An internship in neurofeedback treatment of trauma involved several components over 100 hours. The intern established a brain training pamphlet and parent support group. Reviews and internship goals were completed. Research on brain training treatments was compiled. Training in a brainwave software program was undertaken. Records and other documentation like a procedures and intake manual were established. The lab space was also organized. The internship utilized an integrative approach including neurofeedback, counseling, psychoeducation and skills training to address trauma's effects on cognition, behavior and physiology from a multimodal perspective.

1. Post-Trauma /
Biopsychological
Treatment Plan
Neurofeedback in the Treatment of
our modern-day communities:
An Integrative Approach to Long-
Term Neuropsychological control.
Counseling, optimization and
problem-solving using brain-training.
University of West Alabama
Counseling 509-91
Jacob R. Stotler
Dr. Hayes
June 21, 2020

2. Agenda:
GRANTS
CLIENTS
INTERESTS
ADVERTISEMENT
FUNDING
SALES
RELATIONSHIPS
LEADS
ESTABLISHMENTS
GOALS
DEADLINES
TIMELINES
WORKLOAD
TRADE – Direct Counseling for all establishments possible.

3. Available Plans:
Math – 8 month
July 1, 2020 –February 20, 2020
33 Weeks
~20 hours per week.
8/week Direct hours.
Math – 9 months
July 1, 2020 –March 1, 2020
35 Weeks
~17 hours per week.
~7/week Direct-hour.
Math – 4 months
July 1, 2020 –February 20, 2020
16 Weeks
~38 hours per week.
15/week Direct-hour
Math – 6 months
July 1, 2020 –December 1, 2020
23 Weeks
~27 hours per week.
10/week Direct hours.

4. Agenda:
• Feedback about Practicum - Weakness awareness.
• Feedback and goals for Internship -Strength building. Goals and vision for caseload (expectations of the intern).
• Presentation from Lab to clinic - Treatment options, Program functions, vision for caseload, Clients that we have
pinpointed can be assisted in the Lab (expectations of the Lab).
• Building a schedule - Views, insight and plan for building a schedule for intern. Hours per week (about 20-25 hours per
week [for 30 weeks] is possible); supervisory goals for this period and for case/work load. Do we have purpose and
expectations to properly establish a paid internship?
• Plan for supervisory meetings - Supervisory input, scheduling plans made, all information relevant to beginning internship
this day and finishing the day at all requirements are fulfilled/all people are fulfilled.
• Closing - any ideas that Administration/management wants or must leave in me or any issues or plans that we must
confront.

5. Agenda:
Treatment options.
Phenomenological and Person-centered therapy (as a means for clinical investigation and biological vs. clinical counseling or education).
Proposed Theoretical orientation
Brain training.
Executive Rx.
Case load.
Type of clients typically served.
Sports/purpose.
Referrals and clients; offering services.
Expectations for business the next one year.
Expectations for intern the next one year.
Group therapy.
Support Groups.
Educational panels on brain training/Grand opening.
Staff trainings.
Mobile brain trainings.
Muse headband
Brain analysis Q-EEG and mobility analysis

6. Neurofeedback
Games
Strategy
Learn about
individual Brain
Component/
Deficit specific
Change Behaviors/
Thoughts
Desensitization
Hierarchy of
Threshold
Exposure therapy
In-vivo Flooding
Self-management
Therapy
Systematic
Desensitization
Stress-Reduction
Learn
mindfulness
Techniques
Relaxation Techniques
Spike in waveform
Avoidance
Progressive Muscle
Relaxation
Techniques
Practice
Areas of
Symptomology
Work on weaknesses
Performing
transitions
/coping
Feedback loop/
Gain strategies
Brain Training
Theta to Alpha/Beta
Training
Connectivity
Synchronization
Awareness of activity /
reactivity
Recognize
Hypervigilance
Hyperreactivity
Psychological
Testing
TQ / Q-EEG
Assessment
Clinical written reports
about brain activity
Beginning
Middle
After treatment
Test / Investigate deficits
Skills Training
Use Test
results as guide
Sensitization
Calibrate brain
constellations
Gain Awareness
Sensitize efforts
neuropsychology
Increase speed
Increase Skills
Learn input to
feedback ratios
Skills Training /
Spec. Area training
Work on all areas in
deficit
Correct connectivity
and synchronization
Learn Timing
Gain abilities
Discover strengths
Gain control
Learn new /
needed
skills
Change Awareness
Gain awareness of
own brain
Discover feeling to
movement
Learn awareness in
counseling
Apply new
knowledge to
feedback process
Learn new skills
Learn about abilities
Use feedback as
guide
Recovery Training
Investigate Reponses
to stimuli or triggers
Desensitize to
triggers / memories
Gain awareness of
spikes and reactions
Learn strategies to recover
thoughts, feelings, behaviors
Learn new balance
Gain control and
gain speed in
recovery efforts
Learn better
associations,
networks
connectivity
Connectivity
Training
Reconnect /
connect
areas in deficit
Notice connections
psychology and
neurology
Association training
Skills training
Skills application
Learn timing
Associate
areas thoughts feelings
behaviors energy effort
Elements and possible applications of the Neurofeedback (neurological brain
activity) and supplemental Biofeedback (physiological vital signs)applications:
Neurofeedback options:

