What neurofeedback therapy is
During neurofeedback therapy, your brainwave activity is tracked in real-time, most often with sensors attached to the head using a technique that’s known as an electroencephalogram (EEG). This electrical activity is transmitted to a computer and the different types of brain activity are separated out. These are then translated into signals that are easier to understand and respond to, such as visual or audio cues.
A trainer will explain what the goal is of your neurotherapy and how this corresponds to the cues you’re receiving. For example, a noise may sound or a visual appear on a screen when your brainwave activity is within the desired range.
You’ll then practice changing your brain activity, with the audio or visual cue being used to demonstrate what it takes or feels like to achieve this change. After some time, you’ll get better at doing this without the need for an audio or visual cue.
Depending on the goal of your treatment, you’ll aim for brainwave patterns associated with different things, including calm and relaxation (for anxiety/stress), alertness and focus (attention deficit hyperactive disorder) and improved emotional regulation and sleep (various mental health conditions/insomnia).
How neurofeedback therapy works
Neurofeedback therapy is based on the idea of brain plasticity – that the brain and central nervous system are able to change and adapt to things that happen in and outside the body. With neurofeedback, you’re learning how to consciously change how your brain responds to things by altering your brainwave activity.
Brain waves are the electrical activity the cells in your brain use to communicate. They’re categorized based on their frequency, using the measurement hertz (Hz), into:
Delta waves (0.5 to 4 Hz) – common during deep sleep, these brainwaves are important for rest, memory consolidation and clearing waste products from the brain
Theta waves (4 to 8 Hz) – associated with creativity, theta waves help with emotional healing, learning, memory retention and can be found when you’re relaxed or dreaming. This is part of the reason why poor sleep can impact your ability to process your emotions and to learn new information
Alpha waves (8 to 14 Hz) – a medium-frequency type of brainwave, alpha waves represent an awake but relaxed brain state where calmness and creativity are promoted
Beta waves (14 to 38 Hz) – a faster-frequency pattern linked to alertness, concentration and problem solving
Gamma waves (48 to 80 Hz) – the highest-frequency brainwaves, gamma waves are important for continued concentration/focus and are present when you’re highly alert
The balance between these types of brain activity is essential for getting the right amount of excitation and inhibition. Too much high-frequency activity can make it hard to focus or to relax, while too much low-frequency activity can make you feel slow, unmotivated or foggy. The frequency of each category of waves varies slightly from person to person.
Neurofeedback therapy helps to identify imbalances in brainwave activity during certain situations and supports you to consciously rebalance this.
While most types of neurofeedback therapy focus on brainwave frequencies (like surface EEG, live Z score, slow cortical potential, infraslow frequency and low energy neurofeedback), hemoencephalography focuses on blood flow regulation instead. It’s usually used for conditions linked to blood flow changes in the brain, like migraines.
Who neurofeedback therapy helps
Although mental health conditions are complex and linked to many different factors, dysregulated electrical activity within the brain plays a part. Trauma, gut health and foundational health (such as sleep or stress) can all influence the development of electrical imbalances.
Conditions like attention deficit hyperactive disorder (ADHD), schizophrenia, and obsessive compulsive disorder (OCD) are associated with increases in lower frequency brainwaves (like delta and theta) and decreases in higher frequency brainwaves (like alpha, beta and gamma) (Newson & Thiagarajan, 2019). Increased beta activity and abnormal alpha activity has also been found in patients experiencing generalized anxiety disorder (Wang et al., 2025).
Standard treatments for many of these conditions rely heavily on medication, with stimulants, anti-depressants and anti-psychotics commonly used. Although these medications are often effective for managing symptoms, they come with side effects and don’t help to retrain the underlying neural patterns.
Neurofeedback may be helpful for people with these health conditions. It’s particularly useful for people who notice patterns in their behaviour that they want to change, such as becoming easily overstimulated, struggling with concentration, or being unable to switch off.
However, neurofeedback therapy takes time and commitment – it isn’t suited to people looking for a quick fix or who need fast relief during an acute mental health crisis.
This type of therapy is typically used as an add-on mental health treatment rather than a replacement for more standard therapies. It may also be an effective adjunct for people struggling with chronic pain.
Chronic pain may be linked to changes in brainwave activity, and there’s some evidence that neurofeedback focusing on theta and alpha waves can reduce pain perception in people with chronic pain (Diotaiuti et al., 2024). As long-term pain management often relies on strong painkillers, neurofeedback therapy could be a good option for people hoping to minimize their reliance on medication.
Similarly, epilepsy also requires treatment with strong medications that often come with side effects. Not everyone is able to control their seizures using medication alone and these individuals may need to resort to brain surgery in some cases. Neurofeedback therapy could help people with drug-resistant epilepsy reduce how often they experience seizures, although it should be used as an add-on treatment rather than a replacement (Marchi et al., 2024).
Common uses
Neurofeedback is most commonly applied to treat ADHD and it’s been used for this purpose since the 1970s. It’s most often used for children with ADHD and there’s a reasonable amount of evidence from randomized controlled trials (RCTs) to support this use (Moreno-García et al., 2022).
