Finding A Qualified Neurotherapist
Paul G. Swingle (Ph.D., F.C.P.A., R.Psych.)
There is an old saying among psychotherapists that clients have difficulty in finding a good match because only about 15% of therapists are competent, and of that limited number the client will get along with only about 15%. This wry observation is overdrawn, of course, but the point is that not all therapists or therapeutic approaches are right for you. This is also true of neurotherapists. Further, brainwave therapy is not a stand-alone therapy but must be integrated with other therapies. In selecting a neurotherapist, you should insist upon several basic requirements. These include: an independent license within the practitioner’s jurisdiction, certified training in neurotherapy, and considerable relevant experience. If possible, you should also be referred by a former client of the therapist.
Let’s take a look at these requirements in order. First, the neurotherapist must hold an independent license within the jurisdiction of the therapist’s practice. Thus, the person should hold a license to practice psychology, medicine, or some other relevant health care profession. For example, the person doing neurotherapy might be a neurologist, psychologist, psychiatrist, naturopathic physician, licensed clinical social worker, chiropractor, registered clinical counsellor, or a medical doctor. The discipline should be relevant to the disorder that you wish to have treated. For example, a chiropractor would probably not be as suitable as a psychologist for a traumatic stress problem, even though both are experienced neurotherapists. Be sure that the person is licensed, certified, or registered by the governmental jurisdiction where the person practices and not simply certified by some professional organization or non-jurisdictional government. A practitioner who does not hold a license to practice psychology or medicine may represent himself as “nationally certified.” This national certification can be a meaningless certification related to a mail-order course. There are several reasons to select a neurotherapist who is an independently licensed health care professional. First, she has something to lose if her treatment is incompetent or unethical. Professional licensing and registration boards or colleges maintain review boards to field client complaints. These professional practice review boards can censure, suspend, or revoke licenses to practice or can impose strict requirements and conditions to limit the practice of violators. Unlicensed practitioners have no such government-mandated monitoring agency to which they are responsible. They can be psychological or medical hobbyists whose commitment to your treatment is not grounded in systematic training, proper supervision, and accountability to an agency of authority.
The second reason to select licensed practitioners is that they carry professional liability insurance. A psychological or medical hobbyist may carry business insurance, but professional liability (malpractice) insurance is what matters for the client. The practitioner should have relevant therapeutic training to treat the disorder for which you seek help. When you consult with a health care provider, you seek a remedy for a disorder and not necessarily a specific treatment method. If you suffer from migraine headaches, for example, relief from the headaches is the central goal of any therapy. You may wish to pursue biofeedback, but the biofeedback should be administered by a practitioner with other treatment options. Thus a medical physician may be able to use biofeedback in your treatment, but that is not his only treatment option. Similarly a psychologist may offer neurotherapy as a treatment possibility, but she has other options such as biofeedback, relaxation therapies, and other psychotherapies to treat the same disorder.
The agency that certifies training is the Biofeedback Certification International Alliance (BCIA). Select certificants in neurofeedback (EEG biofeedback). These certified individuals have training and experience at a specific, albeit minimal, level. I would only select a neurotherapist who has been certified by this agency because it demonstrates that the therapist has submitted her or his credentials for scrutiny and that the board has accepted those credentials as satisfying a specific standard of training and experience.
Because of the growing problem of minimally qualified medical/psychological hobbyists purporting to practice neurotherapy, be cautious of the franchisees. There is a growing number of organizations who support “one-size-fits-all” franchise-like operations in which unlicensed, uncertified, and minimally trained individuals use fixed treatments for everything. These operations do vary in sophistication. Some use only one treatment for every condition, claiming that if brain functioning is temporarily disturbed in treatment, the brain will reorganize toward more normative functioning. Other franchisers offer several treatment options which the franchisee selects based on the client’s self-report. Thus if the client claims to suffer from depression, the franchisee might administer a treatment over the front of the head designed to decrease the amplitude of Alpha brainwaves. This does work for one form of depression but is ineffective for other forms of depression or worse, can exacerbate the condition. There are many forms of depression and one-size-fits-all treatment of these conditions is irresponsible.