7. Neurofeedback in the Treatment of Trauma Post-Trauma :
Neurofeedback
Neurofeedback(Behavioral): Building Syncretism of
Neurofeedback based treatment for Trauma.
Client is connected to device(s), uses feedback and exercise processes to accomplish [uses
EEG program/components and Vital sign monitoring devices]:
Learns/excercises “stress reduction interventions/strategies for reducing stress (seen as
decreasing high-frequency bands GAMMA waves [30-47Hz] and increasing intermediate bands
ALPHA/BETA [11-20 Hz] (Biofeedbacknews, 2013).
Watch and use feedback process to gain control over Vital signs: be able to notice when vital
signs are abnormal and thus apply stress reduction techniques or psychological/network
alterations.
Neurofeedback:
Stress strategies
Connectivity
Skills Training
&
Desensitization
Different sites on the brain can be the focus of neurofeedback, especially regarding trauma (and
according to the client’s health/conditions) as trauma affects memory, critical thinking, executive
functioning, network associations, sensory-motor functions, attention, stress, the visual cortex, the
amygdala and other parts of the brain and body (Warner, 2013).

8. Neurofeedback in the Treatment of Trauma Post-Trauma :
Person Centered/Phenomenological
Person Centered: Building Syncretism of Neurofeedback
based treatment for Trauma.
Client is in counseling before and after Neurofeedback and during treatment plan, and during
treatment.
• Client/Clinician approaches of client is expert (in counseling, in training) and clinician is
expert (in training).
• Investigate and discuss therapeutic issues regarding psychology, neurology and subjective
reality of client.
• Refashion old emotions.
• Gain awareness, acceptance, understanding for use in neurofeedback and in “real world”
(Corey, 2017).
Person Centered /
Phenomenological
Subjective reality of client
Refashioning emotions
Awareness, Acceptance,
Understanding

9. Neurofeedback in the Treatment of Trauma Post-Trauma :
Multimodal/Integrative
Counseling
CBT, Behavioral, Person
Cetnered approach
Gain awareness of
problems
Get to know the client.
Assess, process, moniter
Neurofeedback
Brain-body reaction,
awareness of
symptomology, Goal-
setting, Program
[Interview]
Counseling
Psychoeducation
Neurofeedback
Counseling
Homework
Counseling
Psychoeducation
ID emotions, Learn
reactions, Techniques,
Thoughts and action
connects (power),
Counseling
Person Centered, CBT
Behavioral
Monitor homework,
discuss progress, discuss
condition and present
health.
Assess health ongoing.
Assess, process, monitor
Homework
Monitor symptomology,
record difficult circumstances
Notate skills and problems
struggling with. Notate
emotions, thoughts, feelings,
progress, declination.
Awareness, Acceptance,
Understanding
Assess, Process, monitor

10. Clinical and Health Assessment tools.
Forms
Evaluations
Previous history
Risk factors
Screening Tools
Assessments and screenings
Cutting scores
Medical issues/complications that prevent one
from neurofeedback -

12. Neurofeedback in the Treatment of Trauma Post-Trauma:
An Integrative Approach to Long-Term Neuropsychological
Control
• A trauma situation can cause [a long term]:
• Change or disturbance to an individual biologically, psychologically, socially, developmentally, behaviorally.
• Acute situational maladjustment.
• Personality disturbance.
• Reactivity.
• PTSD.
• Acute-traumatic stress disorder.
• Anxiety.
• Stress.
• Maladaptation.
• Interrupt developmental processes.
• Distortions to [critical] thinking.
• Dissociation.
• Repression.
• Issues with autonomy.
• Hallucinations.
• Hysteria.
• Memory problems (Levers, 2012; American Psychiatric Association, 2013).

