Process and Duration of a Biofeedback Therapy

The First Meeting

At the beginning of a biofeedback therapy, as with Neurofeedback, the therapist first does a detailed assessment where the patient can describe his symptoms. Then the therapist discusses with the patient if and how a biofeedback therapy could help.

Biofeedback Stress Test

During this first session a stress test could be performed with the patient. Most biofeedback devices have short and long versions of stress tests integrated into their software. Various body signals (for example, respiration, heart rate, galvanic skin response, muscle tension) are measured while the patient is instructed to relax for several minutes and is then exposed to several stressors. Such a measurement gives information about how the patient reacts to stress and how his ability is to recover from these stressful events. Such a stress test helps to decide which body signals can be used for biofeedback training.

Process of a Biofeedback Session

The patient sits in front of the patient screen and the therapist attaches the appropriate sensors to the patient. This can be, for example, a pulse sensor on the finger, a breathing belt around the abdomen, a temperature sensor on the finger or electrodes for measuring muscle tension or galvanic skin response.

In contrast to neurofeedback, with biofeedback one often works with the original signal as a line or bar. This is perhaps most easily explained with the hand warming training that is often used to support relaxation training:
a small temperature sensor is attached to the finger of the patient and the patient sees a line on the computer screen which represents the course of his finger temperature over time in real time. If the patient is supposed to learn to increase his hand temperature deliberately, then his job is to move the line on the screen upwards. Of course the signal can also control animations, for example a sun rises higher with increasing temperature and sinks beneath the horizon when the temperature falls.

An increase in finger temperature is achieved when the muscles around the peripheral vessels relax and thereby more warm blood flows into the periphery. Many know this autonomic reaction from hand warming during autogenic training.

In contrast to modern ILF-Neurofeedback training, where the patient does not receive any active instructions, but is only supposed to watch the changes in the animations, in biofeedback the patient receives specific instructions in which direction he should change the signal. In both cases, however, we have unconscious learning processes. While biofeedback trains more general state shifts in the vegetative nervous system, effects of training with  Neurofeedback-Training are more specific and profound, because specific neuronal networks can be addressed with the according electrode placements.

Duration of the Biofeedback Therapy

Since biofeedback is mostly used as a complementary tool within an overall treatment concept, it is hard to say generally how long a therapy will take and when it will end. Normally, when the symptoms have disappeared.

Within an overall treatment biofeedback is possibly used as a complement for only 3-5 sessions.

With some indicatons, for example the vasoconstriction training for migraine, biofeedback sessions can be the main part of the therapy. In this case, normally about 10 sessions are needed until the patient learns permanently how to restrict his vessels in the temple area and thereby to suppress the migraine attacks.