NEUROFEEDBACK CERTIFICATION PROGRAM
Instructors: Barry Sterman, PhD and Cynthia Kerson, PhD
(26 BCIA Accredited Instruction Hours)
Level: Introductory to Intermediate
Practice Gap:
Neurofeedback is an up and coming modality that utilizes operant conditioning to regulate brain state. It
is a form of applied psychophysiology – a union of psychology and physiology. There are many
research publications showing efficacy with AD/HD, seizure disorders, substance abuse, autistic
spectrum disorders, mild traumatic brain injury and post traumatic stress disorder, to name a few. A
medical and/or psychological practitioner may, under the scope of his license, practice this intervention.
It is essential that the practitioner gains full knowledge of the neuroanatomical and neurophysiological
features of the brain sites being trained and understands the likely objective and subjective reactions. A
medical professional would be brought to current knowledge about psychological implications and a
psychologist would be brought to current understanding about the organic issues.
References:
Arns, M., de Ridder, S., Strehl, U., Breteler, M., Coenen, A. (2009). Efficacy of neurofeedback
treatment of ADHD: The effects on attention, impulsivity and hyperactivity: A meta-analysis.
Clinical EEG and Neuroscience:40 (3). 179-189.
Sherlin, L., Arns, M., Lubar, J., Heinrich, H., Kerson, C., Strehl, U., Sterman, M. B.
(2011). Neurofeedback and Basic Learning Theory: Implications for research and the clinic. J.
Neurotherapy:15(4). 292-304.
Sterman, M. B. (1976). Effects of brain surgery and EEG operant conditioning on seizure latency
following Monomethelhydrazine intoxication in the cat. Experimental Neurology:50, 757-765.
Thompson, M. & Thompson, L. (2005). Neurofeedback intervention for adult ADHD.Journal of Adult
Development:12 (2/3). 123-130.
Educational need:
Improved understanding of the psychological and physiological implications of brain wave biofeedback
(neurofeedback), improved understanding of treatment protocol selection, improved understanding of
the treatment setting and improved understanding of the outcomes desired.
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Abstract: This 3-day F2F workshop, which is a section of the full 34-hour BCIA didactic course for
certification in neurofeedback, discusses the concepts of the origins, learning principles, best training
protocols, and treatment plans for specific presentations for neurofeedback and neuromodulatory
approaches. This course will also demonstrate EEG recording and training procedures with state of the
art instrumentation and will prepare the clinician for providing neurofeedback in his practice.
9 objectives for this 3-day course:
1. The attendee will gain a foundational knowledge of the history, development and relevant
research relating to the emergence of electroencephalography (EEG) and subsequent EEG
operant conditioning.
2. When brain training, it is fundamental to understand the structure and behaviors of the brain at
the cellular level. This course introduces the concepts of neurophysiology and neuroanatomy and
how they are important to the psychologist in developing neurofeedback treatment plans.
3. The attendee will be oriented to the nature of operant conditioning and its applications with
neurofeedback, neuromodulation, to provide a mechanism for which the psychologist can rely
while training the client.
4. The instructor will provide practical training to facilitate an understanding of the equipment,
electronic and instrumentation concepts so the actual EEG acquisition is without artifact and
provides clean recording.
5. Demonstration and trainings with neurofeedback instrumentation will be provided in small group
settings. This is to build confidence in the psychologist’s ability to manipulate the equipment and
to provide safety guidelines for the psychologist while training the client.
6. Understanding how the brain interacts with medications and how these interactions affect EEG
measure is vital. Many clients appear medicated and/or ascertain new prescriptions while
undergoing neurofeedback training. The psychologist will understand these mechanisms better.
7. Because there are ethical issues specific to neuromodulation and brain training, the instructor
will discuss them to better prepare the psychologist.
8. Because there are relevant clinical populations and non-candidates for neurofeedback training,
the psychologist will be briefed on how to discern them. Additionally, the best protocols, based
upon the QEEG and their presentation, will be discussed.
9. The attendee will be better prepared to sit for the BCIA certification exam to show competence
in this area of treatment.
COURSE OUTLINE
** 2.5-hour lab time required for BCIA didactic credits. This time will be made available in the
evenings and/or during lunch and the time will be mutually decided upon during the first day of class.
