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Neurofeedback Certification Examination Blueprint for Study

The candidate for certification in neurofeedback will meet all of the requirements of the Neurofeedback Blueprint, pass the certification examination and complete the Neurofeedback application.  When you pass the examination you may become certified as a Neurofeedback Specialist, Stress Management Specialist, or both. Items marked (*) are required of all Certified Neurofeedback Technicians and need not be completed a second time.

I. Basics of Neurotherapy (4 CEU Required) (*)

  1. Definition of Neurofeedback
    Neurotherapy is a clinical process for changing the electrical activity, of either cortical or sub-cortical origin, of the Central Nervous System using electroencephalography-based feedback and/or electrical stimulation.
  1. Objective and Goals of Neurofeedback
    The objective and goals of neurofeedback vary considerably according to the client's needs. Clinicians should have a good understanding of the objectives and goals for treating a variety of disorders including but not limited to addictions, attention disorders, closed head injuries, learning disorders, mood disorders, pain management, peak performance, and stress management.  
  1. Definition of Neurofeedback
    Neurofeedback is a process for teaching clients how to relax and re-education their muscles in order to manage stress, pain and hypertension so they can relieve their pain and suffering.  This is similar to the definition most equipment manufacturers are required to use by law in North America, Europe and most of the world.  Licensed professionals may define neurotherapy according to their scope of practice.
  1. Objective and Goals of Neurofeedback
    The objective and goals of neurofeedback for non-licensed professionals are to assist clients in learning how to relax and re-educate their muscles in order to manage stress, pain and hypertension so they can relieve their pain and suffering.  Licensed healthcare professionals may use neurotherapy to accomplish any objective or goal permitted by the scope of their practice as defined by their license.
  1. History and Development of Neurofeedback
    Be familiar with the pioneers in neurotherapy and their contributions to the science of neurofeedback including Tom Budzynski, Elmer Green, Joe Kamiya, Joel Lubar, Siegfried Othmer, Gene Peniston and others.
  1. Research
    Be familiar with the seminal studies in neurofeedback reported in peer-reviewed journals such as the Journal of Neurotherapy

II. Professional Conduct (8 CEU Required) (*)

  1. Professional Code of Ethics (2 CEU Required)
    1. Know and adhere to the NTCB Code of Ethics
    2. Study other codes of ethics used in the biofeedback profession
    3. Write your own professional code of ethics
       
  2. Scope of Practice (2 CEU Required)
    1. Know what you can and cannot legally do in your biofeedback practice
    2. Write an acceptable description of your scope of practice
    3. Write an acceptable waiver and disclosure form for clients to sign
       
  3. Writing Informed Consent Forms (2 CEU Required)
    1. Identify the services you do not provide
    2. Identify the services you do provide
    3. State any requirements clients must satisfy
    4. Offer to make referrals
    5. Have client print their name, address and contact information
    6. Require client signature (keep this form in your file)
    7. Make a copy for your client
       
  4. Working with Other Professionals (2 CEU Required)
    1. Know what services are available from other professionals
    2. Know when and to whom to make referrals for medical care
    3. Know when and to whom to make referrals for psychotherapy
    4. Know when to ask for expert advice from other professionals
    5. Know when and how to ask for expert biofeedback advice

III. Neurophysiology and Neuroanatomy* (16 CEU Required) 

  1. Neurophysiology
    1. Know the bioelectric origin of Alpha, Beta, Delta, Gamma, Lambda, Mu, SMR and Theta in the EEG
    2. Know the definitions for amplitude, asymmetry, coherence, frequency, frequency band, magnitude, phase, phase coherence, power, ratio, spectra, symmetry and synchrony as they relate to EEG.
    3. Know the clinical applications for amplitude, asymmetry, coherence, frequency, frequency band, magnitude, phase, phase coherence, power, ratio, spectra, symmetry and synchrony as they relate to neurotherapy and be able to identify when each is appropriate and inappropriate.
    4. Know the clinical signs of activation via classical and reticular routes in the EEG.
  2. Neuroanatomy
    1. Know the location of the more important sites on the cortex of the brain and be able to describe the basic function of each site including the frontal, parietal, occipital and temporal lobes, the frontal, occipital and temporal poles, inferior and superior temporal gyrus, Rolandic and Sylvian fissures, central and parietal-occipital sulci, premotor, primary and secondary audio, primary and secondary visual, primary and secondary motor cortices, Broca's and Wernicke's areas.
    2. Know the location and function of the major components of the brain including the amygdala, brain stem, cerebellum, cortex, hippocampus, hypothalamus, limbic system, medulla, midbrain, pineal, pituitary, pons, and thalamus and their functions.
    3. Know the fundamental elements of the central nervous system such as axons, cell nucleus, dendrites, neurons, pyramidal cells and synapses.

