Offering high-quality, multidisciplinary, collaborative assessment and behavioral healthcare treatment for children, adolescents, adults, and families in Nashville and Franklin.
Neurofeedback is a method of retraining electrical activity in the brain in order to alleviate psychiatric symptoms. As the health and efficiency of neural networks improve, symptoms related to depression, anxiety, ADHD, and poor sleep improve as well.
During a neurofeedback session, sensors are attached to the scalp to measure electrical activity in the brain. This activity is then displayed on a computer screen, allowing the individual to see their neurological activity in real time. As that activity changes, so does the feedback displayed on the screen. The screen may get darker, or sound may get quieter. These are signals to the brain to change its own electrical activity patterns. As those changes occur, symptoms begin to improve.
Because it focuses on the underlying neurological causes of psychiatric symptoms, neurofeedback can be helpful for a variety of conditions, including anxiety, depression, ADHD, PTSD, and chronic pain.
The first step in the neurofeedback process is the initial qEEG assessment. We place an array of 22 sensors on the head and record the brain’s electrical activity. Then, our board-certified staff analyze the data and use it to create two- and three-dimensional maps of brain function. Using these maps, we construct individual training protocols for each client. These protocols are designed to retrain areas or networks in the brain which may be dysregulated. We then review the maps and discuss implications and training protocols before moving forward.
During training sessions, we use the principles of neuroplasticity and behavioral psychology to change brain function in positive ways. Clients choose a method of feedback from our list of movies, music, and games. When brain function moves in a positive direction, positive feedback is provided. Over time, the brain responds to positive feedback, and slowly begins to change its own function. As brain health improves, negative symptoms begin to recede.
Upon completion of a round of neurofeedback training, we conduct another clinical interview and qEEG assessment. This helps to determine if additional training may be helpful, whether that is designed to address the same symptom profile or a different one.
Because neurofeedback focuses on disorganized or dysregulated brain patterns, anyone with a brain can benefit. However, some specific areas consistently show improvement, specifically the following:
Several unique features contribute to the success of our neurofeedback program.
Our qEEG assessments are recorded and analyzed here on site by our director, Cory Williams, who is certified by both the BCIA and the qEEG Board, as well as Dr. Susanna Quasem, a psychiatrist and is certified by the qEEG Board. Each report, including individualized training recommendations, is reviewed either in person or on a video call.
There are many different types of neurofeedback training, each with different goals and technical underpinnings. We are able to offer several different types, depending on individual needs.
During neurofeedback sessions, we also offer heart rate variability training, a method of biofeedback training that can reduce symptoms related to low energy, depression, and anxiety by balancing the autonomic nervous system.
We utilize a variety of self-reporting scales, clinical interviews, training data, and computer-based neurocognitive assessments to ensure that training goals are being met and symptoms are improving.
Because neurofeedback can take time to enact successful change, it is helpful to come for training sessions 1-3 times a week. In order to accommodate all schedules, we see patients Monday-Saturday in the Nashville office, and Monday-Thursday in the Franklin office.
As brain health improves, it is sometimes necessary to change medication or shift the focus of other therapeutic services. Our clinic has a number of team members who oversee therapy and medication, which makes communication easy. When clients see community providers, we work hard to collaborate with those providers to review training goals and progress.
All qEEG's, training protocols, and neurofeedback progress are reviewed with Dr. Susanna Quasem, a board-certified psychiatrist and qEEG Diplomate.
This varies by insurance carrier and individual plan. We are out ofnetwork with all insurance providers, but we will assist clients with filing insurance claims if desired.
Neurofeedback is a type of biofeedback in which information about neurological function is given to the brain using interactive computer software. The brain uses this information to change the way it functions. Neurofeedback operates on the principles of classical and operant conditioning, as neural processes change based on behavioral learning mechanisms. During neurofeedback sessions, the patient watches a movie or listens to music while a technician observes their brain function. As brain function changes, so does the music or movie, providing feedback about neurological function. Over time, the brain learns to operate more efficiently, and clinical symptoms such as poor focus or depression, decrease. Because the changes to the brain occur on the neuronal level, they are often sustainable over time. The analogy we use is that learning to function more efficiently is a little bit like learning to ride a bike. Once the brain has figured out the best way to do it, it doesn’t really forget.
