Route to Follow for prescriptive authority for psychologists

[Oddball444]

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In the movement to get prescriptive authority for psychologists most of the focus is Post-Doc education in psychopharmacology. What about someone (like me) who just got his B.S. in Psychology, is interested in this movement but is not interested in getting a M.D. degree.
What branches in Psychology will best prepare me for both supporting this movement, but also give me a solid educational base?

Personal interest in Bio/Neurofeedback Research, and Neurocounseling,

 

[WisNeuro]

What do you want to do on a day to day basis, work-wise?

 

[psych.meout]

What is "neurocounseling?"

 

[PsyDr]

In general: Get a clinical phd or psyd which includes an nationally accredited internship, complete a post doc, pass state and national licensing exams, complete a post doctoral masters in psychopharmacology, complete a supervised experience/residency, apply for an extra medical psychologist license, apply for a DEA number, apply for a state pharmacy number, get extra malpractice insurance, then get to practice.

If you just want to support the movement, give money. Or if your state has an RxP bill, call you state congressmen and tell them you support the bill.

 

[Oddball444]

Ok, The responses I've seen so far has made me think about things, targeting myself from the angles given. Although this is a completely different question now. What is the most flexible Ph.D. degree in Psychology? I feel trapped in a strange dichotomy, I have a very specific interest in psychology (bio/neurofeedback) however it is so new and undefined that there is no clear path of specialization, or foundation. It also can potentially touch not only all fields of psychology but also others that are not generally considered to be psychology related. I want to advance both myself and the field, but I don't want to close any doors behind me as I go. Even the choice between clinical practice vs research seems restrictive. I can't tell if this is an emotional problem I have or a cognitive one, or if there really is a problem at all.

If I had to give an answer to the question right now? Teaching university students, public speaking, clinical / experimental research.

Well I can't create a link so you'll have to look it up. However short answer would be a cross between behavioral / cognitive / physical psych

Ok. So just getting a General Clinical PhD is the best route to prepare me for "complete a post doctoral masters in psychopharmacology"? I shouldn't Investigate Neuropsych or Cognitive Psych or Health Psych?

 

[WisNeuro]

Ok, The responses I've seen so far has made me think about things, targeting myself from the angles given. Although this is a completely different question now. What is the most flexible Ph.D. degree in Psychology? I feel trapped in a strange dichotomy, I have a very specific interest in psychology (bio/neurofeedback) however it is so new and undefined that there is no clear path of specialization, or foundation. It also can potentially touch not only all fields of psychology but also others that are not generally considered to be psychology related. I want to advance both myself and the field, but I don't want to close any doors behind me as I go. Even the choice between clinical practice vs research seems restrictive. I can't tell if this is an emotional problem I have or a cognitive one, or if there really is a problem at all.

If I had to give an answer to the question right now? Teaching university students, public speaking, clinical / experimental research.

Well I can't create a link so you'll have to look it up. However short answer would be a cross between behavioral / cognitive / physical psych

Ok. So just getting a General Clinical PhD is the best route to prepare me for "complete a post doctoral masters in psychopharmacology"? I shouldn't Investigate Neuropsych or Cognitive Psych or Health Psych?

With a PhD, you don't need to choose either research or clinical. Many of us do both, to varying degrees. Neuropsych and health psych are specializations within clinical psychology.

 

[AbnormalPsych]

This all seems pretty scattered.

So you do want to be able to see patients, yes? If so, graduate work focused in experimental, cognitive, and some of those other fields will not allow you to do this. You will need a masters degree (e.g., mft, lcsw) or phd/psyd in clinical, counseling, or school psych and pass appropriate licensing exams to see patients. Within these fields you can specialize in working with health psych, neuro psych, geriatric patients, etc

Do you want to be a therapist? Or mainly focus on medication management? If the latter, maybe look into the work of a psychiatric RN or nurse practitioner.

 

[Sanman]

Ok, The responses I've seen so far has made me think about things, targeting myself from the angles given. Although this is a completely different question now. What is the most flexible Ph.D. degree in Psychology? I feel trapped in a strange dichotomy, I have a very specific interest in psychology (bio/neurofeedback) however it is so new and undefined that there is no clear path of specialization, or foundation. It also can potentially touch not only all fields of psychology but also others that are not generally considered to be psychology related. I want to advance both myself and the field, but I don't want to close any doors behind me as I go. Even the choice between clinical practice vs research seems restrictive. I can't tell if this is an emotional problem I have or a cognitive one, or if there really is a problem at all.

If I had to give an answer to the question right now? Teaching university students, public speaking, clinical / experimental research.

Well I can't create a link so you'll have to look it up. However short answer would be a cross between behavioral / cognitive / physical psych

Ok. So just getting a General Clinical PhD is the best route to prepare me for "complete a post doctoral masters in psychopharmacology"? I shouldn't Investigate Neuropsych or Cognitive Psych or Health Psych?

Biofeedback new? Since when? It has been around since the 1970s.

 

[erg923]

Ok, The responses I've seen so far has made me think about things, targeting myself from the angles given. Although this is a completely different question now. What is the most flexible Ph.D. degree in Psychology? I feel trapped in a strange dichotomy, I have a very specific interest in psychology (bio/neurofeedback) however it is so new and undefined that there is no clear path of specialization, or foundation.

Its not new. However, it (neurofeedback) does have poor research base and is not covered service for most insurance plans.

I dont understand how this fits into your desire to obtain Rx authority.

 

[PsyDr]

Ok, The responses I've seen so far has made me think about things, targeting myself from the angles given. Although this is a completely different question now. What is the most flexible Ph.D. degree in Psychology? I feel trapped in a strange dichotomy, I have a very specific interest in psychology (bio/neurofeedback) however it is so new and undefined that there is no clear path of specialization, or foundation. It also can potentially touch not only all fields of psychology but also others that are not generally considered to be psychology related. I want to advance both myself and the field, but I don't want to close any doors behind me as I go. Even the choice between clinical practice vs research seems restrictive. I can't tell if this is an emotional problem I have or a cognitive one, or if there really is a problem at all.