IV. Neurotherapy Coaching Training* (40 CEU Required)

  1. Licensed Healthcare Therapists May Be Exempt
    1. If Biofeedback is within their scope of practice - this may include those licensed as medical doctors, chiropractors, counselors, dentists, licensed counselors, veterinarians.
    2. If their license is approved by their State or Provincial government and clearly states that biofeedback is within their scope of practice. (Does not include Licensed Massage Therapists).
       
  2. Some Unlicensed Professionals May Be Exempt *
    1. Life Coaches certified by a recognized authority
    2. International Coach Federation Certified Life Coaches

NOTE: Please check with the NTCB to see if you qualify. You must provide a personal (not copied) informed consent form and code of ethics to the NTCB for approval.

V. Coaching Requirements

  1. Coaching Course Requirements
    1. Values Clarification
    2. Mission Statements
    3. Code of Personal Ethics
    4. Active Listening Skills
    5. Reflective Listening Skills
    6. Use of Empowering Questions
    7. Beginning level Coaching Skills

  2. Accredited Providers
    1. The Biofeedback Coach
    2. The Quantum Academies
       
  3. Coaching Resources
    1. What are Therapy and Coaching?

VI. Instrumentation (24 CEU Required)

  1. Know the definitions and applications of the following terms related to EEG instruments:
    1. Amplifier
    2. Analog filters
    3. Analog to digital converters
    4. Band pass
    5. Common mode rejection
    6. Differential amplifier
    7. Digital filters
    8. Electrode impedance
    9. Fast Fourier transforms (FFT)
    10. Impedance
    11. Impedance testing
    12. Integral average
    13. Montage
    14. Optical isolation
    15. Peak to peak
    16. Root mean square
    17. Signal-to-noise ratio
    18. Volume conduction

  2. Sources of artifact
    1. Know how to evaluate environmental noise
    2. Know how to evaluate instrument noise
    3. Know how to check electrode impedances
    4. Know how to perform a continuity checks on electrodes
    5. Know how to perform continuity checks on cables
    6. Know how to identify short and open circuits

  3. Signal acquisition
    1. Know how to attach electrodes to your clients
    2. Know which ear to choose as a reference and why
    3. Know when to use a reference other than one ear
    4. Know when to use and apply a neutral reference
    5. Know when to use and apply a scalp reference
    6. Know which locations to use and why those locations were chosen
    7. Know how electrode impedance affects the EEG
    8. Know the potential effects of prescription, illicit and over-the-counter drugs and remedies on EEG
       
  4. Signal processing
    1. Know the sites on the l0-20 system
    2. Know the montages that derive from the 10-20 system
    3. Know how to explain offset voltages
    4. Know how a PET is different from a QEEG
    5. Know how a SPECT is different from a QEEG
    6. Know how a fMRI is different from a QEEG
    7. Know how a MEG is different from a QEEG

  5. EEG
    1. Be able to recognize normal EEG patterns for the frequency ranges traditionally called delta, theta, alpha, smr, beta, gamma, deltha, thalpha, mu, and lambda in the raw EEG and QEEG
    2. Be able to recognize common artifacts in the raw EEG such as drowsiness, eye blink, eye movement both vertically and laterally, muscle activity such as EMG, EOG, TMJ, frontalis, jaw and neck tension, sleep spindles, sweat, loose or poorly attached electrodes, heart pulse (EKG), electrode wire movement, skin potentials and static electricity, and electromagnetic noise
    3. Be able to identify abnormal EEG patterns, such as those associated with seizure disorders, stroke, memory loss and dementia, attention and learning disorders, addiction, mood disorders, and closed head injuries
       
  6. QEEG
    1. Be able to explain the clinical uses of spectral arrays
    2. Be able to explain the clinical uses of compressed spectral arrays
    3. Be able to explain the clinical uses of topographic brain maps
    4. Be able to explain the clinical uses of databases and discriminant functions
       
  7. Computers in Neurotherapy
    1. Know how to use a computer with at least one computerized EEG system
    2. Know how to use at least one neurotherapy software package with a computer
    3. Know how computer speed affects the speed of neurotherapy
    4. Know how FFT and digital filtering delays neurotherapy

VII. Physiology and Anatomy* (40 CEU required)

  1. Physiology
    1. Recognize the names of the major muscle groups which generally respond to biofeedback training
    2. Recognize the names of the major bones associated with these muscles
    3. Know the names and be able to describe the disorders which are generally expected to respond to biofeedback training
    4. Know the clinical applications for EMG, SEMG, temperature training, heart rate variability and EDR/GSR as they relate to biofeedback training and be able to identify when each is appropriate and inappropriate
    5. Know the clinical signs for hypertension, stress, pain and be able to describe how to handle each in a clinical setting
       
