An Assessment of an Automated EEG Biofeedback System for Attention Deficits in a Substance Use Disorder Residential Treatment Setting

The article “An Assessment of an Automated EEG Biofeedback System for Attention Deficits in a Substance Use Disorder Residential Treatment Setting” examined the effectiveness of EEG biofeedback treatment. Specifically, its effectiveness in the treatment of ADHD symptoms in clients in a residential addiction treatment program was the focus of the research. Although the effectiveness of EEG biofeedback on the treatment of addiction was not directly addressed, indirectly one may reason that treating a co-occuring psychological disorder in a client with addiction would improve treatment outcomes for addiction, as well.

According to the article, ADHD is prevalent in clients with addiction. Although ADHD affects about 4% of the adult population, it affects as up to 35% of cocaine addicts. Furthermore, clients with co-occuring ADHD and addiction are less likely to complete inpatient treatment and more likely to relapse than those without ADHD. Further confounding the treatment of ADHD in clients who also have addiction is the common use of psychostimulant medications. Not surprisingly, these medications are often a drug of abuse for those with ADHD and addiction.

In addition to looking at the effects of EEG biofeedback, this study compared clinician-guided EEG biofeedback and automated EEG biofeedback. The control group received an additional 15 counseling sessions (in addition to the treatment as usual offered at the residential rehab program). Both EEG biofeedback groups received 15 sessions of EEG biofeedback (in addition to the treatment as usual offered at the residential rehab). The TOVA (Test of Variables of Attention) was used as the measure to determine if EEG biofeedback was effective in decreasing symptoms of ADHD.  This was done in a test-retest format.

According to the study, both groups which received EEG biofeedback (both clinician-guided and automated biofeedback) showed a reduction in ADHD symptoms as measured by the TOVA. The clients who received the additional 15 counseling sessions showed no improvement on their TOVA scores.

One shortcoming of this article is that it does not describe what type of therapy was provided in the individual counseling sessions or whether it focused on addressing ADHD symptoms, addiction, or other issues. If ADHD was not addressed in the individual sessions, one would not expect that there would necessarily be a reduction in ADHD symptoms for these clients. Therefore, one cannot say based on this article if EEG biofeedback is more effective than individual counseling. Nevertheless, this research indicates that automated EEG biofeedback is just as effective as clinician-guided EEG biofeedback in treating ADHD in adults in an inpatient addiction treatment setting.

This is an important finding, as most addiction treatment professionals are not trained in administering clinician-guided EEG biofeedback. The implications of this research are such that addiction treatment professionals may employ automated EEG biofeedback without having to go through time consuming and expensive training. Furthermore, addiction professionals may be more confident that automated EEG biofeedback is effective in treating clients with co-occuring ADHD and addiction.

It is worth noting that the participants in this study were dealing with addictions from various substances. In other words, they were not homogenous in their addictions. Drugs to which clients were addicted ran the gamut from cocaine to heroin to marijuana and alcohol (not an exhaustive list, of course). This is important as it shows that the effectiveness of EEG biofeedback on co-occuring ADHD is not limited to a single type of addiction. Additionally, the 95 participants of the study were randomly assigned to either of the three groups. The groups were mostly evenly split between males and females and included multiple ethnicities mostly even split, as well. The average level of education was about 12 years per group.

Overall, this article was thorough in its description of research methods (identified variables, measures, research participants, etc.). Additionally, it provided good background on previous studies and defined the purpose clearly. The contribution to the field of addiction treatment is obvious, as it provides clinicians another possible tool in the treatment co-occuring ADHD and addiction in inpatient settings.

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