Neurofeedback help

[Neuroplast]

Hello everyone, anyone knows or have any knowledge on where I can find training manuals/etc. on neurofeedback. I am about to start on a new job proposition beginning January 2016 at a new TBI rehab center that's going to open and wanted to get the gist of neurofeedback work. This will be aside from my clinical practicum in Behavior therapy so I will be very busy come next month. I've previously done EEG work but the guy I'v been talking to is looking to do qEEG work in patients, specifically with concussion, head trauma and blast injury patients. He also mentioned 2 softwares that will be used for the therapy, BrainMasters and Skill. Any information on this is greatly appreciated, thanks.

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[WisNeuro]

I still have yet to see any good data on qEEG.And, haven't AAN and other bodies come out with position papers questioning the science as it stands? I have only seen qEEG used by "specialists" who engage in some shady practice settings. There may be something there, someday, but I think it's still confined to the "needs more research" realm.

 

[Neuroplast]

Can you enlighten me more on these "specialists"? He is looking to put a team of neurologists, audiologists, neuropsychologists, EEG techs and rehab therapists to conduct these procedures within the next week so I am little skeptical but thanks for the input though.

 

[Therapist4Chnge]

qEEG w. concussion is super sketchy (at least based on the last time I checked the research). I've seen some case study reports and small N studies, but nothing rigorous in regard to qEEG interventions for concussion.

 

[WisNeuro]

The specialists that I am used to seeing use qEEG have mostly been psychologists who have been attached to a treatment center like the Amen clinic. Essentially, they find "something" wrong with every patient that comes in the door. But that's ok, because they have a proprietary treatment for that!

I'm all about new techniques and advances in medicine. But I am not about bilking people out of their money with something that has no predictive validity when that money could go towards treatments that can actually help a person.

 

[Therapist4Chnge]

I've only seen it pushed in private practices. I get a handful of patients a year who get talked into "treatment". Not surprisingly they end up at my office still looking for answers. They also are the ones who have 15-20+ page reports of "neuro this" and "neuro that"…it looks impressive to a layperson, but the reports amount to poorly worded jargon.

If possible, ask for some references (or even just reading materials), as I'd like to see what support is out there for qEEG intervention for concussion/head injury.

 

[Ollie123]

So...embarrassing and tangential question, but here we go anyways.

What IS qEEG? I mean, I obviously know what it stands for. I know sleep and some seizure stuff is still diagnosed through visual inspection, but its probably been 20 years since I've seen anything in a remotely legitimate journal that wasn't using a quantitative approach....so in my mind that is just EEG? Surely when folks speak of qEEG they aren't referring to studies like this: http://journals.lww.com/psychosomaticmedicine/Abstract/2003/07000/AlterationinBrain andImmuneFunctionProduced.14.aspx even though it meets the technicial definition? Is it just when people go overboard on trying to build clinical application out of EEG work that doesn't support it? I've published a half dozen papers on EEG/ERP and I've never been able to figure out what is actually meant when distinguishing the two. In the literature, use of the term qEEG just seems to mean "We did a crappy EEG study with outdated methods, an n of 6, no control group and overstated our results - so we put a q in front of EEG to make up for it" but I can't figure out any other clear distinction. Different preprocessing? Different stats? Different equipment?

 

[PsyDr]

qEEG- 6,000 coacqyird variables, and the sens/spec is less than neuropsych.

Neuro feedback- eeg obtained on ~25% of the electrodes used in clinical eeg/qEEG, indicates it can reduce symptoms of:TBI,autism, mdd, bipolar disorder, etc. Despite curing damn near everything, there is limited evidence of support. Comparable to placebo when sham treatment is applied in add.

Btw: this guys plan is bs. Neurologists hate this crap. the guy isn't even willing to invest in the good eeg stuff. Skill is basically free and is easy to use. In comparison, there is another with a price tag of 7k that is much more difficult to use. But what about the amplifier, you say? Surely when you are dropping thousands on an amplifier you'd be willing to throw down on some software, right? But oh noes. Ever seen the brainmaster brand at a hospital? Nope? Guess what the price comparison to known brands like nicolet is? (Hint: it's not more expensive).

 

[Neuroplast]

Thanks for your inputs, I'm a bit skeptical and uncertain to take on this job opportunity as it will greatly be a benefit. Part of me says to jump on the wagon and the other part says that it may be lead to uncertain circumstances down the line, I don't know what to do. This is something that has been taken me many sweat and tears to reach as down here in South Florida there is a harsh competition level for psychology related positions, and Ive been through so many interviews that it felt good to reach this opportunity.

I'm at a crossroad, I have a family with 2 kids and have been stable in a job that has nothing to do with psychology relate just some clerical stuff that I'v been doing for the past 4 years and I have been trying to move on with my field. My wife thinks it's too good to be true yet she is up for the new opportunity so she is feeling the same as me. If I leave my current boring stable full time job for this great opportunity, I don't want to be feeling guilty later on down the road if something would happen and jeopardize the expenses of living and let my wife down. This is my dilemma and I don't know what to do.

 

[PsyDr]

From a business perspective: I've seen this business model fail time and time again. People get excited about being able to bill for multiple patients at the same time and predict fortune raining down upon them. The problem is that there is a limited population who is a) interested in this, b) have the cash, and c) will show up. You are banking on a revolving patient base that has the relevant disorder, prefers alternative treatments, has insurance that will pay for this no supported treatment, or cash despite being disabled. You could easily do the math for prevalence in your area, and find out the base rate for cam preferences.

I'm not saying it can't work. But it typically does not.

 

[WisNeuro]

I personally would be worried about a hit to my CV doing qEEG the most. If I'm on a hiring committee for a neuropsychologist and see that someone has spent x years doing qEEG clinical work, that person is moving to the bottom of my list.

 

[Neuroplast]

I personally would be worried about a hit to my CV doing qEEG the most. If I'm on a hiring committee for a neuropsychologist and see that someone has spent x years doing qEEG clinical work, that person is moving to the bottom of my list.

Woah... that bad huh, crap. Not even for learning purposes until I move on to bigger things, I'd figured I'd get more hands on experience and not only for just the money. Wow this is horrible, I'm still debating on it and it's killing me, I'll see what I can do =( Thanks.

 

[WisNeuro]

In the end, you got to do what's right for you. I've always been at places that do clinical research and heavily value empirically supported clinical interventions, so this would be a no go for me. If the job were more research based, trying to examine the possible clinical uses of qEEG to see if it does anything at all, I'd say go for it. But, in terms of the current clinical use of qEEG in actual clinical populations, I can't recommend it. It's just bad medicine.