A related concern with the one-size-fits-all and unqualified neurotherapy practitioners is that they do not have the essential expertise to deal with the total condition of the client. Clients who come for treatment require more than simply realigning the brainwave functioning. They often require psychological and/or behavioral therapy as well. An example of this problem is a depressed client who has been exposed to a severe emotional stressor at some point in their life. This client is likely to have a major emotional abreaction during treatment of depression. Practitioners unqualified to deal with these situations can cause significant psychological damage to such clients.
The last factor to consider in the selection of a neurotherapist is the level of experience they have with cases similar to yours. It takes five days to train a person to do a few basic neurotherapy protocols. It takes several thousand supervised treatment sessions before one can be considered an expert. Inexperienced therapists tend to rely only on research they read rather than what they have witnessed and accomplished in their own practice. For example, when a child has attention problems, four out of five of them will experience a 50% improvement with forty to eighty sessions of Theta suppress/Beta enhance EEG feedback at the top of the head. When the treatment is done by an expert, a person experienced with hundreds of cases, these treatment statistics can be remarkably different. With common ADD, for example, experienced neurotherapists with fully equipped offices and skills in behavior therapy can claim success rates of over ninety percent.
Some therapists are more effective than other therapists with equivalent or more years of experience. Every discipline has gifted practitioners, be it music, art, medicine, architecture, psychology, or neurotherapy. Examining the practitioner’s credentials will provide the client with only a basic understanding of how well trained and experienced she is. The only way to find the truly talented neurotherapist is by asking former clients of the practitioner. The gifted therapists gain deserved reputations for helping their patients. However, when relying on the recommendation of former clients, keep in mind that a therapist skilled in the treatment of, say, depression may be inexperienced in the treatment of traumatic stress. Hence, even though one hears raving praise of a therapist’s treatment, make sure he knows how to deal with your problem.
Occasionally, potential clients will ask to speak with clients who have been treated by the practitioner. They believe that way they will obtain a valid indication of the therapist’s merit. There are several problems with this method. First, therapists are going to refer you to the successes, not the failures. Speaking with a successfully treated client may be reassuring, but it does not provide a valid substitute for important qualifications. Second, I am reluctant to put potential clients in touch with my clients because I know very little about the potential client. That person could be problematic and disruptive to my client’s therapy.
The reverse situation is also a problem. I am frequently asked to recommend therapists in other cities. I often know therapists with excellent professional reputations, but I really know little about their therapeutic effectiveness. I recommend with the disclaimer that I cannot vouch for them as therapists and that the client must make their own assessment after a few visits. All I can tell the person is that the therapist has the necessary training and credentials and that he is recognized in the profession.
Clients can often obtain the same information by researching the therapist on the web. The therapist’s licensing and certifications, if any, are all accessible to the public. Again, finding the truly talented professionals usually happens by word of mouth from previously treated clients.
Dr. Swingle is a clinical psychoneurophysiologist in private practice in Vancouver. His book “Biofeedback for the Brain” was recently published by Rutgers University Press.
Dr. Swingle was Professor of Psychology at the University of Ottawa from 1972 to 1997 prior to moving to Vancouver. He was Lecturer in Psychiatry at Harvard Medical School from 1991 to 1998 and during the same time period was Associate Attending Psychologist at McLean Hospital (Boston) where he also was Head of the Clinical Psychophysiology Service. Professor Swingle was Clinical Supervisor at the University of Ottawa from 1987 to 1997 and was Chairman of the Faculty of Child Psychology from 1972 to 1977. Dr. Swingle is a Registered Psychologist in British Columbia and is Board Certified in Biofeedback and Neurotherapy.
For more information about neurotherapy see Dr. Swingle’s web-site at www.swingleandassociates.com.