FAQ Neurofeedback

Neurofeedback is a specialized form of biofeedback in which the brain’s electrical activity (EEG) is measured and fed back in real time. Sensors placed on the scalp detect brainwaves and display them visually or acoustically. This allows users to learn how to influence specific brain activity patterns.

The method is based on the principle of operant conditioning and has been researched and used in clinical practice since the 1960s.

→ Detailed explanation: Neurofeedback Introduction

A typical session lasts about 45–60 minutes: EEG electrodes are placed painlessly on the scalp, brain activity is displayed in real time (e.g., as waveforms, bar charts, or animations), and the therapist or trainer evaluates the results.

Depending on the indication, typically 20–40 sessions are recommended (once or twice per week).

→ Detailed process: Neurofeedback Training

Neurofeedback has been scientifically studied for several decades. The level of evidence varies by application area:

• ADHD: The most extensive body of research. Meta-analyses (including Arns et al., 2009; Van Doren et al., 2019) show significant improvements in inattention and impulsivity. The European ADHD Guidelines Group (EAGG) classifies neurofeedback as a treatment option.
• Epilepsy: Reduction in seizure frequency in treatment-resistant epilepsy (Tan et al., 2009).
• Migraine: Significant reduction in attack frequency and intensity (Stokes & Lappin, 2010; Minen et al., 2025).
• Tinnitus: Improvement in tinnitus symptoms through Alpha/Delta protocols (Güntensperger et al., 2019).
• Depression: Reduction of depressive symptoms, particularly through alpha asymmetry training (Xia et al., 2024, meta-analysis).
• PTSD / Trauma-related disorders: Symptom improvement in clinical studies (Askovic et al., 2023, meta-analysis).
• Substance use disorders: Reduction of craving and improvement of self-regulation (Wan et al., 2025, meta-analysis).
• Sleep disorders: Improvement of subjective sleep quality through SMR training.
• Peak performance: Performance optimization in sports, music, and professional settings – growing evidence from controlled studies.

Important: Neurofeedback is not a substitute for medical or psychotherapeutic treatment but is used as a complementary approach in clinical practice. For an overview of current studies, visit our Studies Overview.

Neurofeedback is used as a complementary approach for various conditions, including:

• ADHD – Improving attention and impulse control
• Epilepsy – Reducing seizure frequency (complementary)
• Migraine and headaches – Influencing cortical excitability
• Sleep disorders – Training sleep-wake regulation
• Anxiety and stress – Promoting self-regulation
• Tinnitus – Modulating auditory processing
• Depression – Training hemispheric balance
• PTSD / Trauma-related disorders – Supporting affect regulation
• Substance use disorders – Reducing craving
• Peak performance – Performance optimization in sports, music, or professional settings

The applications depend on the chosen training protocol and individual assessment. Professional guidance by a qualified therapist or trainer is recommended.

→ All applications in detail: Neurofeedback Applications

For ADHD, neurofeedback is one of the most extensively studied non-pharmacological approaches. The training aims to improve self-regulation in brain areas associated with attention, impulse control, and concentration.

Commonly used protocols include:

• Theta/Beta training: Reducing slow theta waves and increasing fast beta waves to promote attention
• SCP training (Slow Cortical Potentials): Training cortical excitability for better self-regulation

Meta-analyses show that neurofeedback can lead to significant improvements in inattention in ADHD (Arns et al., 2009). The effects can persist beyond the end of training (Strehl et al., 2017). In practice, neurofeedback is often used as a complement to other therapies, not as a replacement for medical treatment.

Neurofeedback is frequently used as a complementary approach for children with ADHD and learning difficulties. The developing brain has high neuroplasticity, meaning it can respond particularly well to learning-based methods like neurofeedback.

Advantages for children:

• Gamified training with animations and games that motivates children
• Non-invasive and medication-free
• Can promote self-awareness and self-regulation

Treatment should be carried out by qualified therapists or trainers with experience working with children. Parents should be involved in the therapy process. The evidence for neurofeedback in children with ADHD is comparatively well documented (Van Doren et al., 2019).

Neurofeedback is offered at various facilities:

• Occupational therapy practices – the most common providers, especially for ADHD in children
• Specialized neurofeedback clinics – focused on EEG-based training
• Psychotherapy practices – as a complementary approach
• Hospitals and rehabilitation centers – e.g., in neurorehabilitation
• University institutions – as part of research projects

When choosing a provider, look for the therapist’s or trainer’s qualifications and experience. Professional associations such as the German Society for Biofeedback (DGBfb) or the Biofeedback Certification International Alliance (BCIA) offer provider directories.

Neurofeedback is provided by various qualified professionals:

• Occupational therapists with additional training (largest provider group)
• Psychotherapists (clinical psychologists and psychiatrists)
• Alternative medicine practitioners with neurofeedback training
• Physicians (especially neurologists, psychiatrists, pediatricians)

Specific neurofeedback training is recommended. Recognized training institutes include:

• Academy for Neurofeedback – practice-oriented training programs
• German Society for Biofeedback (DGBfb) – continuing education and certifications
• Biofeedback Certification International Alliance (BCIA) – international standard

The number of sessions depends on the condition and individual progress:

Regular and consistent training is important for success. Initial changes are often reported after 10–15 sessions, while sustained effects typically require more training units. The exact plan is tailored individually by the treating therapist or trainer.

Neurofeedback costs consist of individual session fees:

• Single session: approx. €80–150 (depending on provider, region, and duration)
• Initial assessment / QEEG: approx. €150–400 (one-time, not at all providers)
• Total cost (25–40 sessions): approx. €2,000–6,000

Prices vary by region and provider qualifications. Some providers offer package rates. It is advisable to have an initial consultation to discuss expected duration and costs.

Coverage varies by country and insurance type. In the German-speaking region:

Statutory health insurance (GKV): Neurofeedback as a standalone therapy is not a standard benefit. However, neurofeedback is often provided within the framework of occupational therapy, which is covered. With a physician’s prescription for occupational therapy (e.g., for ADHD), costs can be covered by statutory health insurance.

Private health insurance (PKV): Some private insurers reimburse neurofeedback when supported by a medical referral. Coverage depends on the individual plan.

Self-pay: Those who prefer not to wait for a therapy slot (waiting times of several months are common) can start treatment as a self-paying patient.

Recommendation: Clarify coverage with your health insurer before starting treatment.

Neurofeedback is considered a non-invasive and low-risk procedure. Only sensors are placed on the scalp – no electrical current is applied to the brain (unlike procedures such as tDCS or TMS).

In rare cases, the following may occur temporarily:

• Fatigue or mild headaches after a session
• Temporary restlessness or changed sleep patterns at the beginning of training

These effects typically subside quickly and can be minimized by adjusting the training protocol. Serious side effects are not documented in the scientific literature.

Neurofeedback is not a substitute for medical or psychotherapeutic treatment. Existing medications should not be changed without consulting a physician.