If I had to give an answer to the question right now? Teaching university students, public speaking, clinical / experimental research.

Well I can't create a link so you'll have to look it up. However short answer would be a cross between behavioral / cognitive / physical psych

Ok. So just getting a General Clinical PhD is the best route to prepare me for "complete a post doctoral masters in psychopharmacology"? I shouldn't Investigate Neuropsych or Cognitive Psych or Health Psych?

IMO:

There is almost no flexibility in the path to clinical or counseling psychology doctorates, which are the only degree paths that lead to licensure and thus psychopharmacology. If you want to treat patients, you have to be licensed.

Many licensed psychologists engage in research on at least a part time basis.

There are a TON of VERY VERY bad online/hybrid/etc psychology PhDs which will promise you the stars and moons. These are generally worthless. Universities won't hire people with these to teach. Clinical positions won't hire people with these to treat patients. These programs usually have intense marketing, and make it seem like a good idea. It is not.

One would be well served by educating oneself with how one becomes a psychologist.

 

[Oddball444]

I am sorry I am so scattered. I guess I'll have to give some background to explain my outlook. I'll try to keep this short. I am 39 years old. I have AD(H)D, OCD, Depression, Autism (Aspergers) + other things. 10 years or so ago I was "existing" in a 1 room apt firmly believing I was past all hope and help, alive only because I was unwilling to totally give up and commit suicide. My parents however never gave up either, and directed me to a Neurofeedback specialist that had just moved into the city (the only one at the time). 4 days ago had my grad ceremony 3.69 GPA with my major in psychology (3.73). My whole college experience has been one progressive system of setting goals, seeing my growth potential expand beyond them and revising those goals to meet a higher expectation for myself. Above all I want to promote the field that has so impacted my life because I know I would still be just "existing" without out it. In short, I found something that changed my life and I want to share it with everyone I can, and make it better for everyone.

So yes of course i want to help people, and being a therapist would allow me to do that, but only for those few that I see. However simply going into "research" won't cut it either. It is VERY hard to ethically experiment with NFB without treating someone at the same time. In most cases people treated know if the treatment is having an effect or not. You can't separate the researcher from the therapist, hence my problem trying to figure what / how I should go about furthering my education.

 

[Oddball444]

Its not new. However, it (neurofeedback) does have poor research base and is not covered service for most insurance plans.

I dont understand how this fits into your desire to obtain Rx authority.

While I am an advocate of NFB due to my past history with it, I am not so narrow minded to think that my way is the only way. One branch of research with NFB currently is understand drug interactions on a EEG frequency level so as to make BETTER choices with drugs. For example there are 2-3 different brain states that all behaviorally show up as ADHD. The current system model though is (which I lived through) try medication A and see what happens, if that doesn't work try medication B, and so on. The idea is that with a NFB scan and proper comparison you can make a better choice by not giving someone a medication that will only make the problem worse.

So having Rx abilities would give me the option to A take over medication management. B possibly run experiments that can track and chart effects of medications on the brain. Its just another way for me to stay flexible.

 

[Oddball444]

Biofeedback new? Since when? It has been around since the 1970s.

yes biofeedback is not new. However neurofeedback is (relatively)

 

[AbnormalPsych]

I'm sorry you have gone through all that, but I am glad you made it through and are doing well.

In short, if you really want to focus on neurofeedback, go into a phd program so you can do research on it as well as get some clinical time in if you run participants in your studies. That education will also give you the ability to practice one day. If you want a clinical career, I am sorry, but you will not be doing much neurofeedback. There are much more effective treatments out there for the disorders you seem interested in.

 

[erg923]

I In short, I found something that changed my life and I want to share it with everyone I can, and make it better for everyone.

So yes of course i want to help people, and being a therapist would allow me to do that, but only for those few that I see. However simply going into "research" won't cut it either. It is VERY hard to ethically experiment with NFB without treating someone at the same time. In most cases people treated know if the treatment is having an effect or not. You can't separate the researcher from the therapist, hence my problem trying to figure what / how I should go about furthering my education.

This field should not be used to "spread the good news."

 

[Oddball444]

This field should not be used to "spread the good news."

*heh* yes your right, and I don't need a PhD to do it either. However as i said before the quotation, "Above all I want to promote the field". I do want to go into psychology, I do like the field, I do enjoy what I have chosen, I do find the research fascinating. Even if I didn't have a pesonal connection to it I could still easily see myself getting into this.

 

[AbnormalPsych]

"Above all I want to promote the field".

I'm not clear on what you mean by this.

 

[erg923]

"Above all I want to promote the field".

Psychology is a not a religion. We aren't converting people to anything. We dont need people to think we can "save" them. Patients largely need to be lead to the conclusion that can, and are ultimately responsible for saving themselves, actually.

Our field has some really good treatments for variety of MH problems, but we are FAR away from having magic bullets that work for everyone that you need to proclaim from the top of the Mount. If by "promote" you mean dissemination research, that slightly different.

 

[Oddball444]

I'm sorry you have gone through all that, but I am glad you made it through and are doing well.

In short, if you really want to focus on neurofeedback, go into a phd program so you can do research on it as well as get some clinical time in if you run participants in your studies. That education will also give you the ability to practice one day. If you want a clinical career, I am sorry, but you will not be doing much neurofeedback. There are much more effective treatments out there for the disorders you seem interested in.

Thank you for the advice.