Other common uses for neurofeedback therapy include:
Anxiety and stress
Post-traumatic stress disorder (PTSD)
Insomnia (sleeping problems)
Epilepsy (especially drug-resistant epilepsy)
Varying protocols are used to treat each condition which focus on training different types of brainwave activity. However, there is mixed evidence on how effective neurofeedback is for many of these mental health conditions.
What the evidence supports
While neurofeedback therapy is still considered experimental in many ways, there is moderate evidence from a variety of RCTs that it’s effective for ADHD, PTSD, chronic pain and substance misuse. The benefits of neurofeedback were shown to persist at study follow-up in most cases, but many of these trials have issues with blinding (being aware who’s receiving the active treatment and who’s not) .
ADHD is the area that has the most substantial evidence base. Several RCTs have shown that neurofeedback therapy can help improve attention and remission rates (defined as no longer experiencing symptoms) in children with ADHD (Arns et al., 2020; Van Doren et al., 2018).
A meta analysis of RCTs including individuals with PTSD found that neurofeedback therapy can improve PTSD symptoms in conjunction with therapy and medication, although some of the included studies were not high quality (Voigt et al., 2024).
Another meta analysis, this time into chronic pain, found that neurofeedback therapy has a medium effect at reducing pain and may also improve symptoms of depression, anxiety, fatigue and sleep in people with chronic pain (Patel et al., 2020). However, it’s worth noting that many of the included studies were case studies or of low quality.
A systematic review included 17 RCTs investigating neurofeedback for people with addiction. It found that EEG neurofeedback significantly alleviated addiction symptoms, with stronger effects for people experiencing substance addiction (Wan et al., 2025). The number of sessions and the type of neurofeedback therapy seemed to impact how effective treatment was.
Where the evidence is limited
While there is some interesting research on neurofeedback therapy and conditions like depression, traumatic brain injury and autism, treatment of these conditions is more experimental pending larger trials (Chen et al., 2023; Mekkawy, 2021; Xia et al., 2024).
Most of the current trials in these areas are small, feature short follow-up periods, use different protocols/targets and contain expectancy bias due to lack of sham controls (participants who take part in a fake treatment that’s designed to be similar to neurofeedback therapy but without any known benefits).
Safety and regulations
Neurofeedback therapy is considered to be a safe, non-invasive and pain-free treatment, although it’s possible to experience mild, temporary side effects like tiredness, dizziness or headaches. Many people describe therapy sessions as relaxing or calming.
Neurofeedback therapy is not approved by the FDA and neurofeedback protocols are not regulated by them for any health condition. However, some neurofeedback devices are cleared by the FDA for use as part of “general relaxation training” - clearance is for low to medium-risk devices that are similar to existing devices on the market while approval is saved for higher-risk treatments that require rigorous testing. Some devices have been cleared for specific health conditions, such as the Prism device as an add-on therapy for treating PTSD.
There’s no legal requirement to have a license when offering neurofeedback therapy or to be a qualified healthcare professional, which may put patients at risk of having unrealistic expectations and receiving incorrect medical advice. It’s important that neurofeedback therapy providers are trained and competent at the service they’re providing. One way of proving competence is via the Biofeedback Certification International Alliance certification in neurofeedback therapy.
The experience
During a neurofeedback session, you’ll typically attend a clinic and be attached to a monitoring device. This is most often electrodes attached to the brain, but it may involve putting some kind of headband or helmet device on or sitting inside a magnetic resonance imaging (MRI) machine.
Your brain activity will then be tracked and transformed into sounds or visual cues on a screen that you can control with your thoughts and actions. For example, your brainwave intensity may be linked to the loudness of a sound that’s playing, or the image of a ball approaching you or something filling up.
A therapist will guide you on what the aim of your therapy session is and how you’ll use the visual/audio cues to consciously train your brain activity. You won’t feel pain or active stimulation, and many people report feeling relaxed during or after therapy.
While neurofeedback therapy is usually active, low-energy neurofeedback system (LENS) neurofeedback is a passive alternative that uses electromagnetic signals to change your brain activity rather than active effort from you. It’s usually most suited for children or adults who don’t have enough conscious control for standard techniques.
Depending on what you’re hoping to achieve with neurofeedback therapy, your treatment may take between 20-40 sessions.
The future of neurofeedback therapy
Neurofeedback therapy home devices are becoming increasingly popular, allowing you to gain some of the benefits of this type of therapy without having to visit a clinic.
While there is some evidence that these devices can be useful in certain cases, home devices may lead to poor EEG quality, signal misinterpretation and lack of professional guidance, which can prevent effective treatment (Autenrieth et al., 2023).
Better training on how to use these devices effectively and access to professional support throughout treatment may help to make home neurofeedback devices more effective.
Takeaway
Neurofeedback therapy is a non-invasive way to monitor brain activity and learn how to voluntarily achieve a desired brain state, such as better focus or emotional balance.
There’s a growing amount of evidence that this therapy can help with ADHD symptoms, PTSD, seizures and even substance abuse in combination with other treatments. However, lack of standardized protocols, regulations and licensing requirements means that results can vary – make sure to do your research before selecting a provider.
