audio cues about what it is doing so that it can correct itself. When the brain becomes dysregulated, a slight pause or interruption is sent through the music or sound in the movie, which invites the Central Nervous System (CNS) to break up those unhealthy patterns and come into balance. The repetition of this training is what leads to shifts in the system at a foundational level as the brain learns how to regulate itself more efficiently and quickly. Individuals are sitting in a comfortable chair or laying on a comfortable table and are invited to take the session time to relax. You can also fall asleep and the training will still work as your brain has an amazing ability to hear and respond to sound while you are asleep.

How long does it take to see changes? What should I pay attention to or look for in regards to those changes?

The number of sessions it takes for people to notice changes depends on the individual. Every brain is unique. While some people notice changes quickly into starting sessions, most typically begin to observe shifts 5-8 sessions in. This is why more frequent sessions during the initial phase of training is recommended. Like learning a new skill, the more frequent and consistent it is practiced in the beginning, the faster the skill will be acquired. What to pay attention to in regards to the shifts themselves, is how you’re able to move through stress and dysregulation. The brain is not learning how to not have difficult emotions or responses, but rather to regulate through that stress faster and more efficiently. It is all about the system learning to flow. Because it is a ground-up approach, changes will be gradual and not always noticeable until multiple sessions in when you can look back and use hindsight reflection to remember how you may have responded previously versus now.

How do you measure progress?

Neuroptimal® Neurofeedback does not collect EEG data for review. Progress is primarily and most importantly based on how the individual is feeling and what they are noticing in terms of shifts. Client reporting is important and the clinician supporting you will ensure to check in to see what you are noticing over time and what to look for in terms of shifts. A Neuroptimal® tracker questionnaire is also sent throughout the course of training and reviewed with the practitioner to help individuals track shifts among different rated items (ie. sleep, focus, anxiety, stress etc.). Ongoing consultation and training reviews with one of our Neurofeedback clinicians can also provide the support you need to track your shifts and coach you through what to pay attention to in understanding or noticing them.

What is the paste used on the sensors and how do I wash it off?

In order to create a connection between the individual’s brain activity and the sensors reading it, a conductive paste is used. This paste is non-toxic and water soluble so easily washed out with soap/shampoo and water. The supporting technician/clinician will try to wipe off as much as possible following the training session, but sometimes there is remaining paste left over that can easily be washed off at home.

Am I able to watch my own movies or listen to my own music? What am I allowed to do during the training sessions?

The movies and audio soundtracks are integrated into the training system. With that, individuals must choose one of the options offered at the beginning of the session by the supporting technician or clinician. It is recommended that children and young teens either listen to the music or watch a movie, while older teens and adults listen to the calming music to further promote relaxation of their CNS. Individuals are encouranged to take the session time to relax and rest. Reading casually or doing a low-key activity that does not involve a lot of movement (ie. Sudoku, crossowrd puzzles) are permitted during sessions. Individuals are strongly encouraged to not play games on their phones/devices or check their social media pages. Outside of training, video games and high-intensity screen time have been linked to changes in the EEG, some of which may connect to reported symptoms (ie. attention problems, reduced motivation). Most public health organizations recommend no more than 2 hours per day on these types of electronic devices, especially for children as their brains are actibely developing.

Should I do anything different with my medication while in NFB?

Any changes to medication regime are to be done through a doctor or medical professional. Medication changes are beyond the scope of Neurofeedback trainers and clinicians providing it as a psychological service. It is however, important that the supporting clinician knowns of any changes to medications throughout the course of the training program. Benzodiazepines (ie. Lorazepam, Xanax, Ativan, Valium) have been found to increase fast activity in the brain and in turn, can impact the effectieness of training. Chronic cannabis use may also have an impact on trainign effectiveness.

Are there any side effects to watch for at the start?

Negative side effects are uncommon. Sometimes individuals feel tired after sessions, particularly in the beginning when it is more of a “workout” for your brain. This is most commonly due to the ‘exertion’ that is new to your brain, similar to exercising a muscle. On occasion and mostly in the beginning, some individuals will report feeling more emotional following sessions or dreaming more vividly. This can be equated to the brain learning to decompress and as a result, engage in deeper processing of feeling and experience. It is also linked to new pathways forming in the brain or different area of the brain being activated, which can induce different and new processing and perception. Finally, on occasion, individuals may report a headache following their initial sessions, which may be a result of more oxygen flow to the brain. All of these potential side effects typically level out quickly into training.

Are there things I can do to enhance the process?

The positive effects of Neurofeedback training can be compounded or enhanced through a healthy lifestyle. Sleep habits for example, can provide a healthy foundation for the brain as it is learning to be more efficient and respond differently. Likewise, consistent sleep allows for new information to consolidate in the brain. This does not suggest however, that great sleep is required to do Neurofeedback as many individuals struggle with sleep difficulties when they begin training. The supporting clinician will provide guidance and support as you explore different areas of your well being and life that you are wanting to focus on/adjust.

Do I have to come back once I’m done with Neurofeedback training?

Once the training program has been completed, there is generally no maintenance required. Research suggests that the majority of individuals will continue to hold their progress over time. Some individuals however, will choose to engage in some infrequent ‘booster’ sessions to facilitate this. Typically, these refresher sessions consist of a small number of consistent sessions to remind the brain as to what it learned during its initial training.

Are Neurofeedback sessions covered under regular insurance or extended health benefit plans?

Neurofeedback sessions are billed as a Psychological Service or Alternative Therapeutic Service under the governing body of the primary clinician or practitioner supporting you. Although Neurofeedback services are not covered by OHIP, most individuals with standard health benefit plans have coverage for sessions. Your supporting clinician will provide you the information you need to claim your sessions and answer any questions you have pertaining to payments. Individuals pay following sessions and then submit for coverage with the receipt provided. Payment methods will be provided to you by the clinic you are receiving support from.

For Parents and/or Caregivers:

Can I come into the training room with my child?

It is recommended that parents wait in the waiting room. Kids tend to do best with minimal distractions. It is also important that they are learning the independent task of self-regulation and although parents can be helpful to coach their children, the goal of Neurofeedback is to facilitate a child’s ability to do this independently. Parents/caregivers will be informed of the process initially, which generally requires accompanying the child to the training room for their first session. The supporting clinician will request feedback from parents/caregivers about how their child is progressing and the shifts that they ntotice from their perspective.