Can monitoring brain waves boost mental health?

David Dodge does an interesting article asking whether neurofeedback has delivered the mental health revolution it has been promising for decades. The bottom line is that no experiments with proper double-blind controls have been convincing, and positive results obtained in less rigorous experiments with small numbers of subjects could be due to placebo effects.

Well-heeled investors, including the former secretary of education, Betsy DeVos, continue to pour millions into neurofeedback companies that promise dramatic improvements to the ways our brains function...However, neurofeedback is still not accepted as a mainstream treatment within mental health circles — and the most robust research into the intervention so far suggests it is no more effective than a placebo.

Practitioners across the country use neurofeedback to treat conditions like attention deficit hyperactivity disorder, major depressive disorder, anxiety disorder, epilepsy and traumatic brain injuries. The Food and Drug Administration has cleared a wide range of neurofeedback devices to treat these and other conditions, and the Centers for Disease Control and Prevention list it as an option in cases of ADHD in children, though they stop short of endorsing it.

Robert Thibault, a postdoctoral scholar at the Meta-Research Innovation Center at Stanford University, notes that neurofeedback advocates point to peer-reviewed research that have “impressive results,” but most are not rigorous double-blind, placebo-controlled trials. Of the dozen or so such trials, all but one concluded that fake neurofeedback works just as well as real neurofeedback...neurofeedback therapy success stories are likely caused by the placebo effect and not the treatment. He suggested that the therapy’s success may have something to do with the “healing environment” that practitioners create in their clinics or the allure of using sophisticated brain-monitoring technology.

In many instances, an online course is all that is needed to earn the certificate required to operate one of the dozens of neurofeedback devices on the market...Some companies skip the practitioner entirely by selling pricey neurofeedback devices directly to consumers...While its effectiveness is still debated, neurofeedback is generally thought to be safe. Even critics admit there are few side effects or downsides for those who have the time and money.