Infra-Low Frequency (ILF) Neurofeedback
About This Program
Target Population: Adults who have been traumatized and adults suffering from PTSD or symptoms of PTSD
Program Overview
ILF Neurofeedback is a noninvasive form of brain training that is designed to help clients of all ages improve self-regulation of emotional, behavioral, and physical functioning and manage stress more effectively. ILF Neurofeedback targets extremely low frequencies in foundational neural networks. In addition to having experienced trauma, ILF Neurofeedback can be used with clients with high ACE scores, numerous psychosocial stressors, and multiple co-occurring challenges.
A model of online training and clinical support was developed to ensure clinical quality and client safety and an online, HIPAA-compliant Results Tracking System (RTS).
Infra-Low Frequency (ILF) Neurofeedback has been used with populations other than adults and for conditions other than trauma, but the CEBC has not reviewed it for these populations or conditions.
Program Goals
The goals of Infra-Low Frequency (ILF) Neurofeedback are:
- Decrease PTSD symptoms
- Reduce suicidal ideations
- Increase the ability to overcome addictions
- Reduce anxiety, depression, and intrusive thoughts
- Reduce emotional regulation (e.g., fewer angry outbursts and improved emotional control)
- Improve coping with stress
- Improve executive functions such as decision-making, impulse control, and planning
- Improve relationships with family members
- Reduce psychiatric emergency room visits and hospitalizations
Logic Model
The program representative did not provide information about a Logic Model for Infra-Low Frequency (ILF) Neurofeedback.
Essential Components
The essential components of Infra-Low Frequency (ILF) Neurofeedback include:
- Neurofeedback:
- Form of brain training to improve functioning
- Safe, noninvasive and nonverbal approach
- Engages the brain’s own mechanisms of self-regulation
- Infra-Low Frequency (ILF) Neurofeedback:
- Type of neurofeedback that focuses on both higher frequency brain waves, as well as extremely low frequency brain waves
- Not about learning to relax
- Client instructed not to try and do anything beyond attending to the process
- Does not suppress normal emotions, energy, or creativity
- Designed to open possibilities for clients who are otherwise unable to reach their potential
- Designed for use when the brain is stuck in hypervigilance, hyperexcitability, and/or dysregulation
- Can be integrated with talk therapy if desired
- Initial Evaluation:
- Initial discussions include a comprehensive evaluation of the client's neurological and psychological status by reviewing the client’s:
- History of brain injuries
- Trauma history
- Mental health symptom issues, and medications
- Client completes a cognitive assessment, often using a computerized Continuous Performance Test (CPT) to measure the client’s ability to maintain focus and resist impulsive responses
- Protocols for the client (i.e., the target areas of the brain to address based on the client’s history and symptoms) determined based on the symptom issues and the client history
- ILF Neurofeedback Session:
- Starts with placing four to five EEG sensors on the scalp to pick up brain wave activity that controls the feedback on the screen
- Clients watch a video or play a video game that provides the brain with feedback on its performance, such as:
- In the video game, a race car might speed up and slow down
- When watching a movie, the picture gets bigger and smaller
- Clients can also hold a stuffed animal that is designed to vibrate as part of the feedback process.
- Finding the “optimal training frequency”:
- Training frequency shifted by the provider during the session
- Particular frequencies cause a combined relaxation + alertness response
- No single “good” training frequency
- Very person-specific - One might view it as analogous to their being themselves on a good day.
- The ILF Neurofeedback training is most productive and efficient at this frequency.
- ILF Neurofeedback is aimed at helping the brain achieve a state of self-regulation and improve specific cognitive or emotional states, such as anxiety, attention, or trauma processing.
Program Delivery
Adult Services
Infra-Low Frequency (ILF) Neurofeedback directly provides services to adults (regardless of whether they are parents or caregivers) and addresses the following:
- PTSD, traumatic experiences, difficulty in concentrating, flashbacks, impulsiveness, irritability, intrusive memories, reckless behavior, stress, traumatic nightmares, trouble sleeping, addictions, anger, anxiety, depression, suicidal ideations
Recommended Intensity:
One to three weekly 50-minute sessions for a total of 20+ sessions.
Recommended Duration:
3 – 6+ months
Delivery Settings
This program is typically conducted in a(n):
- Outpatient Clinic
- Community-based Agency / Organization / Provider
Homework
This program does not include a homework component.
Languages
Infra-Low Frequency (ILF) Neurofeedback has materials available in a language other than English:
Spanish
For information on which materials are available in this language, please check on the program's website or contact the program representative (contact information is listed at the bottom of this page).
Resources Needed to Run Program
The typical resources for implementing the program are:
ILF Neurofeedback therapist and ILF Neurofeedback equipment, which includes a computer and software
Manuals and Training
Prerequisite/Minimum Provider Qualifications
Approximately 40 hours of training on ILF Neurofeedback for individuals with a bachelor’s degree in psychology, medicine, nursing (including two-year registered nurses with license, not LVNs or LPNs), physical therapy, occupational therapy, social work, counseling, marriage family therapy, rehabilitation, chiropractic, recreational therapy, physician's assistant (with certification or license), exercise physiology, speech pathology, and sports medicine.
