Implementation Science Application to EEG Neurofeedback Research: A Call to Action




implementation science, neurofeedback, systematic review


This article is a call to action for implementation research in the field of electroencephalogram (EEG) neurofeedback. While the effectiveness of neurofeedback in improving clinical outcomes has been well established and is continuing to expand into a variety of symptom presentations and mechanisms of action, there is lack of research bridging the gap between the research setting and neurofeedback’s implementation in mental health clinics. Our review of the published research to date revealed no articles incorporating the burgeoning utility of implementation science into neurofeedback research to bridge the gap and provide practical information about how to use neurofeedback in real-world settings. Research is urgently needed to explore the feasibility and process of implementing neurofeedback in the clinical setting, without which the applicability and usefulness of outcome studies are called into question.


Aarons, G. A., Hurlburt, M., & Horwitz, S. M. C. (2011). Advancing a conceptual model of evidence-based practice implementation in public service sectors. Administration and Policy in Mental Health and Mental Health Services Research, 38(1), 4–23.

Aguilar-Prinsloo, S., & Lyle, R. (2010). Client perception of the neurofeedback experience: The untold perspective. Journal of Neurotherapy, 14(1), 55–60.

Arnold, L. E., Arns, M., Barterian, J., Bergman, R., Black, S., Conners, C. K., Connor, S., Dasgupta, S., deBeus, R., Higgins, T., Hirshberg, L., Hollway, J. A., Kerson, C., Lightstone, H., Lofthouse, N., Lubar, J., McBurnett, K., Monastra, V., Buchan-Page, K., … Williams, C. E. (2021). Double-blind placebo-controlled randomized clinical trial of neurofeedback for attention-deficit/hyperactivity disorder with 13-month follow-up. Journal of the American Academy of Child and Adolescent Psychiatry, 60(7), 841–855.

Askovic, M., Watters, A. J., Coello, M., Aroche, J., Harris, A. W. F., & Kropotov, J. (2020). Evaluation of neurofeedback for posttraumatic stress disorder related to refugee experiences using self-report and cognitive ERP measures. Clinical EEG and Neuroscience, 51(2), 79–86.

Balas, E. A., & Boren, S. A. (2000). Managing clinical knowledge for health care improvement. Yearbook of Medical Informatics, 09(01), 65–70.

Bauer, M. S., & Kirchner, J. A. (2020). Implementation science: What is it and why should I care? Psychiatry Research, 283, Article 112376.

Berenholtz, S., & Pronovost, P. J. (2003). Barriers to translating evidence into practice. Current Opinion in Critical Care, 9(4), 321–325.

Bluhm, R. L., Williamson, P. C., Osuch, E. A., Frewen, P. A., Stevens, T. K., Boksman, K., Neufeld, R. W. J., Théberge, J., & Lanius, R. A. (2009). Alterations in default network connectivity in posttraumatic stress disorder related to early-life trauma. Journal of Psychiatry and Neuroscience, 34(3), 187–194.

Bluschke, A., Schreiter, M. L., Friedrich, J., Adelhöfer, N., Roessner, V., & Beste, C. (2020). Neurofeedback trains a superordinate system relevant for seemingly opposing behavioral control deficits depending on ADHD subtype. Developmental Science, 23(6), Article e12956.

Brownson, R. C., Colditz, G. A., & Proctor, E. K. (Eds.). (2017). Dissemination and implementation research in health: Translating science to practice (2nd ed.). Oxford Academic.

Chalmers, I., & Glasziou, P. (2009). Avoidable waste in the production and reporting of research evidence. The Lancet, 374(9683), 86–89.

Dalkner, N., Unterrainer, H. F., Wood, G., Skliris, D., Holasek, S. J., Gruzelier, J. H., & Neuper, C. (2017). Short-term beneficial effects of 12 sessions of neurofeedback on avoidant personality accentuation in the treatment of alcohol use disorder. Frontiers in Psychology, 8, Article 1688.

Damschroder, L. J., Aron, D. C., Keith, R. E., Kirsh, S. R., Alexander, J. A., & Lowery, J. C. (2009). Fostering implementation of health services research findings into practice: A consolidated framework for advancing implementation science. Implementation Science, 4(1), Article 50.

Dehghani-Arani, F., Rostami, R., & Nadali, H. (2013). Neurofeedback training for opiate addiction: Improvement of mental health and craving. Applied Psychophysiology and Biofeedback, 38(2), 133–141.

Dehghani-Arani, F., Rostami, R., & Nostratabadi, M. (2010). Effectiveness of neurofeedback training as a treatment for opioid-dependent patients. Clinical EEG and Neuroscience, 41(3), 170–177.

Dobrakowski, P., & Łebecka, G. (2020). Individualized neurofeedback training may help achieve long-term improvement of working memory in children with ADHD. Clinical EEG and Neuroscience, 51(2), 94–101.

Drolet, B. C., & Lorenzi, N. M. (2011). Translational research: Understanding the continuum from bench to bedside. Translational Research, 157(1), 1–5.

