Module 3: Biofeedback Training Sessions-
How Biofeedback is Performed
The biofeedback training session begins when you escort your client into your biofeedback training room. The session ends when you conduct your client back out of your biofeedback training room. Everything in between is part of the biofeedback training session. You are responsible for what happens to your clients during their biofeedback training sessions. Therefore we caution you to learn everything you can about conducting biofeedback sessions for your clients. Here's a partial list of what you will be doing:
- Greet your clients, escort them into the biofeedback training room, seat them and get them comfortable.
- Discuss what's going on with your client
- Coach your client using basic biofeedback coaching skills
- Connect your clients to the device if that is required.
- Tell your clients to be comfortable, breathe deeply and relax.
- Repeat step five as often as necessary throughout the session.
- Obtain your baseline data
- Do what you need to do
- Disconnect your clients from the device if that is required
- Coach your client using basic biofeedback coaching skills
- Thank your client and escort them out of the biofeedback training room
The Biofeedback Training Room
If at all possible have a waiting area for your clients where they can comfortably wait for you to come and invite them to your biofeedback training room. If this is not possible, make every effort to meet your clients at the door and escort them to a seat near your biofeedback device. Be cordial and professional. At the end of the biofeedback training session make an effort to escort your clients to the door. Again, be friendly, cordial and professional.
We shouldn't need to say this, but keep your biofeedback training room clean, uncluttered and professional looking. Books should be neatly arranged in a bookcase. Files should be properly filed or hidden from view. Clutter and dust should be regularly removed. Cleanliness is very important. Professional appearances are important. Being professional in all you do is important.
Take the time to make your biofeedback training room clean, uncluttered and befitting the professional you are. Make it appealing and professional in appearance to your clients. File what needs to be filed. Hide what needs to be hidden. Clean what needs to be cleaned. Do this as often as necessary to maintain a professional appearance.
How to Conduct a Biofeedback Training Session
The client is connected to the biofeedback device, told to become comfortable, breathe deeply and relax. The operator controls the device to determine the amount of stress the client is experiencing now. This is called the "baseline." Some biofeedback devices do not need to be physically connected to the client to obtain a baseline. Others must be connected at several different locations.
The baseline is your starting point for biofeedback training. Some devices track improvement in stress reduction. Others track relative stress. You need to know what your biofeedback device tracks and how this information is displayed. With some devices you want the training to be above the baseline. With other devices you want the training to be below the baseline. With some devices the amount of stress is presented as a percentage of baseline. You need to know which system your equipment utilizes.
In your basic hands-on training workshop, you'll learn how to connect your clients to your device. You'll also learn how to operate the equipment you purchase. Each kind of biofeedback device has specific instructions for client connections and operating the device. You'll need to learn and follow those instructions.
Some devices are connected to clients with electrodes that require paste. Others require no paste. Some require the electrode to be attached to the client is first soaked in a saline solution. Most electrodes do not require pre-soaking in a saline solution. Some electrodes are disposable and can be used only once. Others need to be cleaned and sterilized after each use. These things are covered in the basic skills hands-on face-to-face training. We do not pretend to teach those skills in a correspondence course.
Never touch your clients or attach anything to them without first asking for their permission. Show them what you intend to do and ask their permission to do it. This is very important. Touching your clients without their permission is legally an assault. To be safe, always ask your clients if you can touch them, explain why you need to touch them, show them anything you want to attach to them, ask their permission to proceed and then act accordingly. Some clients need to be convinced that what you propose doing to them is necessary. Others will want to participate in connecting the electrodes to their body. You'll need to be flexible and still obtain a good connection to your client.
The biofeedback device "feeds back" the training information to your clients, operator or both. This feedback is usually accomplished visually, auditorily, kinesthetically or by some combination of these. This feedback confirms whether clients are reducing their stress or re-educating their muscles or not.