Please define "more effective", Faster results? yes absolutely. That is what a pill is, the side effect is, it then slaves the person to the pill. Neurofeedback is slower, but whatever gains the person gets be it small or drastic isn't attached to some conditional external object. It gives control back to the person. If I could post links on the forum i would of studies done of treatment efficacy. Studies rate NFB as at least as effective as any other treatment for various issues.
Also I am uncertain on what you are basing your statement of "If you want a clinical career, I am sorry, but you will not be doing much neurofeedback". My clinical therapist can barely keep up with the demand, he's had people coming 50 miles for treatment. He and the manager had to open up another branch in a different city to meet the demand. When he started started here 12 years ago he was the only one, now there's at least half a dozen.

 

[Oddball444]

I'm not clear on what you mean by this.

As was mentioned earlier NFB is a small, but growing field. Research is continuing to come back supporting its efficacy in many things. However at the university i got my B.S. at, all but one professor had even heard of it. By promote i mean "increase research, treatment modalities, and public exposure".

 

[Oddball444]

Psychology is a not a religion. We aren't converting people to anything. We dont need people to think we can "save" them. Patients largely need to be lead to the conclusion that can, and are ultimately responsible for saving themselves, actually.

Our field has some really good treatments for variety of MH problems, but we are FAR away from having magic bullets that work for everyone that you need to proclaim from the top of the Mount. If by "promote" you mean dissemination research, that slightly different.

Agreed. I'm not out to "save anyone". I know very well that treatment is no more effective that the effort a person puts into it. One must take their medication, or attend their therapy sessions. Nor do I believe that NFB is a magic bullet, I still have all my issues, but weight of them is now within a managable range. Some people like my sister saw no effect at all. Still the growing number of studies that suggest an accecptable level of efficacy, but a lack of awareness as a treatment option bothers me so yes I am a little "look look isn't this cool?"

 

[erg923]

To my knowledge, biofeedback shows efficacy for 1-2 conditions and Neurofeeback (EEG Biofeeback) is not empirically supported for the treatment of any psychiatric condition at this time, much less as a first-line treatment.

Unless you work for the Amen clinics or something similarly unscrupulous, your clinical work will probably have to be a relatively run of the mill practice that uses currently accepted EBT for garden variety conditions and you can use the beloved neurofeedback when patients can pay for it, because insurance doesn't...and probably wont for a long time to come.

For an academic career pursing this area, you will need to be a superstar in grad school and be able obtain external funding to live, because your bills will largely need to be paid by something else.

 

[Sanman]

I'm glad you are doing well and that neurofeedback helped you. However, one-off experiences are a poor basis for a career. So, some thoughts about what you have stated so far:

No, neurofeedback is not knew. It is EEG biofeedback and EEG actually dates back to the 1920s. What you are refering to is the application of neurofeedback to the treatment of certain mental health and developmental conditions, which has had a resurgence recently.


If you want to provide neurofeedback and neurotherapy, you don't need a PhD in psychology. Check out the BCIA for credentialing related being a biofeedback/ neurofeedback technician.

If you want to do research related to the field, you do need a PhD. However, this research alone is unlikely to pay your salary. Are you teaching and attempting to establish yourself as an academic at a university? That is a long road and one that can get expensive. I came out of a psychophysiology lab that utilized biofeedback and they are not cheap to set up. Part of reason that certain research can be sparse is that no one is willing to fund said research. How do you plan to fund a lab for this? DO you like teaching? Do you like conducting research or just reading it?

Do you plan on funding yourself through clinical work? If so, doing only neurofeedback may not provide a steady income and you may not be allowed to provide such treatment at an academically affiliated clinic without a significant body of research to establish it as a standard treatment (which it is not currently). Will you want to do traditional psychotherapy all day?

Psychotropic meds - These are largely managed by psychiatrists and psych NPs. Some psychologists, in specific states and in DOD, can prescribe after additional training following a PhD/PsyD in conjunction with a PCP. If you plan to manage these patients using EEG as you suggested, good luck having a PCP agree to co-manage with you. That is not the accepted standard of care.

The bottom line here is you are talking about doing too many things that would require much more education and leave in the fringes of the field rather than in the mainstream. You can do any ONE of these things and maybe two if you are motivated. However, what you are doing currently is daydreaming. You have not actually identified a job or way to make a living. What you have done is provide a mish mash of various jobs that you would like to put together. So, what is it exactly that you want to focus on?

FYI, an alternative view point from your own OP:

Read this before paying $100s for neurofeedback therapy

EDIT:The above was supposed to read that you don't need a PhD to simply engage in neurofeedback/therapy. See BCIA for further info

 

[Oddball444]

To my knowledge biofeedback shows efficacy for 1-2 conditions and neurofeeback is not supported for the treatment of any psychiatric condition, much less first-line, at this time.

Until this system will let me post links to research I can't counter your knowledge so I am just going to drop it. However I am not looking to frontline anything, I am looking to open up choices. When I had treatment as a child / teen, the only choice i seemed to have was which pill i wanted to try, there was no CBT, no ACT, no Neurofeedback. Even when my Asperger's was diagnosed the sum total of what was written about it in the DSM was about 2 paragraphs long that basically said "we acknowledge this condition exists and we don't know what to do about it". I believe that NFB is a viable choice, and people should be aware of it.

 

[Oddball444]

I'm glad you are doing well and that neurofeedback helped you. However, one-off experiences are a poor basis for a career. So, some thoughts about what you have stated so far:

No, neurofeedback is not knew. It is EEG biofeedback and EEG actually dates back to the 1920s. What you are refering to is the application of neurofeedback to the treatment of certain mental health and developmental conditions, which has had a resurgence recently.


If you want to provide neurofeedback and neurotherapy, you need a PhD in psychology. Check out the BCIA for credentialing related being a biofeedback/ neurofeedback technician.

