Can I do neurofeedback training at home?

Many licensed health professionals won't support clients doing neurofeedback at home since their goal is to help clients see improvement. Most feel confident about producing consistent benefits to clients at their office. They can make adjustments to the training more easily and monitor it more carefully. Having users do this at home is much harder. From other clinicians, they've heard of some of the challenges (and failures) of sending home units. It's much harder to support users at home.

Some clinicians do support home training. For certain situations it can be very helpful. But home training can reduce the chances for successful training compared to training in an office. Certain clients or situations don't tend to do as well at home. Who might do well and who might not isn't always obvious. Most experienced clinicians would agree - success for the client is much harder to predict at home. The only exceptions to this - and it's still challenging - could be for autism and RAD.

Doing neurofeedback training at home should be done under careful supervision and support. Clinicians should be very experienced before offering home support. It's possible not everyone in the field will agree with this approach. There is always room for divergent approaches, and the field of neurofeedback certainly has them. Just be very careful and cautious before making your decision.

Here are guidelines for looking into home training:

1. Training at the clinician's office should be your first choice.
   The chances of success and the degree of success from office training is much more assured.On the other hand, if you are very distant or there are other reasons that require home use, then it's worth considering. If you're relatively close (a drive of 45 minutes or less) it's better to do the drive and have the maximum chance for success if at all possible. If there's a need for ongoing training over a long time (certain conditions), having a home unit is worth considering. Discuss this carefully with a qualified clinician.
   
2. Consider talking to other home users who have worked with your clinician.
   If you find a clinician close by who supports home training, ask them for references of 2 or 3 individuals they've trained at home. In particular, you'd like to talk with clients that started have already done 6-12 months of home training. Find out their success, their challenges. Every situation is different, but it will give you some idea about the process - and the clinician's support you can expect. Some clinicians will not want to give give out names because of confidentiality. However, it is possible for a clinician to have a client sign a waiver that would allow him or her to talk with you - though it does take effort.
   
3. The clinician should do training in the office first - for a number of sessions.
   Most experienced clinicians feel they want to know how the individual is responding to the training and what seems to work before they send them home to train. That could take at least 10-20 sessions of training. It's much easier to support someone at home when you have experience training them.
   
   Caution would be strongly recommended for a clinician who states they "routinely send people home with home units, and they all have great success." Neurofeedback is not a panacea. It often takes careful observation and fine-tuning of training parameters to produce the optimum training effect - even within a professional office.
   
4. Training.
   If a clinician provides support to home users, careful training should be provided to insure that the individuals can be effective at training. Not everyone is "cut out" to run a neurofeedback session. The quality of the hookup and the ability to assess when it is a problem must be included in the training. We recommend to any home user that an impedance measurement (numeric measure of quality of electrode hookup) be made to insure a quality hookup.
   
5. Office visits.
   You should talk regularly with your clinician to discuss progress and to discuss questions. Any adjustments to the training approach can only be made based on feedback. Periodically, most clinicians ask that their clients visit face-to-face - some things just don't come across on the phone. We've seen a few clinicians discuss using remote cameras on the Internet in place of visits. This is a very unproven alternative so far and is not the same as face-to-face.
   
6. Family dynamics. Frankly, not all situations are a good fit for training. For example, if parents are training a child and have high expectations of performance (even if never stated), neurofeedback training could be counterproductive. The person running the session is part of the equation - and in a sense, part of the feedback loop.
   
7. Getting feedback on progress.
   Adjustments in training can at times be made based on careful feedback from the client/patient. In a family, or in close relationships, one can be "too close" to be able to carefully note subtle changes. It's much easier to be assessed by an independentthird party trained to look specifically for effects/progress from the neurofeedback. Can a parent or individual do training on his own with limited or no neurofeedback training? These questions arise often. Wouldn't it be more convenient to do training at home, and less costly? Can't you do more training per week and make progress faster? The clinician/technician just pushes some buttons - couldn't I do that just as easily myself at home? If it were only so simple.

   Many licensed health professionals won't support clients doing neurofeedback at home since their goal is to help clients see improvement. Most feel confident about producing consistent benefits to clients at their office. They can make adjustments to the training more easily and monitor it more carefully. Having users do this at home is much harder. From other clinicians, they've heard of some of the challenges (and failures) of sending home units. It's much harder to support users at home.

   Some clinicians do support home training. For certain situations it can be very helpful. But home training can reduce the chances for successful training compared to training in an office. Certain clients or situations don't tend to do as well at home. Who might do well and who might not isn't always obvious. Most experienced clinicians would agree - success for the client is much harder to predict at home. The only exceptions to this - and it's still challenging - could be for autism and RAD.

   Doing neurofeedback training at home should be done under careful supervision and support. Clinicians should be very experienced before offering home support. It's possible not everyone in the field will agree with this approach. There is always room for divergent approaches, and the field of neurofeedback certainly has them. Just be very careful and cautious before making your decision.
   
   Here are guidelines for looking into home training:

8. Training at the clinician's office should be your first choice.
   The chances of success and the degree of success from office training is much more assured.On the other hand, if you are very distant or there are other reasons that require home use, then it's worth considering. If you're relatively close (a drive of 45 minutes or less) it's better to do the drive and have the maximum chance for success if at all possible. If there's a need for ongoing training over a long time (certain conditions), having a home unit is worth considering. Discuss this carefully with a qualified clinician.
   
9. Consider talking to other home users who have worked with your clinician.
   If you find a clinician close by who supports home training, ask them for references of 2 or 3 individuals they've trained at home. In particular, you'd like to talk with clients that started have already done 6-12 months of home training. Find out their success, their challenges. Every situation is different, but it will give you some idea about the process - and the clinician's support you can expect. Some clinicians will not want to give give out names because of confidentiality. However, it is possible for a clinician to have a client sign a waiver that would allow him or her to talk with you - though it does take effort.
   
10. The clinician should do training in the office first - for a number of sessions.
    Most experienced clinicians feel they want to know how the individual is responding to the training and what seems to work before they send them home to train. That could take at least 10-20 sessions of training. It's much easier to support someone at home when you have experience training them.
    
    Caution would be strongly recommended for a clinician who states they "routinely send people home with home units, and they all have great success." Neurofeedback is not a panacea. It often takes careful observation and fine-tuning of training parameters to produce the optimum training effect - even within a professional office.
    
11. Training.
    If a clinician provides support to home users, careful training should be provided to insure that the individuals can be effective at training. Not everyone is "cut out" to run a neurofeedback session. The quality of the hookup and the ability to assess when it is a problem must be included in the training. We recommend to any home user that an impedance measurement (numeric measure of quality of electrode hookup) be made to insure a quality hookup.
    
12. Office visits.
    You should talk regularly with your clinician to discuss progress and to discuss questions. Any adjustments to the training approach can only be made based on feedback. Periodically, most clinicians ask that their clients visit face-to-face - some things just don't come across on the phone. We've seen a few clinicians discuss using remote cameras on the Internet in place of visits. This is a very unproven alternative so far and is not the same as face-to-face.
    
13. Family dynamics. Frankly, not all situations are a good fit for training. For example, if parents are training a child and have high expectations of performance (even if never stated), neurofeedback training could be counterproductive. The person running the session is part of the equation - and in a sense, part of the feedback loop.
    
14. Getting feedback on progress.
    Adjustments in training can at times be made based on careful feedback from the client/patient. In a family, or in close relationships, one can be "too close" to be able to carefully note subtle changes. It's much easier to be assessed by an independentthird party trained to look specifically for effects/progress from the neurofeedback.