Some modern devices give what is called subtle feedback and do not give an auditory, visual or kinesthetic signal to indicate progress. If you're operating such a device, you need to be the feedback agent for your clients. When they appear tense or distracted, you need to remind them to close their eyes, breathe deeply and relax. When they are breathing deeply and relaxed, you need to reinforce this behavior by telling them they're doing a good job. You can say something like: "You're doing just fine. Keep doing whatever you're doing." Meanwhile you continue doing what you need to be doing.
The intended purpose of biofeedback is to help clients relax more and more and reduce the amount of their stress. Keep this thought in mind as you work with your clients. The more they relax the more they reduce their stress. The more they relax the more they manage their pain. The more your clients manage their stress and pain the more effective biofeedback will be for them. The more your clients manage their stress and pain the more their body will be able to heal itself.
How to Work with Your Clients
Your job is to keep your clients focused on relaxing more and more and releasing more and more stress. The more clients pay attention to breathing deeply and relaxing, the more effective their biofeedback training sessions will be. The more interested your clients become in what you're doing, the less your clients will relax. Clients are able to reduce their stress only if they are able to relax. Keep your clients focused on relaxing and reducing their stress. Remind them to breathe deeply and relax. It also helps to suggest they close their eyes, breathe deeply and relax.
As your clients continue to breathe deeply and relax, the amount of stress they experience decreases. The more they relax, the more effective their biofeedback session will be. The more they relax, the more toxins their cells and body releases. On a cellular level the cells in their body are releasing metabolic toxins and absorbing oxygen and other nutrients. Cells that release toxins can use these nutrients to heal themselves. The purpose of biofeedback is to encourage as many cells as possible to relax, release their toxins and absorb more nutrients. As this occurs the stress and pain stored in these cells is also released.
Keep your clients breathing deeply and relaxing more and more. Learn how to do progressive relaxation with your clients as you're monitoring and adjusting your biofeedback equipment. Develop a patter. When your clients ask you what you're doing, tell them: "I'm helping you relax more and more so your body can learn how to reduce your stress, manage your pain and improve the quality of your life. Please breathe deeply and relax. (pause) Breathe deeply and relax."
Do not be distracted and attempt to explain what you're doing in more detail than this. You will only confuse your client. When they ask you how you help them relax more and more, the best answer is: "When you need to relax more, I tell you to breathe deeply and relax. Please breathe deeply and relax. (pause) Breathe deeply and relax. Then continue doing what you need to be doing.
Some clients will be very persistent and continue to ask questions about how you know when they need to relax more and more. The best answer is: "When the biofeedback says you need to relax more and more, I tell you to breathe deeply and relax. Just be calm and relax. (pause) Close your eyes and relax. (pause) Please breathe deeply and relax. (pause) Breathe deeply and relax.
Be kind and loving with your clients but keep them focused on breathing deeply and relaxing. That's their job. Your job is to stay focused on what you need to focus on and do what you need to do.
The Purpose of Biofeedback
The purpose of biofeedback is to help clients relax and re-educate their muscles so they can learn to manage their stress and pain and improve the quality of their lives. Biofeedback training will help people relax and re-educate their muscles. There are many other techniques that can be used to attain these same results. Some clients may actually do better with one or more of these techniques than biofeedback. Most clients will do better if you incorporate one or more of these techniques into your biofeedback practice. Here is a partial list of these techniques:
Contemplation - Contemplation is a process of going inside yourself to observe what's going on and attempting to resolve any issues that arise. One way to do this is to read scripture and then think about what you read until an issue comes to your mind. Then contemplate that issue until you can resolve it. Contemplation is more relaxing if accompanied by slow, deep and rhythmical breathing.
Contemplative Prayer - Contemplate anything until an issue arise and then pray for a resolution of that issue, or for guidance in resolving that issue, or for the strength to do what you know you must do. Contemplative Prayer is more effective if accompanied by slow, deep and rhythmical breathing.
Deep Breathing - Find a comfortable position. Breathe deeply and relax. As you continue to breathe deeply and relax, you will ender deeper and deeper states of relaxation. With practice, deep breathing sessions of twenty to thirty minutes in length can be as effective as biofeedback training.