DAY 1– 7.5 HOURS
INTRODUCTIONS
8:15-8:45 (.5 hour)
Brief orientation and introductions from the instructor and attendees. Course overview and
determination of lab times.
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I. OPERANT CONDITIONING AND NEUROFEEDBACK – Dr. Kerson
8:45-10:15 (1.5 hours)
(Obj 1, 3 5 and 9); BCIA Blueprint area I (1.5 hrs)
The instructor will provide a review of the discovery of surface electrical potentials from the
brain first by Caton in animals and then by Berger in humans, opening the door to a relatively rapid
development of the EEG field in basic science and medicine. Discuss how parallel development of
behavioral conditioning methods by the work of Thorndike, Skinner, and Hull provided the foundation
for operant conditioning of the EEG once technology had developed the necessary tools. Review the
development of biofeedback training concepts and technical requirements.
BREAK
10:15-10:30 (.25 hour)
II: ELECTRONICS, IMPEDANCE AND EEG ARTIFACTS – Dr. Kerson
10:30-12:30 (2 hours)
(Obj. 2 and 5); BCIA blueprint area III (2 hours)
This section will familiarize the attendee with the electronics and instrumentation used to
facilitate neurofeedback. This will include Ohms’ law, EEG impedance measures, analog and digital
recording, the 10-20 International System for site location and some impedance and artifact issues.
Examples of EEG artifact will also be presented.
Review of the terminology associated with EEG instrumentation and data collection. Discuss
referencing issues, including basic linked-ear reference and mathematically corrected common average
Laplacian reference methods. Explain the basis for common-mode-rejection circuit in EEG amplifiers
and resulting distortions of rhythmic EEG voltages at sites near earlobe reference electrodes. Show
related distortion of topographic findings due to earlobe corruption from propagated dominant frequency
activity.
Compare analog and FFT-derived digital EEG recording methods. Review the differences
between magnitude, power, and logrhythmic FFT outcome values and their effects on the probability
requirements of parametric statistical analyses. Describe FFT spectral analysis parameters affecting
outcomes, including epoch duration, sampling rates and windowing methods. Demonstrate artifact
removal methods. Stress the importance of competent (less than 10K) impedance levels for electrode
placements, and the noise and signal-noise consequence of sloppy electrode attachment.
LUNCH
12:30-1:30 (1 hour)
III. REVIEW OF THE ONLINE Fundamental Neuroscience for Neurofeedback SECTION – Dr. Kerson
1:30-2:30 (1 hour)
(Obj 2, 9); BCIA blueprint area VI (1 hour)
A review of basic cellular neuroscience from the Fundamental Neuroscience for Neurofeedback
6-hour online program taught by Dr. Cooper. Additionally there is a handout in your booklets, Drug
Exposure and EEG/qEEG Changes by Gunkelman that further discusses EEG changes due to
medication and/or drug intake.
IV. EEG CLIENT AND SESSION PREPARATION AND TRAINING DEMONSTRATION– Dr. Kerson
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2:30-3:30 (1 hour)
(Obj1, 2, 4 & 9); BCIA blueprint area I & III (.5 hrs each)
The instructor will demonstrate a typical neurofeedback hook-up showing how to prep the scalp,
to measure the 10 20 system and show how to be sure you have low impedance.
BREAK
3:30-3:45 (.25 hour)
V. EEG CLIENT AND SESSION PREPARATION AND TRAINING PRACTICUM– Dr. Kerson
3:45-5:45 (2 hours)
(Obj1, 2, 4, and 9); BCIA blueprint area III (2 hours)
During this time attendees will break into hands-on small-group neurofeedback training sessions.
There will be a “clinician” and “client” and observers. Each attendee will have an opportunity to role
play and/or observe the actual process of hooking up and providing neurofeedback training along with
any assessment interview to determine the best protocol.
VI: Q&A
5:45-6:15 (.5 hour); BCIA blueprint area I (.5 hours)
Q&A period
DAY 2– 8 HOURS
VII: STANDARD TREATMENT PROTOCOLS – Dr. Kerson
8:30-10:00 (1.5 hours)
(Obj 8 and 9); BCIA blueprint area VI (1.5 hours)
In this period, we will discuss the classic treatments for AD/HD, learning disabilities, mTBI,
substance abuse issues, epilepsy, anxiety, depression and affective disorders. It will introduce the
development of such training as SMR for ADHD and Epilepsy, frontal asymmetry for
anxiety/depression, alpha/theta training for SUD and theta/beta ratio (TBR) for attentional issues, slow
cortical potentials, LORETA neurofeedback, rTMS, CES and event related potentials.
