adherence
Research Papers
Neurofeedback Practitioner Factors Related to Client Adherence
Introduction. This study systematically identified, extracted, and organized neurofeedback (NFB) practitioner factors connected to client adherence. It is important to understand this connection because increased adherence leads to improved NFB outcomes. A previous NFB conceptual framework and previous NFB client adherence findings were used to guide the current study. Method. One hundred and ninety-eight NFB practitioners completed online surveys gathering demographic information and ratings of practice behaviors and characteristics. For data set analyses, this study utilized SPSS version 20 for descriptive statistics, frequencies, means, standard deviations, ranges, Pearson product-moment correlation analyses, and independent samples t-tests. Results. Findings indicated that the following significantly correlated with client adherence: (a) practitioner technical and interpersonal techniques; (b) practitioner commitment to improving technical and interpersonal skills; and (c) practitioner confidence displayed during sessions. Results also indicated commitment correlated separately with techniques and confidence. These results suggested that practitioners engaging in self-NFB sessions reported significantly higher adherence rates compared to practitioners not engaging in self-NFB sessions. Findings demonstrated that practitioners conducting ≧ 40 monthly NFB sessions reported significantly higher adherence rates compared to practitioners conducting < 40 monthly NFB sessions. Conclusion. This study concluded that practitioners with commitment to improving their technical and interpersonal expertise leads to increased confidence during NFB sessions, ultimately improving adherence and outcome rates. When averaging 40 or more NFB sessions with clients per month, practitioners provide themselves with continued opportunities to practice current and new technical and interpersonal skills. By conducting self-NFB, practitioners develop their own descriptions of physiological regulation and share their own results with clients, which in turn builds rapport and increases therapeutic bonds leading to higher adherence.
View Full Paper →EEG Neurofeedback for ADHD: Double-Blind Sham-Controlled Randomized Pilot Feasibility Trial
Objective: Preparing for a definitive randomized clinical trial (RCT) of neurofeedback (NF) for ADHD, this pilot trial explored feasibility of a double-blind, sham-controlled design and adherence/palatability/relative effect of two versus three treatments/week. Method: Unmedicated 6- to 12-year-olds with Diagnostic and Statistical Manual of Mental Disorders (4th ed.; DSM-IV) ADHD were randomized to active NF versus sham-NF and to 2X versus 3X/week treatment frequency. Frequency switch was allowed after Treatment 24. Results: In two school years, 39 participants were recruited and 34 (87%) completed all 40 treatments. Child/parent guesses about assigned treatment were no better than chance. At Treatment 24, 38% chose 2X/week and 62% chose 3X/week. Both active NF and sham yielded large pre–post improvement on parent ratings but NF no more than sham. Conclusion: Blinding appears to work, and sham does not prevent recruitment/retention. Treatment frequency of 3X/week seems preferred over 2X/week and was as effective. A large double-blind RCT is feasible and necessary to test specific NF effectiveness.
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