2: Why You Need to Take Biofeedback Courses, Equipment Training, & Mentoring

2: Why You Need to Take Biofeedback Courses, Equipment Training, & Mentoring

What you need to know to perform biofeedback effectively

Article 2: Why you need biofeedback courses, equipment training, and mentoring

By Richard A. Sherman, Ph.D.

Biofeedback practitioners need a basic course in biofeedback to help understand the relationships between the feedback display, the physiology being recorded, and the disorder being treated. A lack of understanding these relationships could result in failure of biofeedback-based interventions.

Some may assume that basic courses are unnecessary because the devices are so sophisticated they can “practically work themselves”. Others feel that because biofeedback is included within a scope of practice, that further training may not be necessary. This simply isn’t the case. Adequate time is needed to address the many training/instrument concepts in sufficient depth. Courses provided by instrument manufacturers frequently do a fine job teaching how to use of a specific device but not how to incorporate the device into a biofeedback based intervention within a multimodal treatment regime.

The risk for clinicians who attempt to practice biofeedback without adequate training, as studies have shown, is that they may assume they are practicing effectively when, in reality, their results are no better than placebo.

An advantage of a basic training course is that it allows new practitioners to learn the strengths and weaknesses of biofeedback applications for specific disorders. Without training, a practitioner might be likely to apply the wrong type of biofeedback, use it incorrectly, or use and charge for treatments that have not been shown to work for the disorder under treatment. A comprehensive basic training course in biofeedback will offer a thorough review of the literature, usually presented by an experienced clinician with biofeedback expertise.

What should you look for in a basic biofeedback course?

Foremost is to seek a course accredited by the Biofeedback Certification International Alliance (BCIA). BCIA accredited courses cover the basic information necessary for certification as detailed in the BCIA Blueprint of Knowledge. Special topics courses will cover some components of the BCIA Blueprint. Don’t hesitate to go to BCIA’s web site to look at their requirements for courses and certification.

It’s also very important that the course you are considering allots sufficient time and depth to cover the material. An appropriate time for basic general biofeedback is 40 hours. Look for a course that is offers training a variety of devises. Focusing on a single device doesn’t permit comparisons between devices.

The course should include extensive personal interaction with an instructor who has extensive clinical and/or research experience in the field. Look for peer-reviewed publications by the instructor in the area in which the course is given. If you are considering a distance education course, be sure to verify there is an instructor with appropriate credentials. Ask if extensive interaction with the instructor is an integral part of the course and if you can easily contact the instructor with questions. Also, inquire if the instructor is prepared to provide extra material to meet your particular interests and needs. Get a clear idea of whether the course will offer audiovisual lectures or just a series of readings.

Look at the organization providing the course. Is the organization established and in good standing with the professional community? Most good CE providers will have program approval from state and national boards such as California’s Board of Psychology or the National Board of Certified Counselors. Colleges should have regional accreditation or, at the very least, state approval. Find out if the organization appears to be biased toward one viewpoint or product. Ask if you can get CE credit for the course toward license renewal, etc. Explore student, hardship, and/or developing nation scholarships.

How do you decide which is best for you, in-person instruction or distance education? First consider how you learn best. If you aren’t self-directed and able to focus on your own, then distance education is not for you. Conversely, if you are sufficiently self-directed and like to be able to initially learn and then review the lectures and materials at your convenience, a distance course should work for you. If you like to have others around to share ideas and you like to have the instructor there with you, then in-person classroom learning is a better alternative.

Also consider the economics. In-person courses can be a week long, and require travel expenses, meals, hotel, etc. Private practitioners may give up income for the week. Given these circumstances, then a distance course would be recommended. Another point is that many distance education courses can be divided into segments, so you may only purchase and take the parts you need.

What level of course and sub-specialization do you need?

Most biofeedback courses are set at one of three levels: (a) general/basic, (b) basic with technique-based subspecialty emphasis, and (c) disorder-based specialized/advanced. For most people, the way to begin learning about biofeedback is with a general biofeedback course to get an overview of what the field is all about and how biofeedback is incorporated into treatments.

However, if you have taken an introductory program, have sufficient knowledge of biofeedback, or know that you are likely to perform a type of biofeedback using one main technique (such as EEG or pelvic floor muscle tension), then you can begin with a basic course concentrating on these techniques. Be sure that the course still includes a good overview of biofeedback, so you can understand where it fits.

If you work primarily with one particular class of disorders (such as ADHD or chronic pain) or want to use biofeedback for that one class, then you should take an advanced course after you take a good basic course. Advanced courses cover many biofeedback techniques as applied to a single class of disorders. This is where you learn the detailed physiology of the disorder and many behavioral approaches to them in relation to other techniques.

Individual training with biofeedback devices and

mentoring with initial clients

Taking a lecture course in biofeedback is not sufficient preparation to incorporate biofeedback techniques into a practice. Once the basic information and protocols are mastered, it is necessary to thoroughly learn to use the biofeedback device. It is not uncommon to have difficulty learning to use devices in a large group setting because attendees may be nervous and hesitant to ask questions. Information may come in so quickly that it can’t be readily absorbed nor remembered. There is also little time to actually learn to use biofeedback techniques for self-practice to control your own functioning. On the other hand, sitting alone in your office with a novel device and only a manual to guide you through its intricacies could be daunting. Because of these issues, BCIA requires that practitioners spend time individually learning to use their equipment under the supervision of somebody who has experience with it.

Once the basics are mastered, it is time to apply technique to a client. With integrating new equipment into practice, it is likely that complications may ensue. It is helpful to have someone (a mentor) onsite to guide you through the first few clients. The mentor will insure that you are taking appropriate steps to integrate the equipment into practice and help you understand how to provide biofeedback to clients. BCIA considers mentoring an integral part of the certification process.

Both individual training and mentoring are available from local biofeedback practitioners and on-line via the web. Regardless of whether you are getting training and experience through online or in a neighboring practitioner’s office, it is important to insure that the mentor has solid training in biofeedback (preferably BCIA credentials) and has expertise in working with the kinds of patients you intend to see.

This article has provided a rationale in support of taking a basic and/or technique-oriented course before getting started in biofeedback, and taking an advanced course before using biofeedback for specific classes of disorders. The author, Richard Sherman, Ph.D. is a Past President of AAPB and teaches basic science and biofeedback training courses. He can be reached at .