The initial assessment before starting neurofeedback is called a quantitative electroencephalogram, or qEEG. Traditionally, EEG is used in the field of medicine to measure the brain’s electrical activity in order to detect seizure activity. When these EEG signals are broken down into component pieces and analyzed quantitatively, we are able to create colorful brain maps that indicate functionality and connectivity of various neural networks. These maps are compared to an age-referenced database of several hundred brains, which helps to indicate areas that may be dysregulated. The qEEG is a simple, non-invasive procedure that takes about 30 minutes to complete. The patient wears a special cap which has electrical sensors sewn into it. These sensors measure the electrical activity of the brain and transmit that activity to the computer. During the recording process the patient should sit as still as possible for about 10 minutes with their eyes open and 10 minutes with their eyes closed.
Every brain is different, which means every person responds to the neurofeedback process differently. On average, most people begin to see gradual positive changes around 6-8 sessions, with bigger ,more noticeable results occurring around 10-12 sessions or so. We recommend that patients complete 20 sessions initially in order to ensure maximum efficacy.
The answer to this question varies depending on a number of factors. Each patient’s ability to learn to self-regulate is different. Their ability to retain information is different. Their brains are different. Most people need between 20-40 sessions to achieve the maximum desired results. These results are typically sustained over long periods of time, with the longest published research showing lasting gains at a 10- year follow up.
In the perfect world, patients come in for training two to three times a week. This allows for the brain to build on the new activity patterns it is learning while also allowing for time to rest and recover. However, we understand that schedules can be tricky, and sometimes patients can only come once a week, or need to come four or even five times a week in order to finish quickly. We are happy to work around scheduling needs. We see patients from 8-7 Monday through Friday and from 8-5 on Saturdays.
Yes. The longest changes that have been published in the literature indicate results that last a full ten years. Neurofeedback creates lasting changes because of the phenomenon known as auto-reinforcement. This means that new pathways, once formed, are used and re-used thereby reinforcing the strength of their connections.
Hans Berger discovered EEG in 1924, but the foundational members of the neurofeedback community began conducting animal studies and publishing research in the 1950’s and 60’s. In the 20 years since then, methodology and technology have become even more refined, allowing for more effective diagnostic and training methods. In addition, over the past 40 years, several databases have been constructed containing the data from several thousand neurotypical brains. These databases allow for reliable comparison to a scientifically sound standard database of typically developing individuals of the same age and gender. These comparisons allow us to identify variations in frequency, phase, amplitude, and coherence, which are of statistical significance and representative of the complex network connectivity that exist within the brain.
NFB has been researched extensively to document its therapeutic efficacy and excellent tolerability. We are happy to provide research papers on the effects of neurofeedback in treating a variety of neurological and psychological conditions. Although strongest evidence exists for neurofeedback in order to improve attention, there is also evidence that neurofeedback can improve short-term memory, sleep, anxiety, pain perception, mental clarity, alertness, creativity, and emotional regulation.
At the end of a round of training, we conduct an interview with the patient and parents (when appropriate) in order to assess changes. We also administer subjective rating scales, and an objective test of attention and executive function, the CNSVS. Finally, we record an additional qEEG assessment in order to compare the first and second qEEG and to determine what aspects of brain function changed. We use all they data points to determine whether additional training may be beneficial.
Neurofeedback is to safe to undergo while taking medication. However, as the brain begins to heal through the neurofeedback process, it may be helpful to reduce the amount of medication prescribed. We work closely with staff members here and with outside providers in order to ensure that medication is optimized throughout the process.
The goal of TMS is to activate areas of the brain that may be underactive using an invasive, magnetic pulse. While neurofeedback can help to activate areas of the brain, it does so in a non-invasive manner. In addition, neurofeedback has the potential to train areas of the brain to be less active. This makes neurofeedback a potentially more versatile intervention, in addition to a non-invasive one.
This varies by insurance carrier and individual plan. We are out of network with all insurance providers, but we will happily help you submit your claims to your insurance company. At that point, if they reimburse it will be to you directly. We are also happy to provide relevant research papers when it comes to submitting appeals.
As mentioned, neurofeedback is a powerful, evidence-based treatment option that can help improve brain function and alleviate symptoms associated with a range of mental health conditions. By training your brain to regulate its own activity, neurofeedback can help reduce stress and anxiety, improve focus and attention, and increase overall cognitive functioning. Whether you are struggling with depression, ADHD, or other mental health conditions, neurofeedback therapy can help you achieve greater mental clarity, emotional stability, and overall well-being.