If you want to do research related to the field, you do need a PhD. However, this research alone is unlikely to pay your salary. Are you teaching and attempting to establish yourself as an academic at a university? That is a long road and one that can get expensive. I came out of a psychophysiology lab that utilized biofeedback and they are not cheap to set up. Part of reason that certain research can be sparse is that no one is willing to fund said research. How do you plan to fund a lab for this? DO you like teaching? Do you like conducting research or just reading it?

Do you plan on funding yourself through clinical work? If so, doing only neurofeedback may not provide a steady income and you may not be allowed to provide such treatment at an academically affiliated clinic without a significant body of research to establish it as a standard treatment (which it is not currently). Will you want to do traditional psychotherapy all day?

Psychotropic meds - These are largely managed by psychiatrists and psych NPs. Some psychologists, in specific states and in DOD, can prescribe after additional training following a PhD/PsyD in conjunction with a PCP. If you plan to manage these patients using EEG as you suggested, good luck having a PCP agree to co-manage with you. That is not the accepted standard of care.

The bottom line here is you are talking about doing too many things that would require much more education and leave in the fringes of the field rather than in the mainstream. You can do any ONE of these things and maybe two if you are motivated. However, what you are doing currently is daydreaming. You have not actually identified a job or way to make a living. What you have done is provide a mish mash of various jobs that you would like to put together. So, what is it exactly that you want to focus on?

heh, guess i need to re-define "new". Correct, I am aware of the history of EEG NFB being do back in the 20's. However what is "new" is technology finally getting to the point that it can provide a proper interface. Sorry for being unspecific.

Thank-you. These are some hard questions and a good reality check. Some of the things you have listed are clearly not things I have seriously thought about. It seems I have to come to term with certain perspectives that am not typically familiar with.

 

[AbnormalPsych]

Until this system will let me post links to research I can't counter your knowledge so I am just going to drop it.

You can post links. See the above post. If you can't manage that, just provide written references so we can look them up ourselves. I am genuinely interested in this research you are referencing.

I believe that NFB is a viable choice, and people should be aware of it.

Sorry, but nobody cares what individuals believe. If you are going to be in this field you need to form opinions based in the accumulation of scientific evidence and practice within the standard of care, or you could do harm to people. The people that do this work for a living, are familiar with the research, and ethical/legal obligations of offering treatment options are giving you some good insight here.

 

[erg923]

Until this system will let me post links to research I can't counter your knowledge so I am just going to drop it. However I am not looking to frontline anything, I am looking to open up choices. When I had treatment as a child / teen, the only choice i seemed to have was which pill i wanted to try, there was no CBT, no ACT, no Neurofeedback. Even when my Asperger's was diagnosed the sum total of what was written about it in the DSM was about 2 paragraphs long that basically said "we acknowledge this condition exists and we don't know what to do about it". I believe that NFB is a viable choice, and people should be aware of it.

It really doesn't matter what you "believe." Healthcare is a business, and it is slow to change and adopt certain methods/approaches. You want a blended academic and clinical career, seemingly, right? The only thing that matters is what you can empirically prove (to fund) and what you can get paid to actually do on a daily basis.

Look.... you can "open up" all the choices all you want. Its a free country. But if its not accepted by science, it is bunk to deliver it in the face of other EBT alternatives, and you wont get paid to do it.

I'm truly sorry your experience (30 years ago?) sucked but ABA services, CBT, ACT, social skills training and variety of wrap-around services for ASD/Aspergers are all available now via a variety of payor sources. I know because I work for one of the largest managed care companies in the US.

 

[erg923]

And again, tie this back to your original inquiry if you could?

What you are interested in doing really has nothing to do with psychiatric prescribing, at least as it is currently practiced and needed in this country.

Unless you develop a boutique cash practice, your Rx privileges as psychologist would simply enable you to be employed by a health system as a "prescriber" just like every other employable psychiatrist and psych NP out there (expect for in 46 of the 50 states)...if you want to work clinically that is? I'm not sure it has any real relation or relevance to what you are interested in actually doing on a daily basis?

 

[Oddball444]

You can post links. See the above post. If you can't manage that, just provide written references so we can look them up ourselves. I am genuinely interested in this research you are referencing.



Sorry, but nobody cares what individuals believe. If you are going to be in this field you need to form opinions based in the accumulation of scientific evidence and practice within the standard of care, or you could do harm to people. The people that do this work for a living, are familiar with the research, and ethical/legal obligations of offering treatment options are giving you some good insight here.

YOU can post links, I'm new here. the system denies my posts with links until certain posting criteria has been met. Just go on pubmed and search for neurofeedback there's lots of stuff, and it keeps growing.

Honestly though I am going to have to end this conversation. I appreciate the info provided and help, it has made me face certain questions I have avoided. Frankly though when I look at the history of some other people's posts on this forum and see the rude, sarcastic and cruel things they've posted before, and then the very statement that "nobody cares about what individuals believe" leads me to believe i may have come to the wrong place for help. I don't want to be an angry poster or argue with people, i just wanted a little information. Thank you

 

[WisNeuro]

YOU can post links, I'm new here. the system denies my posts with links until certain posting criteria has been met. Just go on pubmed and search for neurofeedback there's lots of stuff, and it keeps growing.

Honestly though I am going to have to end this conversation. I appreciate the info provided and help, it has made me face certain questions I have avoided. Frankly though when I look at the history of some other people's posts on this forum and see the rude, sarcastic and cruel things they've posted before, and then the very statement that "nobody cares about what individuals believe" leads me to believe i may have come to the wrong place for help. I don't want to be an angry poster or argue with people, i just wanted a little information. Thank you

The poster is asking for references in genuine interest. You can't post links yet, but you can copy and paste references. I'd be mildly interested too. To be fair, the posters are right, neurofeedback has a checkered past and a dubious present. It's empirical standing is...slim at best. There is potential there, but most of us in neuro world pretty much see snake oil salesman and shysters selling expensive treatments to families desperate for anything. You are telling people that you have read research that backs up certain claims, people just wish to see what you are talking about. This is how the clinical science world works. If something works, beyond placebo and expectancy effects (which are both modestly powerful effects), then we need to be able to point to adequate evidence that it does.

