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Biofeedback

A non-invasive therapy you should know about that can help children and adults with ADHD, Attention, focus, and learning difficulties:  Neurofeedback (also known as EEG Biofeedback) is recognized as a useful intervention to help adults and children learn how to manage their day to day tasks with optimum functioning. Neurofeedback is brain training intended to teaching the brain how to allocate resources differently so that you can face day-to-day challenges with your best foot forward.  Using an operant conditioning model, trained practitioners measure and assess the electrical functioning of the brain and discover how maladaptive patterns could be contributing to attention deficits, behavioral issues at home and at school or work, and learning difficulties. Neurofeedback is best known for its efficacy in the focus and attention field. In 2012, the American Academy of Pediatrics elevated Neurofeedback therapy to a Level One intervention for the treatment of ADHD.  Neurofeedback has demonstrated its effectiveness in the reduction of ADHD symptoms in conjunction with psychotherapy in several peer-reviewed research studies.  Heritage Counseling is pioneering Neurofeedback in North Texas to meet the needs of our clients. From the C-Suite to the football field, our unique approach combines the best practices of neurofeedback and biofeedback to retrain reactions, fine-tune decision-making processes, boost your performance, and improve your mental wellness. We invite you to reach out for a free Neurofeedback consultation today. Linked below are several articles that substantiate Neurofeedback as an effective option for ADHD:  Arns, M., de Ridder, S., Strehl, U., Breteler, M., & Coenen, A. (2009). Efficacy of neurofeedback treatment in ADHD: The effects on inattention, impulsivity and hyperactivity: A meta-analysis. Clinical EEG and Neuroscience, 40(3), 180-189.  	 https://www.ncbi.nlm.nih.gov/pubmed/19715181 Micoulaud-Franchi, J-A., Geoffroy, P. A., Fond, G., Lopez, R., Bioulac, S., Philip, P. (2014). EEG neurofeedback treatments in children with ADHD: An update meta-analysis of randomized controlled trials. Frontiers in Human Neuroscience, 8(906), 1-7. Steiner, N. J., Frenette, E. C., Rene K. M., Brennan, R. T., & Perrin, E. C. (2014). In-school neurofeedback training for ADHD: Sustained improvements from a randomized control trial. Pediatrics, 133(3), 483-492. doi: 10.1542/peds.2013-2059.  	 https://www.ncbi.nlm.nih.gov/pubmed/25431555 Wigton, N. L., & Krigbaum, G. (2015). Attention, executive function, behavior, and electrocortical function, significantly improved with 19-channel z-score neurofeedback in a clinical setting: A pilot study. Journal of Attention Disorders, [e-pub ahead of print]. 	 https://www.ncbi.nlm.nih.gov/pubmed/25823743 Coben, R., Wright, E. K., Decker, S. L., & Morgan, T. (2015). The impact of coherence neurofeedback on reading delays in learning disabled children: A Randomized controlled study. NeuroRegulation, 2(4), 168-178. doi:10.15540/nr.2.4.168 	 http://www.neuroregulation.org/article/view/15893/10087 Wigton, N. L., & Krigbaum, G. (2015). Attention, executive function, behavior, and electrocortical function, significantly improved with 19-channel z-score neurofeedback in a clinical setting: A pilot study. Journal of Attention Disorders, [e-pub ahead of print].

Neurofeedback: An innovative treatment for ADHD

In the landscape of mental health treatment, there's a remarkable approach that stands out for its efficacy in addressing trauma and related conditions: Eye Movement Desensitization and Reprocessing (EMDR) therapy. *** 
 Definition and Origins of EMDR EMDR, developed by Francine Shapiro in the late 1980s, is a psychotherapy approach that integrates elements of cognitive-behavioral therapy with bilateral stimulation to process distressing memories and alleviate their associated symptoms. Through guided eye movements, taps, or sounds, EMDR facilitates the brain's natural ability to heal from psychological wounds. ** How EMDR Works in the Brain EMDR's mechanism operates on the premise that trauma disrupts the brain's processing of information, leading to maladaptive responses and symptoms. Integrating bilateral stimulation, EMDR assists the brain in reprocessing traumatic memories, transforming them into more adaptive narratives and reducing their emotional charge. * EMDR is guided by several core principles, including the importance of accessing and processing traumatic memories, fostering adaptive beliefs, and addressing associated sensory experiences. Through a structured protocol, EMDR empowers individuals to integrate past experiences into their present reality, promoting healing and resilience. ***** 
 