Eccles, M. P., & Mittman, B. S. (2006). Welcome to implementation science. Implementation Science, 1(1), 1.

EPIS Framework. (2024). What is EPIS? [Graphic].

Fisher, S. F., Lanius, R. A., & Frewen, P. A. (2016). EEG neurofeedback as adjunct to psychotherapy for complex developmental trauma-related disorders: Case study and treatment rationale. Traumatology, 22(4), 255–260.

Gapen, M., van der Kolk, B. A., Hamlin, E., Hirshberg, L., Suvak, M., & Spinazzola, J. (2016). A pilot study of neurofeedback for chronic PTSD. Applied Psychophysiology Biofeedback, 41(3), 251–261.

Goldberg, R. J., Greenwood, J. C., & Taintor, Z. (1976). Alpha conditioning as an adjunct treatment for drug dependence: Part I. International Journal of the Addictions, 11(6), 1085–1089.

GrayMatters Health (2023, March 21). U.S. FDA grants GrayMatters Health 510(k) clearance to market prism for PTSD. PR Newswire.,for%20PTSD%2C%20the%20first%20non%2D

Hammond, D. C., Novian, D. A., & Duffy, F. H. (2017). The ISNR comprehensive bibliography of neurofeedback research. International Society for Neuroregulation & Research.

Hardt, J. V., & Kamiya, J. (1978). Anxiety change through electroencephalographic alpha feedback seen only in high anxiety subjects. Science, 201(4350), 79–81.

Horrell, T., El-Baz, A., Baruth, J., Tasman, A., Sokhadze, G., Stewart, C., & Sokhadze, E. (2010). Neurofeedback effects on evoked and induced EEG gamma band reactivity to drug-related cues in cocaine addiction. Journal of Neurotherapy, 14(3), 195–216.

Kettlewell, P. W. (2004). Development, dissemination and implementation of evidence-based treatments: Commentary. Clinical Psychology: Science and Practice, 11(2), 190–195.

Kluetsch, R. C., Ros, T., Théberge, J., Frewen, P. A., Calhoun, V. D., Schmahl, C., Jetly, R., & Lanius, R. A. (2014). Plastic modulation of PTSD resting-state networks and subjective wellbeing by EEG neurofeedback. Acta Psychiatrica Scandinavica, 130(2), 123–136.

Ko, S., & Park, W. (2018). Effects of quantitative electroencephalography based neurofeedback training on autonomous regulations in patients with alcohol use disorder. Asian Nursing Research, 12(2), 136–144.

Kuznetsova, E., Veilahti, A. V. P., Akhundzadeh, R., Radev, S., Konicar, L., & Cowley, B. U. (2022). Evaluation of neurofeedback learning in patients with ADHD: A systematic review. Applied Psychophysiology and Biofeedback, 48(1), 11–25.

Lackner, N., Unterrainer, H. F., Skliris, D., Wood, G., Wallner-Liebmann, S. J., Neuper, C., & Gruzelier, J. H. (2016). The effectiveness of visual short-time neurofeedback on brain activity and clinical characteristics in alcohol use disorders. Clinical EEG and Neuroscience, 47(3), 188–195.

Lamontagne, Y., Hand, I., Annable, L., & Gagnon, M. A. (1975). Physiological and psychological effects of alpha and EMG feedback training with college drug users a pilot study*. Canadian Psychiatric Association Journal, 20(5), 337–349.

Lanius, R. A., Frewen, P. A., Tursich, M., Jetly, R., & McKinnon, M. C. (2015). Restoring large-scale brain networks in PTSD and related disorders: A proposal for neuroscientifically-informed treatment interventions. European Journal of Psychotraumatology, 6(1), Article 27313.

Larson, J. E., Ryan, C. B., & Baerentzen, M. B. (2010). Practitioner perspectives of neurofeedback therapy for mental health and physiological disorders. Journal of Neurotherapy, 14(4), 280–290.

Leem, J., Cheong, M. J., Lee, H., Cho, E., Lee, S. Y., Kim, G. W., & Kang, H. W. (2021). Effectiveness, cost-utility, and safety of neurofeedback self-regulating training in patients with post-traumatic stress disorder: A randomized controlled trial. Healthcare (Switzerland), 9(10), Article 1351.

Lubar, J. F., & Shouse, M. N. (1976). EEG and behavioral changes in a hyperkinetic child concurrent with training of the sensorimotor rhythm (SMR) - A preliminary report. Biofeedback and Self-Regulation, 1(3), 293–306.

Luctkar-Flude, M. F., Tyerman, J., & Groll, D. (2019). Exploring the use of neurofeedback by cancer survivors: Results of interviews with neurofeedback providers and clients. Asia-Pacific Journal of Oncology Nursing, 6(1), 35–42.

Markiewcz, R. (2017). The use of EEG biofeedback/neurofeedback in psychiatric rehabilitation. Psychiatria Polska, 51(6), 1095–1106.