 

[Oddball444]

The poster is asking for references in genuine interest. You can't post links yet, but you can copy and paste references. I'd be mildly interested too. To be fair, the posters are right, neurofeedback has a checkered past and a dubious present. It's empirical standing is...slim at best. There is potential there, but most of us in neuro world pretty much see snake oil salesman and shysters selling expensive treatments to families desperate for anything. You are telling people that you have read research that backs up certain claims, people just wish to see what you are talking about. This is how the clinical science world works. If something works, beyond placebo and expectancy effects (which are both modestly powerful effects), then we need to be able to point to adequate evidence that it does.

Yes, your right. and while I can't post any direct links I think I can post this.
Tan, G., Shaffer, F., Lyle, R., and Teo, I. (2016). Tan, G., Shaffer, F., Lyle, R., and Teo, I. (2016). Evidence-based practice in biofeedback and neurofeedback - 3rd edition. Wheat Ridge, CO: AAPB. Wheat Ridge, CO: AAPB.
You can find 1st edition online for free, but that is like 13 years old. The book lists each Condition, each study, each research backing up its claim. Granted it doesn't lvl 4-5 things all across the board, but it does as people have said seem to hold a lot of potential.

However lets say that people are right at the fact that "brain training" is snake oil. What about the EEG data itself? Its not like the computer is pulling it out of some hidden sub-file installed by programmers across the industry as a hidden joke to the rest of community. As a diagnostic tool EEG NFB in in my opinion still something I am fascinated with. Its quick, comparatively cheap (now, used to have to send the data off to a center and pay them to run a comparison, now the internet / computer's can do the job right at the office) and provides a measure of progress that isn't based on symptomatological increases or decreases but rather hard data that has minimal bias (unless people really can control their brainwave frequencies to such an extent as to alter the results when being tested which is what NFB claims to be teaching people in the first place).

I carry around my early EEG charts with me wherever I go. Whenever I endorse the treatment I always pull them out. Anyone can say "i tried this and felt better", but NFB was the first therapy where I could say "I improved, and here's the data to prove there was a change".

 

[WisNeuro]

Yes, your right. and while I can't post any direct links I think I can post this.
Tan, G., Shaffer, F., Lyle, R., and Teo, I. (2016). Tan, G., Shaffer, F., Lyle, R., and Teo, I. (2016). Evidence-based practice in biofeedback and neurofeedback - 3rd edition. Wheat Ridge, CO: AAPB. Wheat Ridge, CO: AAPB.
You can find 1st edition online for free, but that is like 13 years old. The book lists each Condition, each study, each research backing up its claim. Granted it doesn't lvl 4-5 things all across the board, but it does as people have said seem to hold a lot of potential.

However lets say that people are right at the fact that "brain training" is snake oil. What about the EEG data itself? Its not like the computer is pulling it out of some hidden sub-file installed by programmers across the industry as a hidden joke to the rest of community. As a diagnostic tool EEG NFB in in my opinion still something I am fascinated with. Its quick, comparatively cheap (now, used to have to send the data off to a center and pay them to run a comparison, now the internet / computer's can do the job right at the office) and provides a measure of progress that isn't based on symptomatological increases or decreases but rather hard data that has minimal bias (unless people really can control their brainwave frequencies to such an extent as to alter the results when being tested which is what NFB claims to be teaching people in the first place).

I carry around my early EEG charts with me wherever I go. Whenever I endorse the treatment I always pull them out. Anyone can say "i tried this and felt better", but NFB was the first therapy where I could say "I improved, and here's the data to prove there was a change".

I used to do EEG/ERP research in graduate school. I can tell you how easy it is to p-hack that stuff. Additionally, when we're in the clinical realm, we need to throw out the notion that statistically significant necessarily means anything of substance. If I grab a high enough n and don't control for multiple comparisons correctly (which happens almost all of the time) I can make almost any dataset have some statistically significant findings. You need to examine clinically significant findings in turn. This is only one way that "hard data" can be easily manipulated. If you're really interested, we could go into dozens more. The snake oil salesmen know how to make pretty looking pictures because people are easily taken in by them.

Again, it's quite possible that there may be something there, in the future. But, I just haven't seen any compelling evidence that justifies use in the clinical realm yet.

 

[AcronymAllergy]

And to tie this back to your original question (to some extent)--getting experience with EEG/ERP and related technologies in grad school would seem necessary to support your research and clinical interests.

The pharmacology point, based on what you've said, seems more of an ancillary interest (relatively speaking). To best set yourself up for success there, PSYDR's post has the path as it currently exists. There used to be an in-person fellowship (in NM I believe) for psychopharm for psychologists, which is what I'd recommend if it's still available. In undergrad, if you're able to fit in some of the standard med school pre-reqs and favorites, that might help. In grad school, attending whatever biopsych, neurochem, and psychopharm courses you can may also help. If possible, look at programs in states in which prescription privileges exist (e.g., Louisiana, New Mexico) and see if any training faculty also hold RxP.

If you're wanting to treat patients, a licensable doctorate is what you'll need. Although your interests also still haven't precluded med school, which is the most straightforward route toward prescribing.

 

[psych.meout]

Again, what is "neurocounseling?"

I tried googling it and searching on Google Scholar and it just seems like buzzword vagueness and pseudoscientific use of neuroscience concepts.