Meditation - There are many different forms of meditation. They can all be as effective as biofeedback training with practice. Some of the forms are concentrating on an affirmation or mantra, watching the breath, listening to the heart beat, feeling the muscles relax one by one, quieting the mind or letting the mind go blank.
Visualization - Guided imagery can be used during biofeedback sessions to deepen the client's state of relaxation. Recording a visualization, meditation or relaxation tape and giving it to your clients provides them with a way of relaxing between biofeedback sessions. Another useful technique is to have your clients imagine how they will feel when they have their stress or pain under control. Have them act and speak as if they have already succeeded in reducing their stress or pain and improved the quality of their lives.
One purpose of biofeedback is to help people relax so they can reduce their stress, manage their pain and improve the quality of their lives. Another purpose of biofeedback is to help people re-educate their muscles so they can reduce their stress, manage their pain and improve the quality of their lives. The purpose of biofeedback can be summarized in these five statements:
- Biofeedback is intended to help people learn how to relax.
- Biofeedback is intended to help people learn how to re-educate their muscles.
- Biofeedback may be used to help people reduce their stress.
- Biofeedback may be used to help people manage their pain.
- Biofeedback may be used to help people improve the quality of their lives.
Remember these five statements because these are the only five things you may legally advertise, discuss with your clients and include in your informed consent form. The only exception to this is if you are licensed. If you are licensed you may use biofeedback to accomplish anything within the scope of practice defined by your license.
Medical doctors may use biofeedback for any medical problem. If you are not a medical doctor you may use biofeedback to help people reduce the stress and pain they have because of their medical problems.
Chiropractors may use biofeedback for any medical problem covered by their license. If you are not a chiropractor you may use biofeedback to help people reduce the stress and pain they have because of their medical problems.
Dentists may use biofeedback for any dental problem covered by their license. If you are not a dentist you may use biofeedback to help your clients reduce the stress and pain they have because of their dental problems.
Veterinarians may use biofeedback on animals. If you are not a veterinarian you may use biofeedback to help your client's animals reduce the stress and pain they have because of their medical problems.
Psychologists and psychotherapists may use biofeedback for any psychological or emotional problem covered by their license. If you are not a psychotherapist you may use biofeedback to help your clients reduce their stress and pain associated with their psychological or emotional problems.
Counselors may use biofeedback to help their clients with emotional issues. If you are not a licensed counselor you may use biofeedback to help your clients reduce their stress related to their emotional issues.
To summarize, you may use biofeedback to help your clients:
- Learn how to relax
- Learn how to re-educate their muscles
- Reduce or manage their stress
- Reduce or manage their pain
- Improve the quality of their lives
The Length of a Biofeedback Session
Biofeedback professionals who are also counselors or psychologists tend to have 50 minute sessions for counseling, psychotherapy and biofeedback. The average session is about one-half counseling and one-half biofeedback. They bill in one hour increments. The additional 10 minutes is for record keeping.
Biofeedback professionals who work under the license of a medical doctor or chiropractor tend to have 25 minute sessions. The average session is restricted to biofeedback training. They bill in 30 minute increments. The additional 5 minutes is for record keeping.
Biofeedback research is very clear that sessions running less than 15 minutes are considerably less effective than sessions that run for 15 - 25 minutes in length. The research shows the optimal length of a biofeedback session is between 22 and 28 minutes. Shorter length sessions are far less effective. Longer sessions running from 28 to 50 minutes in length are only slightly less effective. After one hour the quality of training quickly degrades.
For this reason, most biofeedback professionals adopt either 30 or 60 minute sessions with ten minutes of every hour set aside for necessary paper work. Some neurotherapists prefer 45 minute sessions because of the additional time required for hookups and cleanup. Each biofeedback professional needs to make this decision for themselves. We suggest you speak with other professionals using the same device you choose to get some ideas before you make a decision. Just remember that very little progress can be attained after one hour of biofeedback training.
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