BREAK
10:00-10:15 (.25 hour)
VIII: INTAKE, TREATMENT DEVELOPMENT AND PLANNING – Dr. Kerson
10:15-12:00 (1.75 hours)
(Obj 1, 7, 8 and 9); BCIA blueprint area VI (1.75 hours)
Knowing what protocol to use, when to change protocol, when to stop treatment and how to
assess is integral to successful treatment. This section looks at the assessment tools for neurofeedback
and the appropriateness to their utility based upon the clinician’s credentials.
Review standard patient/subject office/lab procedures. Provide examples of relevant intake
interview, stressing the need for person-to-person contact, ethical discussion of privacy and mutual
obligations, and request for prior medical and behavioral reports as indicated, if not previously obtained.
Review and explain treatment plan, including sites and systems implicated, software
customization for treatment objectives, and outcome measurement techniques. Use these elements to
provide the structure and objectives for producing an effective treatment plan.
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LUNCH
12:00-1:00 (1 hour)
IX: EFFICACY GUIDELINES – Dr. Sterman
1:00-2:00 (1 hour)
(Obj 8) BCIA blueprint area IV (1 hour)
In this section, research will be discussed within the context of levels of efficacy as developed by
AAPB in 2002 and in the Yucha & Montgomery publication, Evidence-Based Practice in Biofeedback
and Neurofeedback (AAPB, 2008). Evidence-based practice must take into account both efficacy in
controlled research settings and effectiveness in the real world of clinical practice. Methodological and
statistical criterion will be applied to current published studies. It is important for the clinician to realize
the approval status for the training that he/she plans to use. Accurately describing to your clients, third
party payers, and other involved practitioners where in the range of ‘experimental’ to ‘efficacious and
specific’ the problem to be addressed stands with regard to the treatment planned is vitally important.
X: REVIEW OF RESEARCH AND ITS CURRENT STATE – Dr. Sterman
2:00-3:00 (1 hour)
(Obj): BCIA blueprint area IV (1 hour)
The history of biofeedback and the pioneering studies of Kamiya, Sterman & Lubar leading to
the development of the specialized field of neurofeedback will be reviewed. This field focuses on brain
electrical measures, including EEG, evoked potentials, slow cortical potentials, and mathematically
derived representations of depth activity (LORETA). This review will focus primarily on relevant
studies, which take into account both efficacy in controlled research settings and effectiveness in the real
world of clinical practice. The technical and conceptual requirements for valid and reliable research will
be discussed, as well as the means by which meaningful research can be accomplished within the
context of clinical practice.
A brief review of landmark and current published research in neuromodulation, with a specific
focus on the critical operational issues discussed earlier will be carried out. A discussion of how future
research should be performed will derive from this review.
BREAK
3:00-3:15 (.25 hour)
XI: PRINCIPLES OF OPERANT CONDITIONING LEARNING WITH NEUROFEEDBACK- Dr.
Sterman
3:15- 4:00 (.75 hours)
(Obj 1, 3& 9) BCIA blueprint area I (.75 hours)
Revisiting Thorndike’s “Law of Effect” and the subsequent development of instrumental/
operant conditioning, issues specific to application in the EEG feedback context will be explained, and
solutions reviewed. The critical importance of timing, response specificity, acquisition documentation,
and both objective EEG/QEEG and reported clinical outcomes will be the focus of a methodological
strategy overview.
XII: EEG ORIGIN AND METHODOLIGY – Dr. Sterman
4:00-5:30 (1.5 hour)
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(Obj 6 and 9); BCIA blueprint area I (.25) and VI (1.25 hour)
Discuss what is actually being viewed in the raw EEG and from where in the brain it is derived.
This will help with protocol selection and provide a better understanding of the underlying energy
source as well as coincide with behavior.
