Easing ADHD without meds

I was dismayed by the lack of mention of neurofeedback in "Easing ADHD without meds" in the February Monitor. Significant in terms of overcoming the bias of the medical profession to nonpharmacological approaches, neurofeedback was recently recognized by the American Academy of Pediatrics as a Level 1 (Best Support) treatment for ADHD.

Treatment involves having clients watch a movie that shrinks and fades when the software detects undesired shifts in brainwave activity. The client is not instructed to especially focus or relax. I describe it as akin to the rumble strips on a highway that train drivers to stay in their lane. The improvement, like that in sports or musical training, is gradual, but once proficiency is reached, it is maintained. Treatment typically takes 20 to 40 sessions. The "side effects" are improved sleep, better mood, lessened anxiety and improved frustration tolerance. As treatment involves movies or video games, treatment compliance is rarely an issue.  

Like a good physician, neurofeedback requires technical knowledge and clinical skill. Most clinicians can learn the basics in a week's intensive training followed with ongoing consultation, often via online discussion groups. The cost of equipment is moderate. The biggest barrier is that most insurance companies don't cover neurofeedback. My clients pay out-of-pocket, and my practice is primarily working and middle-class families. One can keep fees reasonable and still do well. However, the greatest professional gratification comes from hearing about the changes in my clients.  

Matthew Fleischman, PhD
Eugene, Ore.

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