 
 Common Mental Health Issues Addressed by EMDR**  Post-Traumatic Stress Disorder (PTSD): PTSD is a complex condition characterized by intrusive memories, hypervigilance, and avoidance behaviors following exposure to a traumatic event. EMDR targets these symptoms by facilitating the reprocessing of traumatic memories, allowing individuals to reclaim a sense of safety and control.
 Anxiety Disorders: Anxiety disorders encompass a range of conditions marked by excessive worry, fear, and physiological arousal. EMDR offers relief by addressing the underlying trauma fueling anxiety, enabling individuals to develop healthier coping mechanisms and reduce symptom severity. 
 Depression: Depression manifests as persistent feelings of sadness, hopelessness, and apathy, often stemming from unresolved trauma or adverse life experiences. EMDR intervenes by processing emotional wounds and fostering a more positive outlook, leading to symptom alleviation and improved mood. 
 Phobias: Phobias are intense and irrational fears of specific objects or situations, often rooted in past trauma. EMDR dismantles phobic responses by reprocessing associated memories and instilling a sense of safety and mastery over triggers. 
 Childhood Trauma and Neglect: Childhood trauma and neglect can profoundly impact one's emotional well-being, contributing to long-term psychological difficulties. EMDR addresses these wounds by revisiting early experiences, fostering healing, and nurturing self-compassion. 
 Grief and Loss: Grief encompasses the complex emotions and adjustments following the loss of a loved one or significant life change. EMDR supports individuals in processing their grief, integrating the loss into their narrative, and finding meaning in the midst of sorrow. 
 
 
 
 The Eight Essential Steps of Eye Movement Desensitization and Reprocessing (EMDR) Therapy***  1. Initial Assessment and Treatment Planning: This first step involves a thorough assessment and collaboration between the therapist and the client. The therapist gathers information about the client's history, current symptoms, and goals for therapy. Together, they identify specific target memories or experiences to address during EMDR sessions. 
 2. Preparation Phase: Building Rapport and Establishing Safety: Establishing a strong therapeutic alliance is essential for successful EMDR therapy. During this phase, the therapist builds trust and ensures the client feels safe and supported. Grounding techniques and coping strategies are introduced to help the client manage distress during the processing phases 
 3. Assessment Phase:  Eye Movement Desensitization and Reprocessing therapy often involves several assessments to evaluate a client's readiness for the therapy, to monitor progress, and to measure outcomes. These assessments typically cover areas such as trauma history, symptom severity, and overall psychological functioning. These can be administered in the office or virtually through a secure portal. 

 4. Desensitization Phase: Processing Traumatic Memories: This phase is most commonly thought of in EMDR therapy. The client recalls the targeted traumatic memory while simultaneously engaging in bilateral stimulation, such as following a light bar with their eyes, holding buzzers, or listening to alternating tones. This dual attention allows the brain to reprocess the memory, reducing its emotional intensity and associated distress. 
 5. Installation Phase: Strengthening Positive Beliefs: Once the distress associated with the traumatic memory has decreased, the focus shifts to reinforcing positive beliefs and adaptive coping skills. The client identifies and internalizes positive affirmations or beliefs that counteract the negative beliefs stemming from the traumatic experience. 
 6. Body Scan: Addressing Physical Sensations Related to Trauma: Trauma often manifests not only in emotional distress but also in physical sensations and discomfort. In this phase, the client tunes into any remaining physical sensations associated with the trauma and works with the therapist to process and alleviate them. 
 7. Closure: Grounding Techniques and Self-Care Strategies: After each processing session, it's crucial to help the client return to a state of stability and calm. Closure involves teaching the client grounding techniques and self-soothing strategies to use between sessions. This helps them feel empowered and equipped to manage any residual emotions that may arise. 
 8. Reevaluation: Monitoring Progress and Identifying Remaining Targets: Throughout the EMDR therapy journey, the therapist regularly assesses the client's progress and adjusts the treatment plan as needed. New targets may emerge as old ones are resolved, and it's essential to continue addressing any lingering symptoms or areas of distress. In summary, EMDR therapy follows a structured yet flexible approach to help individuals process and heal from traumatic experiences. By guiding clients through these seven steps, therapists empower them to confront their past, reframe their beliefs, and move forward with renewed strength and resilience. 
 In conclusion, EMDR offers a transformative path to healing for individuals grappling with the aftermath of trauma and related mental health challenges. As we continue to explore the depths of trauma treatment, EMDR stands as a beacon of hope, guiding individuals toward resilience and wholeness. For those seeking effective trauma therapy, I encourage you to consider EMDR and embark on a journey of healing and growth. At Heritage Counseling, we're dedicated to supporting you on this path toward a brighter tomorrow. Remember, healing is within reach, and you don't have to walk this path alone. If you feel that EMDR could be the right treatment path for you, please contact Heritage Counseling and Consulting at 214-363-2345 to be paired with an EMDR trained clinician.  
 