XIII: Q&A
5:30-5:45 (.5 hour); BCIA blueprint area I (.5 hours)
Q&A period
DAY 3– 8.5 HOURS
XIV: NEUROFEDBACK DEMONSTRATION- Dr. Kerson
8:30-10:30- (2 hours)
(Obj 1, 3& 9) BCIA blueprint area VI (2 hours)
Attendees will observe a neurofeedback hook-up and training along with further discussion about
impedance, training paradigms and how to set training goals.
BREAK
10:30-10:45 (.25 hour)
XVI: NEUROBEHAVIORAL BASICS OF SMR TRAINING– Dr. Sterman
10:45-11:45 (1 hour)
(Obj 6 and 9); BCIA blueprint area VI (1 hour)
Based on the issues discussed earlier and the legacy of findings from animal research the
underlying basis for the SMR rhythm and its relationship to motor and cognitive functions will be
demonstrated. The role of this history in establishing training protocols and dealing with the
complications introduced by medications and non-prescribed drugs and their interactions will be
specified. Demonstration of appropriate methods for addressing the issues of operant conditioning,
treatment session structure, and patient compliance will be provided. Precautions with interpretation of
generalized and corrupting effects will also be presented.
XVII: EVIDENCE-BASED NEUROTHERAPY – Dr. Sterman
11:45-12:45 (1 hour)
(Obj 8 and 9) BCIA blueprint area VI (1 hour)
Knowing what protocol to use, when to change protocol, when to stop treatment and how to
assess is integral to a successful treatment plan. This section looks at the assessment tools for
neurofeedback and the appropriateness to their utility based upon the clinician’s credentials and presents
two cases to illustrate how treatment was assessed and performed.
LUNCH
12:45 – 1:45 (1 hour)
XVIII: TREATMENT PLANNING AND CLIENT PREPARATION Part 1/2 - Drs. Sterman and Kerson
1:45-3:15 (2.5 hours)
(Obj 1, 7, 8 and 9); BCIA blueprint area III (2.5 hours)
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Knowing what protocol to use, when to change protocol, when to stop treatment and how to
assess is integral to a successful treatment plan. This section looks at the assessment tools for
neurofeedback and the appropriateness to their utility based upon the clinician’s credentials.
Review standard patient/subject office/lab procedures. Provide examples of relevant intake
interview, stressing the need for person-to-person contact, ethical discussion of privacy and mutual
obligations, and request for prior medical and behavioral reports as indicated, if not previously obtained.
Review and explain treatment plan, including sites and systems implicated, software customization for
treatment objectives, and outcome measurement techniques. Use these elements to provide the structure
and objectives for producing an effective treatment plan.
BREAK
3:15-3:30 (.25 hour)
IXX: TREATMENT PLANNING AND CLIENT PREPARATION Part 2/2 - Drs. Sterman and Kerson
3:30-5:00 (1.5 hours)
(Obj 1, 7, 8 and 9); BCIA blueprint area VI (1.5 hours)
Knowing what protocol to use, when to change protocol, when to stop treatment and how to
assess is integral to a successful treatment plan. This section looks at the assessment tools for
neurofeedback and the appropriateness to their utility based upon the clinician’s credentials.
Review standard patient/subject office/lab procedures. Provide examples of relevant intake
interview, stressing the need for person-to-person contact, ethical discussion of privacy and mutual
obligations, and request for prior medical and behavioral reports as indicated, if not previously obtained.
Review and explain treatment plan, including sites and systems implicated, software customization for
treatment objectives, and outcome measurement techniques. Use these elements to provide the structure
and objectives for producing an effective treatment plan.
XX: FINAL DISCUSSION AND TEST Q&A
5:00-5:30 (.5 hour); BCIA blueprint area VI (.5)
(Objs 1-9)
Final review and discussion of the 3-day course’s subject matter. The instructors will
reintroduce concepts discussed and facilitate conversation about their deeper implications.
BCIA APPLICANTS - PLEASE NOTE:
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Complete BCIA course work includes completion of this 3-day course (24 hours), the 6-hour
web-based Fundamental Neuroscience for Neurofeedback and 4-hour Ethics for Biofeedback
courses. This course covers the following blueprint areas: I, III, VI and VI
The 2.5 hour lab time partially satisfies blueprint areas III and VI.
Certificate of Completion required for BCIA is an additional fee of $45
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