  2. Basic Anatomy
    1. Know the location and function of the major components of the skeletal and muscle system, endocrine glands and the immune system
    2. Know the fundamental elements of the major body systems including the digestive, circulatory, respiratory, excretory, nervous, lymphatic, urinary and hormonal systems

VIII. Clinical Neurotherapy (40 CEU Required)

  1. Client Intake Skills (2 CEU Required)
    1. Know interview techniques to obtain all the information necessary for treating your client
    2. Know how to obtain a complete medical and personal history of pertinent data
    3. Know how to explain training rationale and expectations to clients with varied backgrounds and life experiences
    4. Know how to motivate client compliance with your training strategy
    5. Know how to discover the potential effects of prescription, illicit and over-the-counter drugs and remedies on prospective neurotherapy interventions
    6. Know the potential effects prescription, illicit and over-the-counter drugs and remedies on learning tasks such as neurotherapy
    7. Know the contraindications for proscription, illicit and over-the-counter drugs and remedies
    8. Know how your client can be expected to relate to training indications
    9. Know how to develop and write a neurotherapy training program
    10. Know how to develop and write a comprehensive training program

  2. Initial Assessment (2 CEU Required)
    1. Know how to prepare the client for a full-cap QEEG
    2. Know how to collect sufficient artifact-free data for quantitative analysis
    3. Know how to prepare the client for a neurotherapy session
    4. Determine the number of sites to be used in each session
    5. Know how to remove or otherwise accommodate non EEG artifact

  3. Training protocols (8 CEU Required)
    1. Know how to develop protocols based on the results of EEG and QEEG analysis.
    2. Know and be able to implement several training protocols for relaxation and stress management
    3. Know and be able to implement several training protocols for muscle re-education and pain management
    4. Know and be able to implement several training protocols for peak performance training
    5. Know and be able to implement several training protocols for quality of life enhancement
    6. Know how to evaluate the effectiveness of any training protocol
    7. Know how to adjust training procedures to improve outcome
       
  4. Complementary Therapies (4 CEU Required)
    1. Know how to implement relaxation and autogenic training
    2. Know how to use deep breathing techniques
    3. Know how to use affirmations
    4. Know how to use visualization and guided imagery techniques
    5. Know how to use other selected techniques
       
  5. Practicum in Neurotherapy (10 CEU Required)
    1. Shadowing (4 sessions minimum)
    2. Constant supervision (8 sessions minimum)

IX. Internship (500 Hours of Supervision Required)

Note: Please review Internship Requirements

  1. Supervision By Qualified Neurotherapy Supervisor Required
    1. Qualified = certified as a NTCB supervisor or instructor
    2. Qualified = licensed therapist practicing biofeedback
    3. Qualified = certified as a BCIAC-EEG Fellow
       
  2. NTCB Supervision Model must be used
     
  3. Licensed Healthcare Therapists May Be Exempt
    1. If Biofeedback is within their scope of practice - this may include those licensed as medical doctors, chiropractors, counselors, dentists, licensed counselors, veterinarians
    2. If their license is approved by their State or Provincial government and clearly states that biofeedback is within their scope of practice. (Does not include Licensed Massage Therapists)
       
  4. Responsibilities of the Supervisor
    1. Require ethical conduct by intern at all times
    2. Require professional conduct by intern at all times
    3. Require intern to provide personal Code of Ethics to each client
    4. Require intern to provide each client a copy of any waivers
    5. Require intern to fully disclose scope of practice to clients
    6. Report any deviations therefrom to NTCB headquarters
    7. Report outstanding performance to NTCB headquarters
       
  5. Responsibilities of the Intern
    1. Be ethical in all neurotherapy undertakings at all times
    2. Be professional in all neurotherapy undertakings
    3. Write an acceptable Code of Ethics and comply therewith
    4. Provide each client a copy of your Code of Ethics
    5. Provide each client a copy of any waivers you require
    6. Fully disclose your scope of practice to each client
    7. Keep a record of all activities done under supervision
      1. Include date and times
      2. Include name of your supervisor
      3. Include client code or number for future reference (no names)
      4. File a copy of the completed record with NTCB headquarters
    8. Read the Internship Instructions.

X. Biofeedback

While there is no requirement for learning biofeedback theory and practice to be certified as a neurotherapy technician or specialist, it is suggested that candidates also meet the requirements of the Biofeedback Blueprint.

 
   

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