13. Neurofeedback in the Treatment of:
Bruxism
Insomnia
Restless sleep
Poor handwriting
Fidgetiness
Impulsivity
Distractibility
Motor coordination
Hormones
Endocrine
Circadian rhythms

14. Neurofeedback in the Treatment of:
Sensorimotor
Rigidity
Obsessiveness
Anxiety
Processing
Sensitivity of sensory related attention issues
Sleep disturbances
Headaches
Light and visual stimuli issues (photophobia)

15. Neurofeedback in the Treatment of:
Autism scale related
Communication
Social integration

16. Neurofeedback in the Treatment of:
OCD
Sensorimotor processing
ADHD
Hyperactivity
Integrated in counseling goals

17. Neurofeedback in the Treatment of:
Mood and Performance issues.

18. Neurofeedback in the Treatment of:
ADHD
Chattering brain
Hypoactive brain (hyperactivity)
Problematic sleep
OCD

21. • Occipital Alpha is the dominant rhythm in relaxed wakefulness in 85% of healthy adults with closed eyes.
• 85% of adults have a resting Alpha rhythm between 9.5-10.5 Hz.
• Some people have Alpha variants (slower or faster) that are generally considered normal if localized to the
occipitals & attenuating (diminishing) with eye opening.
• (8–13 Hz) Mu u Rhythm (usually localized to C3 / C4 in scalp recorded EEG is considered an Alpha-like Rhythm &
reflects motor system activation. (Also relevant to SMR and ability to turn SMR “on and off.”’
• Some individuals have an Alpha asymmetry over non-dominant hemisphere up to 50% greater and this is
considered normal.
• Alpha activity generally attenuates (diminishes) with eye opening, mental activity,
Neurofeedback

22. Neurofeedback
• A: Centro parietal lobe.
• B. Central cortez / “midline"
• C. Posterior cingulate cortex
• D. Anterior cingulate cortex.
• Cz, Fz, Oz, Pz,
• (Cz, C4, C6, CP6, and FT8 electrodes)

23. Neurofeedback in the Treatment of:
Purpose of Neurofeedback: to gain control, reinforce changes (Braintrainer, 2020).
For each component or EEG site, we can assist the client with excercises, skills training,
and make these elements the purpose of a specific Neurofeedback training/trial(s).
We know a great deal about training with Neurofeedback and about the neuroscience
that will support our endevours.
A few examples of what we know we can do now:

24. Neurofeedback and Neurotherapy (Swingle’s input)
Pain is exemplified by Elevated delta in frontal regions and then towards the
back of the brain.
Elevated Delta is associated with elevated Theta – Train Theta brings down Delta
[Theta Training].
Slow Hz Alpha divided by fast wave Hz Alpha = Alpha ratio.
Training: feedback occurs if e.g. Alpha frequency is out of range – this guides the
person to manipulate the frequency band.

25. Neurofeedback and Neurotherapy
Pain is exemplified by Elevated delta in frontal regions and then towards the
back of the brain.
Elevated Delta is associated with elevated Theta – Train Theta brings down Delta
[Theta Training].
Slow Hz Alpha divided by fast wave Hz Alpha = Alpha ratio.
Training: feedback occurs if e.g. Alpha frequency is out of range – this guides the
person to manipulate the frequency band.

26. Peak Frequency
Alpha as a % - want to increase %
Alpha at 10 hz as a % want to increase
Non-Alpha frequencies – want to decrease
We want alpha to stay between 9.5 and 10.5 Hz at peak
frequencies.
We can analyze 0-13 Hz.
Current Peak Freq.
Average Peak Freq
% of time between the target area.
How well client is in control.