 
 
 Sources:  *  https://my.clevelandclinic.org/health/treatments/22641-emdr-therapy   ** https://www.emdr.com/what-is-emdr/   *** https://www.apa.org/ptsd-guideline/treatments/eye-movement-reprocessing   **** https://www.emdria.org/about-emdr-therapy/   *****   https://www.webmd.com/mental-health/emdr-what-is-it 

What is EMDR Therapy?

Seasonal Affective Disorder (SAD), often referred to as seasonal depression, is a type of mood disorder that follows a seasonal pattern. It typically occurs during the fall and winter months when daylight hours decrease and sunlight exposure is limited but is not exclusive to the winter months. This condition can significantly impact an individual's mental well-being, leading to symptoms such as fatigue, irritability, difficulty concentrating, and changes in sleep patterns. Many people may experience symptoms of SAD and refer to the “winter blues” or experience significant changes in emotional experience, mood, and behavior patterns (NIMH, 2024).   
 Seasonal Affective Disorder is characterized by the onset of depressive symptoms that coincide with specific seasons, particularly fall and winter (Hopkins Medicine, 2024). It is considered a subtype of major depressive disorder with a seasonal pattern. The exact cause of SAD is not fully understood, but it is believed to be linked to changes in sunlight exposure affecting the body's internal clock, or circadian rhythm, and serotonin levels. The prevalence of Seasonal Affective Disorder varies depending on geographical location, with higher rates observed in northern latitudes where there is less sunlight during the winter months. According to research, millions of people experience Seasonal Affective Disorder each year, and it is often more common in women than men (NIMH, 2024). 
 Counseling has shown effectiveness in treating Seasonal Affective Disorder. Cognitive Behavioral Therapy focuses on identifying and changing negative thought patterns and behaviors associated with depressive symptoms. In the context of SAD, counseling can help individuals develop coping strategies, set realistic goals, and improve their overall mental well-being. 


 Seasonal Nature of Symptoms and Contributing Factors One key characteristic of SAD is the recurrence of symptoms during specific seasons. Individuals with SAD may experience depressive episodes during fall and winter, while their mood improves during spring and summer. Environmental triggers, such as overcast skies and limited sunlight, play a significant role in exacerbating SAD symptoms. The lack of natural light can disrupt the body's internal clock and negatively impact mood-regulating neurotransmitters.  Other triggers may include changes in temperature, reduced outdoor activities, and altered social rhythms. The symptoms often include low energy, persistent sadness, changes in sleep patterns, weight gain, and difficulty concentrating. Low Energy and Fatigue: Individuals with SAD often report feeling persistently tired and lacking in energy. This fatigue may make even simple tasks feel more challenging.
 Persistent Sadness and Low Mood: A predominant symptom of SAD is a persistent feeling of sadness or low mood. This emotional state may interfere with the ability to experience joy or pleasure in usual activities.
 Changes in Sleep Patterns: SAD can disrupt sleep patterns, leading to difficulties falling asleep or staying asleep. Some individuals may experience increased sleep duration, while others may face insomnia.
 Weight Changes: Changes in appetite and weight are common symptoms of SAD. Some individuals may experience increased cravings for carbohydrates and sugary foods, leading to weight gain during the fall and winter months.
 Difficulty Concentrating: Cognitive difficulties, such as trouble concentrating and making decisions, are common in individuals with SAD. This can impact work, school, and daily activities.
 Social Withdrawal: SAD may contribute to a desire to withdraw from social activities. Individuals may feel less motivated to engage with others, leading to social isolation.
 Irritability and Increased Sensitivity: Irritability and heightened sensitivity to stressors are additional symptoms of SAD. Small stressors that might not typically be bothersome can become more challenging to handle.
 Loss of Interest in Activities: Individuals with SAD may lose interest in activities they once enjoyed. Hobbies, social events, and other sources of pleasure may no longer bring the same satisfaction.
 Feelings of Hopelessness: Feelings of hopelessness and a pessimistic outlook on the future are emotional symptoms that can accompany Seasonal Affective Disorder.
 Physical Symptoms: Some individuals may experience physical symptoms such as headaches or stomach aches, which can be related to the overall impact of SAD on mental and physical well-being. 
 It's crucial to recognize these symptoms and seek professional help if they persist or significantly interfere with daily functioning. If you or someone you know is experiencing symptoms of Seasonal Affective Disorder, consulting with a mental health professional can provide guidance and support in managing and treating the condition. 
 Several factors contribute to the development of Seasonal Affective Disorder. Reduced exposure to sunlight can disrupt the body's internal clock and lead to imbalances in neurotransmitters such as serotonin and melatonin. Additionally, genetic factors, hormonal changes, and a history of other mood disorders can increase the susceptibility to SAD. 