 

[Harry3990]

Hi OP,

Just a couple of things I wanted to add to what people have already said. Do you already have a reasonable amount of experience with research as an undergraduate? That's great that you have overcome so much and done well with your undergrad, but research can be a tricky thing to know whether you will enjoy on a long-term basis for your career unless you've had direct experience with all of the parts of it (data collection, stats, writing papers, etc.) I would suggest getting some/more of that before deciding for sure on what path you lean towards.

As someone who also has interests in biofeedback (less so neuro because of the limited efficacy studies, though I do find the process rather interesting), if I were starting from your position today and mostly interested in clinical practice, I would likely consider getting an LCSW or LPC (2 year masters degree) and then getting extra experience and training to become BCIA certified in general biofeedback and neurofeedback. That seems to be the shortest path of obtaining decent competence in psychotherapy and biofeedback without spending 6-10 more years in school. Just wanted to throw that out there as an option for you even though I believe someone mentioned it above.

Best of luck to you. P.S. try not to take comments like "what an individual believes is meaningless" personally. People on here are direct to the point of bluntness/rudeness at times, but the intention is passing on what they have gained from extensive experience in the field. Looking past the tone can be valuable even if it stings a bit to read.

 

[Oddball444]

And to tie this back to your original question (to some extent)--getting experience with EEG/ERP and related technologies in grad school would seem necessary to support your research and clinical interests.

The pharmacology point, based on what you've said, seems more of an ancillary interest (relatively speaking). To best set yourself up for success there, PSYDR's post has the path as it currently exists. There used to be an in-person fellowship (in NM I believe) for psychopharm for psychologists, which is what I'd recommend if it's still available. In undergrad, if you're able to fit in some of the standard med school pre-reqs and favorites, that might help. In grad school, attending whatever biopsych, neurochem, and psychopharm courses you can may also help. If possible, look at programs in states in which prescription privileges exist (e.g., Louisiana, New Mexico) and see if any training faculty also hold RxP.

If you're wanting to treat patients, a licensable doctorate is what you'll need. Although your interests also still haven't precluded med school, which is the most straightforward route toward prescribing.

Thank-you, yes I got that from PSYDR. Thank you for being direct.

 

[Oddball444]

Again, what is "neurocounseling?"

I tried googling it and searching on Google Scholar and it just seems like buzzword vagueness and pseudoscientific use of neuroscience concepts.

Again, what is "neurocounseling?"

I tried googling it and searching on Google Scholar and it just seems like buzzword vagueness and pseudoscientific use of neuroscience concepts.

Honestly i only heard the term like 2 weeks ago in an e-mail. someone had graduated from UTSA with a M.S. in neurocouseling. according to the video it was first used like 3 years ago so your not too far off the mark.

I am going to try to post the link any way i can so forgive me how scrambled it might look, i hope its self explantiory.

w splat w splat w splat dot splat neurocounselinginterestnetwork splat dot splat com

 

[smalltownpsych]

YOU can post links, I'm new here. the system denies my posts with links until certain posting criteria has been met. Just go on pubmed and search for neurofeedback there's lots of stuff, and it keeps growing.

Honestly though I am going to have to end this conversation. I appreciate the info provided and help, it has made me face certain questions I have avoided. Frankly though when I look at the history of some other people's posts on this forum and see the rude, sarcastic and cruel things they've posted before, and then the very statement that "nobody cares about what individuals believe" leads me to believe i may have come to the wrong place for help. I don't want to be an angry poster or argue with people, i just wanted a little information. Thank you

The statement about what you believe is a statement regarding the scientific method not a personal attack. A few of the posters on here can be a bit blunt, but in all fairness when I taught research methods I would pound the desk at times to try to get people to let go of belief systems that were not founded on any type of empirical evidence. The field of psychology tends to have more of this than other areas of inquiry because everyone, including your Aunt Martha and Uncle Joe or even good ol' distant cousin Harold, has an opinion about why people do what they do.

I think that another problem is that we who have been in the field for a long time take too much of our own knowledge for granted and forget how much we learned along the way. Your question is a typical question from someone at your stage in the field beginning to try to make sense of things. When I was graduating undergrad, I still had no real idea what I would be doing as a psychologist. I just knew that I loved everything about it.

 

[Oddball444]

I used to do EEG/ERP research in graduate school. I can tell you how easy it is to p-hack that stuff. Additionally, when we're in the clinical realm, we need to throw out the notion that statistically significant necessarily means anything of substance. If I grab a high enough n and don't control for multiple comparisons correctly (which happens almost all of the time) I can make almost any dataset have some statistically significant findings. You need to examine clinically significant findings in turn. This is only one way that "hard data" can be easily manipulated. If you're really interested, we could go into dozens more. The snake oil salesmen know how to make pretty looking pictures because people are easily taken in by them.

Again, it's quite possible that there may be something there, in the future. But, I just haven't seen any compelling evidence that justifies use in the clinical realm yet.

That is true. someone COULD do that, but that doesn't mean that is what someone IS doing. From what i learned from my stats classes its possible someone could alter the data from almost any study to make it say what they want it to. That's where beleif and trust come in, if my therapist is trying to screw people over to make money or pad his ego, he's doing an awesome job of hiding it. I am XYY, I am remember the prediction based on some study that i was genetically prone to be in prison for violence. Does the field need standardization, yes. However those that take and are trying to make sure their interest IS taken seriously I really don't believe are trying to swindle people out of their money by manipulating records.

 

[WisNeuro]

That is true. someone COULD do that, but that doesn't mean that is what someone IS doing. From what i learned from my stats classes its possible someone could alter the data from almost any study to make it say what they want it to. That's where beleif and trust come in, if my therapist is trying to screw people over to make money or pad his ego, he's doing an awesome job of hiding it. I am XYY, I am remember the prediction based on some study that i was genetically prone to be in prison for violence. Does the field need standardization, yes. However those that take and are trying to make sure their interest IS taken seriously I really don't believe are trying to swindle people out of their money by manipulating records.