27. Alpha
Beta – or both.
One threshold – All eeg
Goal – to stay below a certain target
How is Beta threshold number – relevant to target?
How is Alpha threshold number – relevant to targets

28. High Beta inhibits this.
0-25% synchrony –
Synchronization?
Ask Pete.

29. Not clear ask Pete about this protocol and take good notes.
Video in training is cut off.
Training using time.
• 100% = brain regions in synchrony (LISTED IN
PROTOCLAS OF Q-EEG).
• 0% = No synchrony.
• Relationship between 2 different sites.

30. Ask Pete
Uses Bars and graphs
All-band coherence
Raw EEG
High-bands
Low-bands
Hz – coherence –
14-16
18-20
22-24
28-30

31. Not clear ask Pete about this protocol and take good notes.
Video in training is cut off.

32. Not clear ask Pete about this protocol and take good notes.
Video in training is cut off.
Ask for training about this – NO training from
videographs in training!

33. • Alpha theta brain waves training has been researched in the areas of therapy,
peak performance, creativity, and personal development.
• Elmer and Alyce Green of the Meninger Foundation pioneered the first
neurofeedback studies, inspired by Japanese research on Zen monks,
reported in Zoren Psychologia 12:205-225 1969.
• They used healthy subjects and taught one group (with neurofeedback) to
mimic the Zen monks (who during meditation were able to systematically
increase alpha {8-12hz} that reduced in frequency until it sank into theta {4-
8hz}), while a control group just tried to relax.
Thomas Budzynski, found that theta states made subjects ‘hyper-suggestable’ (as if
in a hypnotic trance) to suggestions for positive changes to their behavior and
attitudes and they were able to learn languages and other information much faster.
http://yourbraintraining.com/alpha-theta-brain-waves.html
Neurofeedback in the Treatment of Trauma Post-Trauma:
An Integrative Approach to Long-Term Neuropsychological
Control

34. What we have done in Internship/100 hours:
:

37. Neurofeedback in the Treatment of Trauma Post-Trauma :
Multimodal/Integrative
The use of Neurofeedback in clinical treatment and counseling
applied for the treatment of trauma is integrative.
The approach and theoretical orientation:
• Eclectic.
• Integrative Perspective.
• Syncretism. (Where common factors/useful and synchronized factors are
used that are chosen across theoretical orientations).

38. Neurofeedback in the Treatment of Trauma Post-Trauma :
Multimodal/Integrative
The approach and theoretical orientation:
Behavioral
Cognitive Behavioral
Skills Training
Psychoeducation
Person Centered counseling/phenomenological (awareness, acceptance,
understanding).

39. Neurofeedback in the Treatment of Trauma Post-Trauma :
Psychoeducation
Purpose of Neurofeedback: to gain control, reinforce changes
(Braintrainer, 2020).
CONTROL
(American Psychiatric
Association, 2013)
Dissociation
Sensitization
Avoidance
Brain states/
Excitability
Hyperattention
Recurrent
Feelings
Connectivity
Network
Triggers
Hypervigilance
Memory
Attention
For each component
we can assist the client
with excercises, skills
training, and make
these elements the
purpose of a specific
Neurofeedback
training/trial(s).
These components can
work both as
psychological tests, as
well as seed stimulus
and “center of gravity”
excercises to gain
control on the EEG
signal.

40. What we have done in Internship/100 hours:
:

41. What we have done in Internship/100 hours:
:

42. What we have done in Internship/100 hours:
:1. We met on February 3, 2020!
2. I became trained in Braintrainer by 6 weeks in.
3. Established a brain-train pamphlet.
4. Established, advertised and designed a Covid-19 parent support group.
5. Finished 3 JACOB STOTLER Reviews.
6. Finished Goals for Internship.
7. Conglomerated research on brain trainings to support treatment.
8. Video of depressive disorder and manic depressive disorder –
9. https://www.youtube.com/watch?v=PBxw8hwV4H4
10. https://www.youtube.com/watch?v=s6pF6mIAUow
11. Fulfilled TEVERA records (several times).
12. Established P&I.
13. Established Lab.

