What Is Biofeedback Therapy?

Biofeedback therapy is a method used to control a function of the body, such as the speed your heart beats, while connected to sensors that measure information about that function, such as heart rate.1 Neurofeedback therapy is a specific type of biofeedback therapy that uses electrodes to track brainwave activity.2 The readings from the sensors allows you to make subtle physical adjustments (e.g., relaxing muscles) in an effort to control a function that the body typically regulates automatically.1 The newfound body control is used to improve a health condition or physical performance.1

During biofeedback therapy sessions, a therapist will guide you through a series of mental and physical exercises. A machine or computer/smartphone application provides you with immediate feedback on the success of these exercises, including a sound or visual alert when their body has fully reached the desired change.

Biofeedback therapy may be used in physical therapy clinics, medical/healthcare centers, hospitals, and even at home. It may be used to help improve a wide variety of mental and physical health conditions from asthma and anxiety to stroke and urinary incontinence—among many others.1

Biofeedback and Neurofeedback Therapy in Addiction Treatment

There’s limited research on biofeedback therapy in the medical literature, but it is considered by many to be an effective tool in the management of anxiety and stress disorders, including post-traumatic stress disorder.3

Research on biofeedback therapy for the treatment of addiction and substance abuse disorders is limited, but there has been some promising research in the area of heart rate variability biofeedback4–6 as well as neurofeedback, also called EEG biofeedback.7–10

A 2014 study examined the ability of heart rate biofeedback to reduce craving in those being treated for a substance use disorder did not see a benefit over a control group. The study’s authors, however, did find that participant feedback was extremely positive and the intervention well-received by staff.4

Similarly, a 2017 study looking at the effect of heart rate variability biofeedback on long-term abstinence in alcohol dependent patients showed positive results when applied in addition to rehabilitation care, but the results were not statistically significant.5

A 2018 review of existing research on heart rate variability biofeedback suggested that certain rates of controlled breathing may be the key to fully unlocking the technique’s therapeutic potential.6

Early research has suggested that EEG biofeedback therapy may provide information in planning cognitive-behavioral or neurotherapy, especially when substance use is comorbid with a mental disorder.7,8

Building on this research, a 2015 study concluded that EEG biofeedback can effectively improve attention deficits resulting from substance abuse, however, sessions were held twice daily in a residential treatment setting, which may be a barrier for widespread use.9

Use of EEG biofeedback has shown promise as a supplement to existing treatment protocols for both alcohol dependence and opioid use disorder.10,11

A Future for Biofeedback Therapy?

Although there’s increasing evidence that biofeedback can be of benefit to existing addiction treatment modalities, it’s still largely considered experimental, and its use may not be covered by insurance companies.12

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  1. Mayo Clinic. (2019). Tests & Procedures: Biofeedback.
  2. Canadian Agency for Drugs and Technologies in Health. (2014). Neurofeedback and Biofeedback for Mood and Anxiety Disorders: A Review of the Clinical Evidence and Guidelines – An Update.
  3. Caponnetto, P., & Milazzo, M. (2019). Cyber Health Psychology: The use of new technologies at the service of psychological well being and health empowerment. Health Psychology Research, 7(2), 8559.
  4. Eddie, D., Kim, C., Lehrer, P., Deneke, E., & Bates, M. E. (2014). A pilot study of brief heart rate variability biofeedback to reduce craving in young adult men receiving inpatient treatment for substance use disorders. Applied Psychophysiology and Biofeedback, 39(3-4), 181–192.
  5. Penzlin, A. I., Barlinn, K., Illigens, B. M., Weidner, K., Siepmann, M., & Siepmann, T. (2017). Effect of short-term heart rate variability biofeedback on long-term abstinence in alcohol dependent patients – A one-year follow-up. BMC Psychiatry, 17(1), 325.
  6. Alayan, N., Eller, L., Bates, M. E., & Carmody, D. P. (2018). Current Evidence on Heart Rate Variability Biofeedback as a Complementary Anticraving Intervention. Journal of Alternative and Complementary Medicine (New York, N.Y.), 24(11), 1039–1050.
  7. Scott, W. C., Kaiser, D., Othmer, S., & Sideroff, S. I. (2005). Effects of an EEG Biofeedback Protocol on a Mixed Substance Abusing Population. The American Journal of Drug and Alcohol Abuse, 31(3), 455–
  8. Sokhadze, T. M., Cannon, R. L., & Trudeau, D. L. (2008). EEG biofeedback as a treatment for substance use disorders: review, rating of efficacy, and recommendations for further research. Applied Psychophysiology and Biofeedback, 33(1), 1–28.
  9. Keith, J. R., Rapgay, L., Theodore, D., Schwartz, J. M., & Ross, J. L. (2015). An assessment of an automated EEG biofeedback system for attention deficits in a substance use disorders residential treatment setting. Psychology of Addictive Behaviors, 29(1), 17–25.
  10. Cox, W. M., Subramanian, L., Linden, D. E., Lührs, M., McNamara, R., Playle, R., … Ihssen, N. (2016). Neurofeedback training for alcohol dependence versus treatment as usual: study protocol for a randomized controlled trial. Trials, 17(1), 480.
  11. Dehghani-Arani, F., Rostami, R., & Nadali, H. (2013). Neurofeedback training for opiate addiction: Improvement of mental health and craving. Applied Psychophysiology and Biofeedback, 38(2), 133–141.
  12. (2019). Clinical Policy Bulletin 0132: Biofeedback.
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