I'm not saying that your therapist is intentionally trying to manipulate you. He could just really believe in what he is doing, despite the fact that there is no adequate empirical evidence behind it. the highest likelihood is that they do not have the training/ability to competently evaluate research. Happens all of the time. The issue is that this area is built upon shaky foundations, and some people at the higher end, are passing this off as tested and true methods, when that is not the truth. Many of these interventions are simply relying on placebo and expectancy effects. If you're truly interested in this area, I strongly suggest you go somewhere that you can receive in-depth research training and then you can evaluate this area for yourself. The adequate data simply isn't there, and the data that is there relies on some shady methodological issues. If there is something new out there, I'd love to see it. My mind is open in the face of strong evidence to change it, I would strongly advise the same approach on the other side of the issue.

 

[Oddball444]

The statement about what you believe is a statement regarding the scientific method not a personal attack. A few of the posters on here can be a bit blunt, but in all fairness when I taught research methods I would pound the desk at times to try to get people to let go of belief systems that were not founded on any type of empirical evidence. The field of psychology tends to have more of this than other areas of inquiry because everyone, including your Aunt Martha and Uncle Joe or even good ol' distant cousin Harold, has an opinion about why people do what they do.

I think that another problem is that we who have been in the field for a long time take too much of our own knowledge for granted and forget how much we learned along the way. Your question is a typical question from someone at your stage in the field beginning to try to make sense of things. When I was graduating undergrad, I still had no real idea what I would be doing as a psychologist. I just knew that I loved everything about it.

True, everyone has an option, but in a way that is what continues to stand out to me. If this is snake oil, its the best snake oil ever because it continues to grow, and not just with clients, but PhD practitioners. I am willing to accept my own inexperience and naivety, I am also biased due to my exposure however how many people who should know better than to be fooled does it take to stand up and say this might be legit before acceptance is reached? Are all the people getting into this field just blind? Naturally I wouldn't be happy if found that my ideals have been set on snake oil, but not nearly as unhappy as I would be if I tried to get a PhD with my sights set on that goal. Is there some reason I shouldn't trust these people?

 

[Oddball444]

I'm not saying that your therapist is intentionally trying to manipulate you. He could just really believe in what he is doing, despite the fact that there is no adequate empirical evidence behind it. the highest likelihood is that they do not have the training/ability to competently evaluate research. Happens all of the time. The issue is that this area is built upon shaky foundations, and some people at the higher end, are passing this off as tested and true methods, when that is not the truth. Many of these interventions are simply relying on placebo and expectancy effects. If you're truly interested in this area, I strongly suggest you go somewhere that you can receive in-depth research training and then you can evaluate this area for yourself. The adequate data simply isn't there, and the data that is there relies on some shady methodological issues. If there is something new out there, I'd love to see it. My mind is open in the face of strong evidence to change it, I would strongly advise the same approach on the other side of the issue.

*grunt* Which sort of brings me back around to if I should go into a research based program or a clinical based program and the desire to be flexible. One of the reasons I reach out on forums like this is to get as much information as I can so I can avoid nasty surprises later and have fall back positions if things don't turn out the way i expect (I've gotten REALLY used to that).

 

[WisNeuro]

True, everyone has an option, but in a way that is what continues to stand out to me. If this is snake oil, its the best snake oil ever because it continues to grow, and not just with clients, but PhD practitioners. I am willing to accept my own inexperience and naivety, I am also biased due to my exposure however how many people who should know better than to be fooled does it take to stand up and say this might be legit before acceptance is reached? Are all the people getting into this field just blind? Naturally I wouldn't be happy if found that my ideals have been set on snake oil, but not nearly as unhappy as I would be if I tried to get a PhD with my sights set on that goal. Is there some reason I shouldn't trust these people?

I wouldn't use growth as evidence in efficacy. Look at things like GOOP, acupuncture, oil pulling, and the like. Popularity has nothing to do with evidence of efficacy. But, using popularity as evidence of efficacy is indeed a tried and true method of getting people to buy placebos.

*grunt* Which sort of brings me back around to if I should go into a research based program or a clinical based program and the desire to be flexible. One of the reasons I reach out on forums like this is to get as much information as I can so I can avoid nasty surprises later and have fall back positions if things don't turn out the way i expect (I've gotten REALLY used to that).

Well, you can search out a program that will give you both research experience and clinical training. There are many dozens out there that will do that. If you do go the research route, I'd suggest developing a healthy skepticism for clinical beliefs, even those we hold dear. The facts should be the things shaping your opinion, not the other way around.

 

[Oddball444]

Hi OP,

Just a couple of things I wanted to add to what people have already said. Do you already have a reasonable amount of experience with research as an undergraduate? That's great that you have overcome so much and done well with your undergrad, but research can be a tricky thing to know whether you will enjoy on a long-term basis for your career unless you've had direct experience with all of the parts of it (data collection, stats, writing papers, etc.) I would suggest getting some/more of that before deciding for sure on what path you lean towards.

As someone who also has interests in biofeedback (less so neuro because of the limited efficacy studies, though I do find the process rather interesting), if I were starting from your position today and mostly interested in clinical practice, I would likely consider getting an LCSW or LPC (2 year masters degree) and then getting extra experience and training to become BCIA certified in general biofeedback and neurofeedback. That seems to be the shortest path of obtaining decent competence in psychotherapy and biofeedback without spending 6-10 more years in school. Just wanted to throw that out there as an option for you even though I believe someone mentioned it above.

Best of luck to you. P.S. try not to take comments like "what an individual believes is meaningless" personally. People on here are direct to the point of bluntness/rudeness at times, but the intention is passing on what they have gained from extensive experience in the field. Looking past the tone can be valuable even if it stings a bit to read.

