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About neurofeedback

EEG neurofeedback is a form of biofeedback. Sensors on the scalp read brain electrical activity and return sound or visuals in real time so a person can practice self-regulation. Educational overview — not a promise of individual results.

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Overview

History of neurofeedback from Sterman’s 1960s lab work to current efficacy ratings

History — Sterman lab, 1960s, through current efficacy ratings (1 of 6)

EEG neurofeedback is a form of biofeedback: sensors on the scalp read brain electrical activity and return sound or visuals in real time so a person can practice self-regulation.
The method grew from M. Barry Sterman’s 1960s UCLA / NASA work and a 1969 validation study. It is operant conditioning applied to EEG.
A typical session is about 30–45 minutes. Sensors are placed after an assessment. A practitioner watches the live signal and adjusts thresholds. Many sessions are used, not one.
The lecture deck lists ILF, alpha-theta / alpha-down, and SMR as common PTSD protocols. Choice of protocol is a clinical decision, not a website claim.
The same deck treats neurofeedback as adjunctive to psychotherapy, not a standalone cure, and notes the time and training required.

Citations

Applications

What the evidence says

AAPB field ratings from the 4th edition handbook. Protocol names are from the literature — not a prescription. Graphics for ADHD, epilepsy, depression, and anxiety can be added as lecture slides are ready.

Trauma / PTSD

4 / 5 · Efficacious

Khazan et al. (eds), 2023 — AAPB, 4th ed.

Field rating of published biofeedback and neurofeedback evidence. Not a promise of individual results.

Common protocols

Names used in the literature. Not a protocol prescription.

Alpha-theta and alpha-down. Most cited EEG approaches in recent PTSD meta-analyses.
Infra-low frequency (ILF). Very slow rhythms; used to settle arousal.
SMR (sensorimotor rhythm). 12–15 Hz training for physical calm and focus.

Slide summarizing Berman et al. 2025 meta-analysis of neurofeedback for PTSD

Berman et al., 2025 — systematic review and meta-analysis (1 of 5)

Meta-analysis. Askovic et al., 2023 — Ten clinical trials; seven RCTs in the pool. Authors report moderate benefit for PTSD symptoms. Pooled effect was large (SMD −1.76) with very low certainty.
Meta-analysis. Berman et al., 2025 — EEG neurofeedback: moderate-to-large vs passive controls (SMD −1.32); smaller and uncertain vs active controls (SMD −0.43, CI crossed zero).

Citations

Khazan I, Shaffer F, Moss D, Lyle RR, Rosenthal S (eds) (2023). Evidence-based practice in biofeedback and neurofeedback, 4th edn. Association for Applied Psychophysiology and Biofeedback.
Askovic, M., Soh, N., Elhindi, J., & Harris, A. W. F. (2023). Neurofeedback for post-traumatic stress disorder: Systematic review and meta-analysis of clinical and neurophysiological outcomes. European Journal of Psychotraumatology, 14(2), Article 2257435.
Berman, D. E., Cowansage, K. P., Bellanti, D. M., Nair, R., Boyd, C. C., Beech, E. H., Reddy, M. K., Recker, R. S., Belsher, B. E., & Kelber, M. S. (2025). Systematic review and meta-analysis of neurofeedback training efficacy and neural mechanisms in the treatment of posttraumatic stress disorder. Frontiers in Neuroscience, 19, 1658652.
van der Kolk, B. A., Hodgdon, H., Gapen, M., Musicaro, R., Suvak, M. K., Hamlin, E., & Spinazzola, J. (2016). A randomized controlled study of neurofeedback for chronic PTSD. PLoS ONE, 11(12), e0166752.
Gapen, M., van der Kolk, B. A., Hamlin, E., Hirshberg, L., Suvak, M., & Spinazzola, J. (2016). A pilot study of neurofeedback for chronic PTSD. Applied Psychophysiology and Biofeedback, 41(3), 251–261.
Peniston, E. G., & Kulkosky, P. J. (1991). Alpha-theta brainwave neurofeedback therapy for Vietnam veterans with combat-related post-traumatic disorder. Medical Psychotherapy: An International Journal, 4, 47–60.

ADHD

5 / 5 · Efficacious and specific

Khazan et al. (eds), 2023 — AAPB, 4th ed.

Common protocols

Names used in the literature. Not a protocol prescription.

Theta/beta ratio (TBR). Down-train theta, up-train beta. Lubar line; one of three standard ADHD protocols.
SMR. Reward 12–15 Hz over the sensorimotor strip.
Slow cortical potentials (SCP). Train slow EEG shifts; common in European ADHD trials.

Graphics coming soon

Epilepsy

4 / 5 · Efficacious

Khazan et al. (eds), 2023 — AAPB, 4th ed.

Common protocols

Names used in the literature. Not a protocol prescription.

SMR at the motor strip. Sterman’s original clinical protocol. Sites near C3, C4, or Cz.
Slow cortical potentials. Used in some seizure-reduction trials alongside SMR.

Graphics coming soon

Depression

5 / 5 · Efficacious and specific

Khazan et al. (eds), 2023 — AAPB, 4th ed.

Common protocols

Names used in the literature. Not a protocol prescription.

Frontal alpha asymmetry (ALAY). Balance left/right alpha at F3 and F4. Best-known EEG protocol for mood.
Left-frontal beta up / alpha down. Alternate amplitude protocol used in some depression trials.
HRV biofeedback. Peripheral biofeedback often paired with EEG work.

Graphics coming soon

Anxiety

4 / 5 · Efficacious

Khazan et al. (eds), 2023 — AAPB, 4th ed.

Common protocols

Names used in the literature. Not a protocol prescription.

Alpha enhancement. Eyes-closed alpha reward for lower arousal.
SMR and alpha-theta. Calm-focus SMR, or eyes-closed alpha-theta for deeper settling.
HRV, EMG, and temperature. Peripheral biofeedback used alone or with EEG.

Graphics coming soon

More applications

Graphics coming soon

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