 Benefits of Seeking Counseling for Seasonal Affective Disorder Counseling serves as an effective therapeutic approach by addressing both the emotional and behavioral aspects of SAD (Mayo Clinic, 2024). Here are some ways in which counseling can be beneficial for individuals with SAD: Identifying Negative Thought Patterns: Cognitive-behavioral therapy  focuses on identifying and challenging negative thought patterns that contribute to depressive symptoms. This can be especially relevant for individuals with SAD who may experience a shift in mood during the fall and winter months.
 Behavioral Activation: Counseling helps individuals develop strategies for behavioral activation, encouraging engagement in activities that bring a sense of pleasure and accomplishment. This is important for combating the tendency to withdraw from social and enjoyable activities, which can be common in SAD.
 Setting Realistic Goals: Therapists work with individuals to set realistic and achievable goals, considering the challenges posed by Seasonal Affective Disorder. Breaking down tasks into smaller, manageable steps can be empowering for individuals experiencing SAD symptoms.
 Developing Coping Strategies: Coping strategies are an integral part of counseling for SAD. Therapists assist individuals in developing effective coping mechanisms to deal with stressors related to seasonal changes, mood fluctuations, and the impact on daily functioning.
 Light Therapy Integration: In some cases, therapists may incorporate discussions and strategies related to light therapy, a common treatment for SAD. Counseling can help individuals adhere to light therapy routines and address any challenges or concerns related to its implementation.
 Improving Sleep Patterns: Given that disruptions in sleep patterns are common in individuals with SAD, counseling can address sleep hygiene and promote healthier sleep habits. This contributes to overall well-being and mood regulation.
 Exploring Root Causes: Counseling sessions provide a safe space for individuals to explore underlying issues or stressors contributing to their Seasonal Affective Disorder. Understanding these factors can be crucial for developing targeted interventions.
 Emotional Support and Validation: Counseling offers emotional support and validation for the individual's experiences. It provides a non-judgmental space for expressing feelings, fears, and challenges associated with SAD. 
 Counseling can contribute to improved mood, enhanced coping skills, and a better overall quality of life for individuals affected by SAD. If you or someone you know is experiencing symptoms of SAD, consulting with a mental health professional can provide personalized guidance and support. 
 Types of Therapy for Seasonal Affective Disorder  Cognitive-Behavioral Therapy (CBT) :  CBT is a widely recognized and effective form of counseling for Seasonal Affective Disorder. This therapeutic approach focuses on identifying and challenging negative thought patterns and behaviors associated with SAD. By restructuring cognitive patterns and implementing coping strategies, individuals can develop healthier perspectives and better manage symptoms. 

 Light Therapy and Counseling Integration:  Light therapy, a common treatment for SAD involving exposure to a bright light that mimics natural sunlight, can be complemented with counseling. Combining light therapy with counseling sessions allows individuals to explore the emotional and psychological aspects of their experience with a mental health professional, fostering a more holistic approach to treatment. 
 Neurofeedback Therapy :  Also known as EEG (electroencephalogram) biofeedback, Neurofeedback therapy is a therapeutic technique that involves real-time monitoring of brainwave activity to teach self-regulation of brain function. Some research and anecdotal evidence suggest that neurofeedback may have potential benefits for certain individuals with mood disorders (Hammond, 2016). 
 Interpersonal Therapy (IPT): IPT focuses on improving interpersonal relationships and communication patterns, making it particularly relevant for Seasonal Affective Disorder. Individuals may explore how the change in seasons affects their social interactions and relationships. IPT aims to enhance communication skills and address interpersonal issues contributing to SAD symptoms. 


