Neurofeedback (NF) is biofeedback provided to the central nervous system, and is based on the training of the frequency of the neurological firing patterns. NF is a form of “brain training” used in the treatment of a broad range of mental health issues (e.g., ADHD, anxiety, depression, seizures, migraines, panic attacks, PTSD, cognitive performance, mood and many other brain based problems), and NF is also used for peak performance training.

Similar to the occupational therapy process initiated before the use of any therapeutic modality, prior to using NF, an assessment process that includes obtaining the occupational history, client factors, occupational skills and performance patterns, and any other assessment procedures needed to complete a comprehensive occupational profile is necessary.

Many NF clinicians focus largely on the global patterns of neurophysiological arousal symptoms during the assessment process, in order to consider whether a client seems to be generally more under aroused, over aroused or if an “instability” is present (the combination of over and under arousal symptoms).

According to Sebern Fisher (2007),

“When the assessment is completed, sensors are attached to the patient’s head to record the real time EEG (electroencephalogram) on a computer. The trainee looks on a second (computer) screen at a video game that corresponds directly to this EEG and plays the game by shifting the amplitude of targeted frequencies in his brain. Brain frequencies relate to states of arousal. As an example, if someone is making a robust amount of 8-11 Hz (alpha waves) in the right hemisphere, they are likely to feel calm. If they are producing appropriate amplitudes of 15-18 Hz (beta) in the left hemisphere, they are likely to feel alert. The patient is rewarded for increasing appropriate frequencies in the appropriate hemisphere, as established with the assessment, while decreasing frequencies that might interfere with optimal functioning.” (p. 109)

Occupational therapists are becoming certified NF providers, integrating NF into the range of therapeutic modalities offered in practice. For example, Tina Champagne is a certified NF clinician and is working on integrating NF services into mental healthcare services.

For more information on neurofeedback, and existing NF research visit the following websites:

International Society for Neurofeedback and Research:

Zengar Institute:

EEG Spectrum:


Fisher S. (2007). Neurofeedback, affect regulation and attachment: A case study and analysis of anti-social personality. International Journal of Behavioral Consultation and Therapy, 3, 109-117.