The 1970's and 80's were decades of exploration and experimentation with qEEG. The American Medical EEG Association (AMEEGA) Adhoc Committee on qEEG has stated "qEEG is of clinical value now and developments suggest it will be of even greater use in the future".

QEEG has well documented ability to aid in the diagnosis of mild traumatic brain injury, ADHD, learning disabilities, stroke, and epilepsy. AMEEGA emphasizes the importance of rigorous training and certification. AMEEGA's emphasis is on physician usage of qEEG. The American Psychological Association has endorsed qEEG and neurotherapy as within the venue of psychologists with appropriate training.

Two national organizations, the National Registry of Neurofeedback Providers (NRNP) and the Academy of Certified Neurotherapists (ACN) were formed in 1992 for the certification of clinicians in the clinical application of qEEG and its related technology, neurofeedback. The NRNP has been disbanded at this point; many of us felt only one certification agency is necessary. The ACN has been subsumed into the larger Biofeedback Certification Institute of America (BCIA), established over 25 years ago to certify practitioners in peripheral (EMG, temperature, GSR) biofeedback techniques.

John K. Nash, Ph.D., served on the Executive Council of the NRNP and was one of its founding members. Dr. Nash was one of fifteen scientists and clinicians on the NRNP Executive Council defining and promoting rigorous certification standards for clinicians who wished to utilize this powerful, but technically demanding procedure. He is also certified by the ACN and is certified as an advanced neurotherapy instructor by the major equipment manufacturer, Lexicor Medical Technology. He is now BCIA certified in EEG. Dr. Nash has conducted EEG research beginning in 1974. His expertise has been utilized by NASA in the peer review of research grants on human psychophysiology and space medicine.

Operant conditioning of EEG characteristics is well documented in the scientific literature. Training to decrease slow activity and increase fast desynchronized EEG activity has been used for over 20 years to ameliorate ADHD and epilepsy. More recently EEG operant conditioning has been successfully applied to patients with mild traumatic brain injury. Reports of literally hundreds of case studies have been presented at conferences of the National Head Injury Society as long ago as 1987.

Behavioral Medicine Associates, Inc. has many very satisfied patients who can testify that neurotherapy has reduced their brain injury symptoms. Memory has been improved, emotional instability has been decreased or eliminated, and executive function has been improved.

These patients are very grateful to have been able to return to much more normal functioning, even years after no further recovery of function would be predicted by traditional neuropsychologists or neurologists. Patients report "I can remember numbers again." "I can see many sides of a situation now, so I don't fly off the handle anymore." "I am astonished at the change I've felt in the last two weeks, after two and a half years of living in a personal hell." A college student who dropped out with failing grades is now reporting "A" papers and average to above average grades.

IF QEEG AND NEUROTHERAPY ARE SO GOOD, WHY AREN'T MORE CLINICIANS USING IT?

An estimated 1000 clinicians are using neurotherapy in the U.S. Most psychologists and physicians simply have not been educated in the clinical applications of EEG biofeedback and have not read the existing research and clinical literature, in spite of the fact that applications to anxiety, epilepsy and attentional deficits date back to the 1970's.

There also is simply a lack of "big money" behind this technology. Your physician gets free samples and color ads in his or her professional journals for the latest medicines. Continuing education for physicians and psychiatrists is strongly funded by drug companies. You get finely crafted TV commercials. There is currently no mechanism through which biofeedback technology promotes the accumulation of great wealth, which can then be used for lobbying, marketing and physician education.

The instrumentation is expensive and requires serious study and training to use competently. Proper instrumentation has only recently become generally available. The International Society for Neuronal Regulation (iSNR) exists to promote such education. Attendance at national conferences has grown from 60 ten years ago to over five hundred this year. More clinicians are using neurotherapy each year.

Certification in neurotherapy is advancing and, we believe, necessary so that insurers can choose to reimburse only certified clinicians. A Registry of neurologists, neuropsychologists, clinical psychologists, physicians, neuropsychiatrists and psychiatrists who are certified to do this work is published annually by the National Registry of Neurofeedback Providers and by the Academy of Certified Neurotherapists, recently joined with the Biofeedback Certification Institute of America. Together these organizations have approximately 600 certificants.

QEEG is not intended to be a "stand alone" diagnostic or as a substitute for other medical diagnostics. It is, however, a helpful adjunct which can guide prognosis and intervention. QEEG is best used as an tool to aid in the clinical diagnosis of various dysfunctional states and not as a substitute for clinical judgment and medical opinion. The QEEG should be combined with other medical, psychological and neuropsychological data to best aid the patient.

The sister technology to qEEG is called EEG biofeedback, neurofeedback or neurotherapy. The qEEG provides the "targeting" information. That is, it tells us where and under what conditions (reading, listening, math, etc.) the problem is worst. This analysis allows accurate electrode placement for feedback and suggests the tasks that should be used during therapy.

Neurotherapy is EEG feedback-assisted cognitive behavior modification. It couples EEG feedback with the full range of traditional cognitive behavior therapy methods, including imaginal rehearsal, correction of maladaptive thought patterns, and rehearsal of new skills. We commonly utilize intensely activating, challenging tasks during the sessions to enhance brain activation and teach what it feels like to be focused and functional again.

The EEG feedback signals the patient when their brain is in fact in a more activated state, indexed by decreased delta and theta brain wave amplitudes, and increased beta and/or alpha amplitudes.

Neurotherapy is no panacea. Like any therapy, it works best with the smartest, least brain damaged patients. Patients with profound memory loss which prevents the acquisition of new learning at all are not likely to be helped.

On the other hand, patients with emotional dyscontrol, impaired memory and concentration, and a good pre-morbid level of functioning are responding very, very well to the treatment. Most interestingly, good results are being achieved in patients who are 2, 3 or even 5 years post injury; these are times at which improvement cannot be attributed to "spontaneous recovery."