 It's important to note that the choice of counseling for Seasonal Affective Disorder may vary based on individual preferences, the severity of symptoms, and the specific challenges faced. A mental health professional can tailor counseling approaches to meet the unique needs of each individual, providing valuable support and guidance in managing Seasonal Affective Disorder effectively. 



 In conclusion, Seasonal Affective Disorder is a significant mental health condition that affects individuals in a seasonal pattern, with symptoms typically worsening during fall and winter. Understanding the prevalence, contributing factors, and environmental triggers can help individuals recognize and address SAD. Seeking counseling, particularly cognitive-behavioral therapy, can be a valuable therapeutic approach, providing individuals with the tools and support needed to manage symptoms and improve their overall mental health. If you or someone you know is experiencing symptoms of Seasonal Affective Disorder, consider reaching out to Heritage Counseling and Consulting at 214-363-2345 to work with a qualified mental health professional. We are proud to offer high-quality and effective counseling and Neurofeedback interventions.   






 Sources:  https://www.nimh.nih.gov/health/publications/seasonal-affective-disorder https://www.mayoclinic.org/diseases-conditions/seasonal-affective-disorder/diagnosis-treatment/drc-20364722 https://www.isnr-jnt.org/article/view/16553  (Hammond, 2016) https://www.hopkinsmedicine.org/health/conditions-and-diseases/seasonal-affective-disorder   




Counseling Options for Seasonal Affective Disorder

Neurofeedback therapy has become a more popular treatment option for many different mental illnesses, but there are still questions surrounding this therapeutic approach. We sat down with our Director of Neurofeedback, Betsy Ezell, M.A., LPC, BCN to discuss Neurofeedback, including what sessions look like, who might benefit from it, and more.  



 Q: What is Neurofeedback Therapy?  A: Neurofeedback is a type of brain training. It’s non-invasive, painless, and has very little risk associated with it. How it works: Initially, we complete an assessment called a qEEG Brain Map. Using sensors placed on the scalp we record brain waves (also known as electroencephalogram). Using the brain wave information in the EEG, we can identify areas of the brain and the brain wave resources that may be over or under-utilized and how that contributes to functioning. Once we have this information, we know specifically which areas of the brain we want to train and which brain waves we want to target for each individual.  


 Q: What does a session look like? 
 A: Neurofeedback sessions are scheduled twice a week for 30-minute appointments. During training sessions, a neurofeedback provider will place sensors on the client’s head, according to the protocol created after the qEEG. The client will elect an engaging TV show or a game of their choice. During the session, clients will receive visual and auditory feedback as the brain works to meet thresholds, set in the neurofeedback software designed to regulate brain wave functioning.  


 Q: Who would benefit from doing Neurofeedback? A: Neurofeedback’s most robust body of research is indicated for focus and attention difficulty (ADHD), mood and anxiety disorders, post-traumatic stress disorder (PTSD), sleep quality enhancement, substance use/abuse, head injury recovery,  and athletic/peak performance as well as for cognitive clarity/performance. We’re also seeing the research body grow for Neurofeedback’s efficacy with Autism Spectrum Disorders.  


 Q: Is it safe and are there any side effects?  A: On the spectrum of neuromodulation interventions, Neurofeedback, when performed ethically and by a board-certified provider, is considered one of the safest and least invasive neuromodulation interventions. A large portion of the literature reviewing side effects of Neurofeedback commonly identifies mild drowsiness and fatigue after a training session as possible symptoms. These symptoms typically are present if the targeted brain wave frequency range is too high or low. Neurofeedback providers work directly with clients to identify the exact individualized frequency range for each client, and the aforementioned negative symptoms are easily mitigated.  




 Neurofeedback therapy can be a great therapeutic approach to a variety of mental health struggles. If you are interested in learning more about Neurofeedback therapy, please reach out to Heritage Counseling at 214-363-2345. We offer Neurofeedback at our Dallas, Plano, and Austin offices, and our administrative team will be happy to help connect you with the right Neurofeedback technician.  

Neurofeedback Therapy Q & A with Betsy Ezell, M.A., LPC, BCN

Betsy is a Licensed Professional Counselor in Texas and Colorado. Betsy joined Heritage in 2021 and serves as the director of Neurofeedback Services and as a clinical counselor. She is experienced in providing clinical services to a broad range of clients in various settings: residential care, private practice, and community mental health. Betsy is proficient in tailoring her therapeutic approach to the needs of her clients. She is passionate about brain health and supporting clients to achieve optimum mental health. Her areas of clinical focus include: anxiety, depression, ADHD, PTSD, and trauma work.