Thanks for the feedback. I was annoyed by his comment but i was more upset by someone else (not naming names, don't wana be a troll too) I bothered to check out someone else's profile, and their former postings, when you see someone telling other people to "shut the **** up" and other fairly rude things I started to question the professionalism of the forum and I got a little heated.

 

[Oddball444]

I wouldn't use growth as evidence in efficacy. Look at things like GOOP, acupuncture, oil pulling, and the like. Popularity has nothing to do with evidence of efficacy. But, using popularity as evidence of efficacy is indeed a tried and true method of getting people to buy placebos.

Unless placebos are the form of therapy being tested. The fact that it does work shouldn't be invalidated if you can't prove why it worked. I know its the sticky ethical question, but if someone comes to you for help, you treat them, they get better, but you can't explain to them why they got better does it invalidate the fact that they did get better? If the popularity grows because people leave feeling that they have improved and are empowered, and that number of people is statistically larger than the people who leave and feel nothing or worse, isn't that evidence that Something is going on even if scientifically you can't nail down what it is?

 

[psych.meout]

Thanks for the feedback. I was annoyed by his comment but i was more upset by someone else (not naming names, don't wana be a troll too) I bothered to check out someone else's profile, and their former postings, when you see someone telling other people to "shut the **** up" and other fairly rude things I started to question the professionalism of the forum and I got a little heated.

I don't think I've ever seen someone here tell someone else to "shut the **** up," especially not any of the regular posters who have commented in this thread.

Unless placebos are the form of therapy being tested. The fact that it does work shouldn't be invalidated if you can't prove why it worked.

You're conflating two separate concepts, placebos vs actual treatments whose mechanisms are unclear. A placebo is something that is inert and has no actual therapeutic value beyond belief that one is receiving a treatment. They are used in testing treatments to see if they have actual therapeutic value, in that the therapy needs to have an effect size statistically larger than that for the placebo group. A treatment could be demonstrably efficacious (i.e., provide benefit and do so above and beyond a placebo), but current science may not fully explain why or how it actually works. This does not mean it is a placebo. There are plenty of psychotropic drugs that were used before we fully understood their mechanisms of action, but they were very much not placebos.

I know its the sticky ethical question, but if someone comes to you for help, you treat them, they get better, but you can't explain to them why they got better does it invalidate the fact that they did get better? If the popularity grows because people leave feeling that they have improved and are empowered, and that number of people is statistically larger than the people who leave and feel nothing or worse, isn't that evidence that Something is going on even if scientifically you can't nail down what it is?

That's not the point. You can't experiment on patients or administer placebos or other treatments of dubious safety and efficacy outside of a research context. Furthermore, it's harmful to the field as a science to be administering these treatments and having their popularity and placebo effects be their empirical basis. That's not how science is supposed to work and it's not how we should conduct ourselves if we want to have our work respected as both clinicians and scientists.

 

[WisNeuro]

Unless placebos are the form of therapy being tested. The fact that it does work shouldn't be invalidated if you can't prove why it worked. I know its the sticky ethical question, but if someone comes to you for help, you treat them, they get better, but you can't explain to them why they got better does it invalidate the fact that they did get better? If the popularity grows because people leave feeling that they have improved and are empowered, and that number of people is statistically larger than the people who leave and feel nothing or worse, isn't that evidence that Something is going on even if scientifically you can't nail down what it is?

I don't think you quiet understand the placebo effect and what we are saying. It is a powerful effect, that works temporarily in some cases. We are saying that many of the claims made in neurofeedback rely on poorly done studies utilizing the placebo effect, with either no matched controls, or inappropriately matched control groups and/or no adequate follow-ups in the medium to long-term. And, the scenario you describe is indeed NOT direct evidence that there is a treatment effect. It maybe evidence of an effect, most likely placebo, but not a treatment effect. Also, in relation to a neurofeedback place in town that utilizes qEEG and supplements, the placebo effect doesn't need to cost upwards of several thousand dollars a month to work.

 

[Sanman]

Unless placebos are the form of therapy being tested. The fact that it does work shouldn't be invalidated if you can't prove why it worked. I know its the sticky ethical question, but if someone comes to you for help, you treat them, they get better, but you can't explain to them why they got better does it invalidate the fact that they did get better? If the popularity grows because people leave feeling that they have improved and are empowered, and that number of people is statistically larger than the people who leave and feel nothing or worse, isn't that evidence that Something is going on even if scientifically you can't nail down what it is?

That means that there is an effect. Finding out the reason behind the effect IS science. You don't take things on trust and faith in science, that is why independent replication exists. You take things on trust and faith in religion. This comes back to my previous post, are you an advocate or a scientist? Nothing wrong with either, but you can't be both. Either you accept the science and move on or you don't and continue to advocate. Scientists study problems to figure out the best solution, you are discussing a singular solution. You are not the doctor/scientist in that case, but the pharmaceutical company in your pill analogy. Pharmaceutical companies advocate for the use of pills regardless of what the data says, they have a stake in the outcome.

 

[WisNeuro]

https://s3.ca-central-1.amazonaws.com/razlab.org/publications/NF_AMP_2017.pdf

Just going to leave this here.

 

[AcronymAllergy]

Relatedly, it's important to note that practitioners aren't immune to cognitive biases. If a practitioner has a group of patients they really want to help, but has been frustrated by limitations in doing so, they may become more lenient with respect to the level of evidence they want to see before offering a treatment. Particularly if more and more providers in the area seem to be offering the treatment, and more patients seem to be asking for it. Providers aren't immune to market forces and the pull of profitability, either, after all. Eventually, they may think to themselves, "well, clients say it's helping them, it seems to look scientific/exciting, it gets people in the door (if they aren't here, I can't help them), and other providers are doing it--so if I don't offer it, someone else will. It can't really be that bad, right?"