Marzbani, H., Marateb, H. R., & Mansourian, M. (2016). Methodological note: Neurofeedback: A comprehensive review on system design, methodology and clinical applications. Basic and Clinical Neuroscience, 7(2), 143–158.

Micoulaud-Franchi, J. A., Jeunet, C., Pelissolo, A., & Ros, T. (2021). EEG neurofeedback for anxiety disorders and post-traumatic stress disorders: A blueprint for a promising brain-based therapy. Current Psychiatry Reports, 23(12), Article 84.

Morris, Z. S., Wooding, S., & Grant, J. (2011). The answer is 17 years, what is the question: Understanding time lags in translational research. Journal of the Royal Society of Medicine, 104(12), 510–520.

National Institute of Mental Health. (2022). National institute of mental health strategic plan for research.

Nicholson, A. A., Ros, T., Densmore, M., Frewen, P. A., Neufeld, R. W. J., Théberge, J., Jetly, R., & Lanius, R. A. (2020). A randomized, controlled trial of alpha-rhythm EEG neurofeedback in posttraumatic stress disorder: A preliminary investigation showing evidence of decreased PTSD symptoms and restored default mode and salience network connectivity using fMRI. NeuroImage: Clinical, 28, Article 102490.

Noohi, S., Miraghaie, A. M., & Arabi, A. (2017). Effectiveness of neuro-feedback treatment with alpha/theta method on PTSD symptoms and their executing function. Biomedical Research (India), 28(5), 2019–2027.

Panisch, L. S., & Hai, A. H. (2020). The effectiveness of using neurofeedback in the treatment of post-traumatic stress disorder: A systematic review. Trauma, Violence, & Abuse, 21(3), 541–550.

Passini, F. T., Watson, C. G., Dehnel, L., Herder, J., & Watkins, B. (1977). Alpha wave biofeedback training therapy in alcoholics†. Journal of Clinical Psychology, 33(S1), 292–299.<292::AID-JCLP2270330166>3.0.CO;2-L

Peniston, E. G., & Kulkosky, P. J. (1989). Alpha-theta brainwave training and beta-endorphin levels in alcoholics. Alcoholism: Clinical and Experimental Research, 13(2), 271–279.

Peniston, E. G., & Kulkosky, P. J. (1991). Alpha-theta brainwave neuro-feedback for Vietnam veterans with combat-related post-traumatic stress disorder. Medical Psychotherapy, 4, 47–60.

Perl, M., & Perl, D. (2019). EEG amplitude neurofeedback: A review of the research. Asia Pacific Journal of Neurotherapy (APJNT), 1(1), 44–55.

Purper-Ouakil, D., Blasco-Fontecilla, H., Ros, T., Acquaviva, E., Banaschewski, T., Baumeister, S., Bousquet, E., Bussalb, A., Delhaye, M., Delorme, R., Drechsler, R., Goujon, A., Häge, A., Kaiser, A., Mayaud, L., Mechler, K., Menache, C., Revol, O., Tagwekrker, F., … Brandeis, D. (2019). Personalized at-home neurofeedback compared with long-acting methylphenidate in children with ADHD: NEWROFEED, a European randomized non-inferiority trial. Journal of Child Psychology and Psychiatry, 63(2), 187–198.

Riesco-Matías, P., Yela-Bernabé, J. R., Crego, A., & Sánchez-Zaballos, E. (2021). What do meta-analyses have to say about the efficacy of neurofeedback applied to children with ADHD? review of previous meta-analyses and a new meta-analysis. Journal of Attention Disorders, 25(4), 473–485.

Robbins, J. (2008). A symphony in the brain: The evolution of the new brain wave biofeedback. Grove Press.

Rogel, A., Loomis, A. M., Hamlin, E., Hodgdon, H., Spinazzola, J., & van der Kolk, B. (2020). The impact of neurofeedback training on children with developmental trauma: A randomized controlled study. Psychological Trauma: Theory, Research, Practice, and Policy, 12(8), 918–929.

Saxby, E., & Peniston, E. G. (1995). Alpha‐theta brainwave neurofeedback training: An effective treatment for male and female alcoholics with depressive symptoms. Journal of Clinical Psychology, 51(5), 685–693.<685::AID-JCLP2270510514>3.0.CO;2-K

Scott, W. C., Kaiser, D., Othmer, S., & Sideroff, S. I. (2005). Effects of an EEG biofeedback protocol on a mixed substance abusing population. The American Journal of Drug and Alcohol Abuse, 31(3), 455–469.

Sterman, M. B., & Friar, L. (1972). Suppression of seizures in an epileptic following sensorimotor EEG feedback training. Electroencephalography and Clinical Neurophysiology, 33(1), 89–95.

Trocki, K. F. (2006). Is there an anti-neurofeedback conspiracy? Journal of Addictions Nursing, 17(4), 199–202.

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

van Doren, J., Arns, M., Heinrich, H., Vollebregt, M. A., Strehl, U., & Loo, S. K. (2019). Sustained effects of neurofeedback in ADHD: A systematic review and meta-analysis. European Child and Adolescent Psychiatry, 28(3), 293–305.