43. What we have done in Internship/100 hours:
:14. Established relationships.
15. Established Pilot trials and videographs with Mr. P and Kerry (Available).
16. Derived lessons and implicit applications from this.
17. Downloaded newest versions of braintrainer.
18. Established HEG protocols.
19. Innovated manuals for running HEG.
20. Innovated manuals for running EEG.
21. Connected Brain-computer interface HEG and EEG in the laboratory for client use. (Shadowing and protocols).
22. Met with Pete and established meeting and training for 1.5 hours(videographed/available).
23. Met in weekly meetings for 16 weeks!
24. Survived 1st form of Covid-19.
25. Established a working invitation to accumulate 112 hours! 40 Direct contact in brain lab and in session!
26. Did 4 intakes, two weeks worth of brain training with P.
27. Ordered new materials for lab.
28. Designed posters for lab.
29. Familiarized with TQ-7
30. Paved path for Q-EEG assessments. Able to do in 25 minutes.

44. What we have done in Internship/100 hours:
:31. Made training manuals and will 3-ring binder – manuals and training guides for clinicians for the brain trainings.
32. Researched and became familiar with the IM system.
33. Did two write-ups on “ET.”
34. One write-up on “A. and Clayt.”
35.

45. University of West Alabama
Counseling 509-91
Jacob R. Stotler
Dr. Hayes
June 21, 2020

46. Neurofeedback Assessment,
fitness, treatment
An Integrative Approach to
Long-Term Neuropsychological
control.
University of West Alabama
Counseling 509-91
Jacob R. Stotler
Dr. Hayes
June 21, 2020

47. References
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). ISBN: 978-0-89042-554-1.
American Psychological Association. (2009). Different approaches to psychotherapy. Retrieved June 21, 2020 from
https://www.apa.org/topics/therapy/psychotherapy-approaches.
Braintrainer. (2020). Braintrainer for BioEra software. [Online resource]. Retrieved June 21, 2020 from https://brain-trainer.com/courses/brain-trainer-for-
bioera/lessons/brain-trainer-bal4c-rh-protocol/.
Biofeedbacknews. (2013). How does neurofeedback session work? An ADHD treatment as example. [Youtube.com video]. Retrieved June 21, 2020 from
https://www.youtube.com/watch?v=H276cfkL5Lo&t=2s.
Dunham, M., Burder, A., Hileman, B., Chance, E., Hutchinson, A., Kohli, C., DeNiro, L., Tall, J. & Likso, P. (2019). Brainwave self-regulation during Bispectral
IndexTM neurofeedback in trauma center nurses and physicians after receiving mindfulness instructions. Frontiers in psychology 10, 1-14. doi:
10.3389/fpsyg.2019.02153.
Etkin, A., Maron-Katx, A., Wu, W., Fonzo, G., Huemer, J., Vertes, P., … O’Hara, R. (2020).Using fMRI connectivity to define a treatment-resistant form of post-
traumatic stress disorder. Sci Transi Med 11(4868). Retrieved June 21, 2020 from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6980337/.

48. References
Levers, L. (2012). Trauma Counseling: Theories and interventions. Springer Publishing. ISBN: 978-0-8261-0683-4
Mayo Clinic. (2020). Biofeedback. [Online resource]. Retrieved June 21, 2020 from https://www.mayoclinic.org/tests-procedures/biofeedback/about/pac-20384664 .
Psychology & Psychiatry Journal. (2019). Psychology and Psychiatry Journal Atlanta 340, 1.
Rosenthal, H. (2008). Encyclopedia of counseling ed. 3. Routeledge Tailor & Francis Group. ISBN-13:978-0-145-95862-2.
Sandham, J. (2020). EBME & clinical engineering articles. Bispectral index (BIS) monitoring. Retrieved June 21, 2020 from
https://www.ebme.co.uk/articles/clinical-engineering/bispectral-index-bis-monitoring.
Swingle, P. (2015). Adding neurotherapy to your practice. Clinician’s guide to the clinicalQ, neurofeedback, and brain-driving. Springer. ISBN: 978-3-319-15526-5.
Warner, S. (2013). Cheat Sheet for Neurofeedback. [Online resource]. Retrieved June 21, 2020 from
http://www.stresstherapysolutions.com/uploads/STSCheatSheetoftheBrain.pdf.
https://www.nature.com/articles/s41598-020-62525-7