The primary intention of the Handbook of Neurofeedback: Dynamics and Clinical Applications (Evans, 2007) includes providing a comprehensive review of the field of neurofeedback that would be of use for both experienced practitioners and those interested in entering the field. Additionally, the author sought to stimulate further theory and research on the reasons why neurofeedback is effective in treating a variety of disorders. The book is divided into four sections, with the majority of chapters devoted to the last two sections concerning training protocols and specific clinical applications.
The purpose of the first section was to provide a historical background of neurofeedback. Although a history of the development of neurofeedback is certainly presented, the chapter reads somewhat more like a marketing report as opposed to more of a description of the research involved in the development of neurofeedback and the early uses of neurofeedback in clinical settings. The monetary cost of early units is detailed and the present status of neurofeedback is provided, in terms of the number of practitioners as well as the total amount of equipment sales and billing (in dollars). The author also mentions the current application of neurofeedback in the areas of life and performance enhancement, stating his involvement in The International Mind-Fitness Foundation and in MindFitness. A website is also provided for MindFitness where the interested reader may purchase training seminars and equipment. Regarding the future, the author addresses the economic potential of neurofeedback as well as brief discussions of the use of neurofeedback in entertainment and issues related to certification of practitioners. The focus on economic issues in this section may not be surprising, given that the author is president of a corporation that sells neurofeedback equipment. This chapter would have benefited from the inclusion of an author who has extensive experience in conducting research in the field or who has considerable experience with clinical applications of neurofeedback.
The second section presents information regarding the neurophysiological basis for neurofeedback as well as other variables that might influence neurofeedback treatment outcome. Comparisons are also provided between neurofeedback and other treatments for a variety of disorders, particularly pharmacotherapy. Interesting viewpoints are offered regarding the electrophysiology of neurofeedback, with an emphasis on the role of interhemispheric connections, the brainstem, and neural networks. Importantly, the section also provides an honest and forthright discussion of the potential role of several process-, client-, and therapist-related variables in neurofeedback treatment. Several procedural variables are also mentioned in relation to the success of neurofeedback, variables such as electrode placement, bandwidth selection, and the number and timing of neurofeedback sessions. Interestingly, it is mentioned that all of the procedures have support in treating disorders. However, the precise common mechanism underlying these various neurofeedback treatment procedures was not explored in depth. A primary limitation of this section is the paucity of references to support many of the statements and claims offered by the authors. For instance, it is proposed that neurofeedback has superior efficacy in the treatment of steady-state conditions such as dysthymia and generalized anxiety, as compared with pharmacotherapy and that it may be useful in treating a wide range of other disorders. However, neither of these propositions were sourced with relevant research. Additionally, considerable space is devoted to discussing connectivity between various regions of the brain. But no mention of interhemispheric connections other than the massa intermedia and corpus callosum (such as the anterior and posterior commissures). Additionally, the emphasis on bioelectric causes of disorders and its relationship to neurofeedback comes at the expense of a more well-rounded discussion that considers the dynamic interplay that exists between behavior and all levels of central nervous system functioning. Traditional behavioral therapies, for instance, are known to produce changes in brain functioning (as measured by electrophysiology as well as regional cerebral blood flow) and administration of pharmacological agents has been shown to affect electrophysiology.
Sections 3 and 4 are devoted to descriptions of training protocols and specific clinical applications. These sections comprise the most substantive portion of the book and would be of the most benefit to someone in the field. Information is presented that would be of great use to individuals practicing or planning to practice neurofeedback, including the future direction of multichannel tomographic neurofeedback, the integration of cognitive training exercises with neurofeedback, and the use of audio-visual entrainment. Specific procedures and considerations for applying neurofeedback to a range of disorders is also provided, including ADHD, depression, Autistic spectrum disorders, as well as problems related to aging and brain injury. Thus, a clinician may find these sections of the book informative. However, these sections suffer the same aforementioned limitation, a paucity of appropriate references to source many of the claims and statements offered. Many of the graphs and figures in the chapters are quite difficult to read and interpret, limiting their informative value. Additionally, some of the references are cited incorrectly, such as the wrong year being listed for the study. This makes it difficult for the reader to follow-up and pursue additional reading on the topics. There are also problems with incorrect usage of terms (such as “neurogenesis” being defined as nerve cell death) and a lack of operational definitions for some of the disorders discussed.
To summarize, the primary audience that may benefit from the Handbook of Neurofeedback: Dynamics and Clinical Applications would be clinicians in the field or those interested in learning about neurofeedback. The book is useful in describing technique and specific applications for a number of disorders. It is well-organized, easy to read and understand, and written from the perspective of a clinician with many personal observations. However, the empirical utility of the book is limited due to the lack of references to support the claims made. Further, although some experiments are described, they often have low sample sizes or are case studies. The field would certainly benefit from more large-scale investigations and, as the editor wrote in the preface, perhaps this book will stimulate such research.