To Implement Neurofeedback Within Our Existing Healthcare System with Particular Concern for Agencies Working with the Underserved
Efforts to Date
One of the goals of the project is to demonstrate that NFB can be successfully implemented in real world settings. Three years ago we implemented NFB in three agencies in Oregon: a community mental health center, the forensics unit of a county mental health department and a program that offered transitional housing and support for male and female felons released from prison. We then expanded to a child treatment program, a program that offers “whatever it takes” to support high-risk youth, a community substance abuse and mental health program and a private mental health group that works with Medicaid clients.
As expected, this was not an easy client population. Nearly all of these clients had co-occurring disorders: Anxiety 85%, Sleep 71%, Depression 62%, Pain 48%, Attention/Learning issues 38%, Attachment/Personality problems, 31%. The average ACE’s score (Adverse Childhood Events) was 5.9, which places them at very high risk of severe medical and mental health problems, of substance abuse, and of having encounters with the law. And these are clients leading very hard lives, with an average of 5 on a 10 point scale of possible psychosocial stressors (family problems, isolation, poverty, health problems, homelessness, legal problems, etc.).
Tracking results is integral to our advocacy model. We measure change using client-chosen concerns as the metric. Clients select between 5 and 8 concerns. Every session, the client rates how they are doing. We developed an on-line platform for collecting and analyzing data.
Our method, the Results Tracking System (RTS),is HIPAA compliant. The RTS is very easy to install and use.
Our results showed over nearly a 45% reduction in the severity of the client-selected, client-rated concerns by 20 sessions.
NFB impacts clients. It also impacts agencies. Every one of the initial agencies sought to expand its neurofeedback services to new service areas. When there was staff turnover, each agency sought to hire and train replacements. Each agency reports that clients not receiving neurofeedback were asking to be offered these services. Each agency reports that they are getting reimbursement from Medicaid for these services. Reimbursements rates are generally adequate to support these services.