Documenting the Effects of Noninvasive Prefrontal pIR HEG Neurofeedback in the Treatment of Common Mental Health Problems


  • Christine Tyrrell Baker Private Practice



neurofeedback, pIR HEG, limbic overload, self-efficacy, data-driven practice, Prefrontal cortex


Clients with mixed diagnoses were provided passive infrared hemoencephalography (pIR HEG) neurofeedback in a mental health private practice treatment setting. This is the first formally documented investigation of pIR HEG neurofeedback applied to a mental health population. Both qualitative and quantitative data were collected. Results from 66 clients showed that five sessions of neurofeedback resulted in statistically significant changes in anxiety, depression, limbic overload, and coping self-efficacy. For clients who completed 10 or 15 sessions, results showed robust changes in anxiety, depression, limbic overload, general self-efficacy, coping self-efficacy, and dissociation. The impact of neurofeedback on self-efficacy is discussed as well as limitations and implications for future research.


Baker, C. T. (2020). The Limbic Overload Scale: Measuring clients’ perception of deficits in global brain control and self-regulation. Please contact the author for permission to use the scale.

Baker, C. T. (2022). Understanding the benefits of (pIR HEG) neurofeedback in the treatment of anxiety, depression, stress, and trauma: The Stress Regulation and Learning Model. Professional workshop presentation. Delivered via Zoom May and December 2022.

Bandura, A. (1997). Self-Efficacy. New York, NY: W. H. Freeman and Company.

Carmen, J. (2004). Passive Infrared Hemocephalography: Four years and 100 migraines. Journal of Neurotherapy, 8(3), 23–51.

Carmen, J. (2018, 2020). Personal communication. Introductory training on EZpIR and advanced clinical seminar.

Coben, R., & Padolsky, I. (2008). Infrared imaging and neurofeedback: Initial reliability and validity. Journal of Neurotherapy, 11(3), 3–13.

Cheon, E.-J., Koo, B.-H., Seo, W.-S., Lee, J.-Y., Choi, J.-H., & Song, S.-H. (2015). Effects of neurofeedback on adult clients with psychiatric disorders in a naturalistic setting. Applied Psychophysiology and Biofeedback, 40(1), 17–24.

Chesney, M., Neilands, T., Chambers, D., Taylor, J., & Folkman, S. (2006). A validity and reliability study of the coping self-efficacy scale (CSE). British Journal of Health Psychology, 11(3), 421–437.

Czeisler, M. É., Lane, R. I., Petrosky, E., Wiley, J. F., Christensen, A., Njai, R., Weaver, M. D., Robbins, R., Facer-Childs, E. R., Barger, L. K., Czeisler, C. A., Howard, M. E., & Rajaratnam, S. M. W. (2020). Mental health, substance use, and suicidal ideation during the COVID-19 pandemic—United States. Morbidity and Mortality Weekly Report, 69(32), 1049–1057.

Dalenberg, C., & Carlson, E. (2010). Adult (Brief Dissociative Experiences Scale [DES-B]—Modified DES-B modified for DSM-5.

Dana, D. (2018). The Polyvagal theory in therapy. New York, NY: W. W. Norton.

Fleischman, M. J. (2022). Documenting the impact of infra low frequency neurofeedback on underserved populations with complex clinical presentations. Frontiers in Human Neuroscience, 16, 921491.

Goldberg, E. (2009). The new executive brain. New York, NY: Oxford.

Judd L. L., Akiskal, H. S., Maser, J. D., Zeller, P. J., Endicott, J., Coryell, W., Paulus, M. P., Kunovac, J. L., Leon, A. C., Mueller, T. I., Rice, J. A., Keller, M. B. (1998). A prospective 12-year study of subsyndromal and syndromal depressive symptoms in unipolar major depressive disorders. Archives of General Psychiatry, 55(8), 694–700.

Kohl, S. H., Mehler, D. M. A., Lührs, M., Thibault, R. T., Konrad, K. & Sorger, B. (2020). The potential of functional near-infrared spectroscopy-based neurofeedback—A systematic review and recommendations for best practice. Frontiers in Neuroscience, 14, 594.

Kroenke, K., Spitzer, R. L., & Williams, J. B. (2001). The PHQ-9: validity of a brief depression severity measure. Journal of General Internal Medicine, 16(9), 606–613.

Magnavita, J. (2018). Introduction: How can technology advance mental health treatment? In J. J. Magnavita (Ed.), Using technology in mental health practice (pp. 3–10). American Psychological Association.

Rance, M., Walsh, C., Sukhodolsky, D. G., Pittman, B., Qiu, M., Kichuk, S. A., Wasylink, S., Koller, W. N., Bloch, M., Gruner, P., Scheinost, D., Pittenger, C., & Hampson, M. (2018). Time course of clinical change following neurofeedback. NeuroImage, 181, 807–813.

Schwarzer, R., & Jerusalem, M. (1995). Generalized self-efficacy scale. In J. Weinman, S. Wright, & M. Johnston, Measures in health psychology: A user’s portfolio. Causal and control beliefs (pp. 35–37). Windsor, UK: Nfer-Nelson.

Spitzer, R. L., Kroenke, K., Williams, J. B., & Löwe, B. (2006). A brief measure for assessing generalized anxiety disorder: The GAD-7. Archives of Internal Medicine, 166(10), 1092–1097.

Stokes, D. A., & Lappin, M. S. (2010). Neurofeedback and biofeedback with 37 migraineurs: A clinical outcome study. Behavior and Brain Functions, 6, Article 9.

Toomim, H., & Carmen, J. (2009). Hemoencephalography: Photon- based blood flow neurofeedback. In T. Budzynski, H. Budzynski, J. Evans, & A. Abarbanel (Eds.), Introduction to quantitative EEG and neurofeedback, (2nd ed.; pp. 169–194). Academic Press.

van der Kolk, B. (2015). The body keeps the score: Brain, mind, and body in the healing of trauma. New York, NY: Penguin.

van der Kolk, B., Hodgin, H., Gapen, M., Musicaro, R., Suvak, M., Hamlin, E., & Spinazzola, J. (2016). A randomized controlled study of neurofeedback for chronic PTSD. PLoS ONE, 11(12), Article e0166752.

Walker, A. K., & Lyle, R. R. (2016). Passive Infrared Hemoencephalography (pIR HEG) for the Treatment of Migraine Without Aura. NeuroRegulation, 3(2), 78–91.

Yu, S.-H., Tseng, C.-Y., & Lin, W.-L. (2020). A neurofeedback protocol for executive function to reduce depression and rumination: A controlled study. Clinical Psychopharmacology and Neuroscience, 18(3), 375–385.






Clinical Corner