Manual Information
There is not a manual that describes how to deliver this program.
Training Information
There is training available for this program.
Training Contacts:
- Roxana Sasu, MD (Romania), RN
www.neurofeedbackadvocacyproject.com/training-registration
Roxana@NeurofeedbackAdvocacyProject.org
phone: (818) 620-2655 - Maria Perez-Huff
www.neurofeedbackadvocacyproject.com/training-registration
maria@neurofeedbackadvocacyproject.org
phone: (713) 498-8626
Training Type/Location:
Training is delivered virtually and includes practicum starting in the first of two 2.5-day training sessions with all necessary equipment and software provided to various sites where therapists are training.
Number of days/hours:
Training is delivered in two 2.5-day sessions over 3 weeks for a total of 40 hours of training.
Implementation Information
Pre-Implementation Materials
There are pre-implementation materials to measure organizational or provider readiness for Infra-Low Frequency (ILF) Neurofeedback as listed below:
All potential trainees are met with as part of the onboarding process.
Formal Support for Implementation
There is formal support available for implementation of Infra-Low Frequency (ILF) Neurofeedback as listed below:
There are bi-weekly consultation meetings.
Fidelity Measures
There are fidelity measures for Infra-Low Frequency (ILF) Neurofeedback as listed below:
The Results Tracking System (RTS) developed in-house records every session and results are tracked. This HIPAA-compliant platform is shared at all consultation meetings.
Fidelity Measure Requirements:
Fidelity measures are required to be used as part of program implementation.
Established Psychometrics:
Fleischman, M. J. (2022). Documenting the impact of Infra Low-Frequency Neurofeedback on underserved populations with complex clinical presentations. Frontiers in Human Neuroscience, 16, Article 921491. https://doi.org/10.3389/fnhum.2022.921491
Implementation Guides or Manuals
There are implementation guides or manuals for Infra-Low Frequency (ILF) Neurofeedback as listed below:
There are checklists for implementation and formal agreements for both the agency and the Neurofeedback Advocacy Project.
Implementation Cost
There have been studies of the costs of implementing Infra-Low Frequency (ILF) Neurofeedback which are listed below:
Doe, C. T., & Fleischman, M. (2023, July). The potential of Infra-Low Frequency Neurofeedback to reduce medical claim costs and dramatically improve patients’ lives. Health Watch. https://www.soa.org/sections/health/health-newsletter/2023/july/hw-2023-07-doe/
Research on How to Implement the Program
Research has been conducted on how to implement Infra-Low Frequency (ILF) Neurofeedback as listed below:
Fleischman, M. J. (2022). Documenting the impact of Infra Low-Frequency Neurofeedback on underserved populations with complex clinical presentations. Frontiers in Human Neuroscience, 16, Article 921491. https://doi.org/10.3389/fnhum.2022.921491
Relevant Published, Peer-Reviewed Research
Child Welfare Outcome: Child/Family Well-Being
Winkeler, A., Winkeler, M., & Imgart, H. (2022) Infra-low Frequency Neurofeedback in the treatment of patients with chronic eating disorder and comorbid post-traumatic stress disorder. Frontiers in Human Neuroscience, 16, Article 890682. https://doi.org/10.3389/fnhum.2022.890682
Type of Study:
Randomized controlled trial
Number of Participants:
36
Population:
- Age — Mean=28.36 years
- Race/Ethnicity — Not specified
- Gender — Not specified
- Status — Participants were patients suffering from an eating disorder (anorexia nervosa, bulimia nervosa, or binge eating disorder) and comorbid posttraumatic stress disorder.
Location/Institution: Not specified
Summary:
(To include basic study design, measures, results, and notable limitations)
The purpose of the study was to evaluate to what extent adding Infra-Low Frequency Neurofeedback (ILF Neurofeedback) could improve symptom reduction within an established inpatient treatment program. Participants were randomized to either ILF Neurofeedback in addition to regular therapy or a “media-supported relaxation” placebo intervention in addition to regular therapy. Measures utilized include the Body Mass Index (BMI), Eating Disorder Examination-Questionnaire (EDE-Q), Impact of Event Scale-Revised (IES-R), and study-developed questionnaires. Results indicate that there were better treatment outcomes in the ILF Neurofeedback group with regards to trauma-associated avoidance as well as with regards to restraint eating and increase in body weight. Furthermore, patients who had received ILF Neurofeedback rated the intervention they received and, in tendency, their overall treatment more positively, and they experienced fewer complications in the course of treatment. Limitations include a lack of homogeneity within the examined sample with regards to the eating disorder (ED) diagnoses and the associated BMI distribution between the groups and lack of follow-up.
Length of controlled postintervention follow-up: None.
Additional References
Fleischman, M. J. (2022). Documenting the impact of Infra Low-Frequency Neurofeedback on underserved populations with complex clinical presentations. Frontiers in Human Neuroscience, 16, Article 921491. https://doi.org/10.3389/fnhum.2022.921491
Society of Actuaries. (2024, March 4). Neurofeedback: A potential game changer for mental healthcare? [Podcast]. https://soapodcasts.libsyn.com/webpage/health-section-neurofeedback-a-potential-game-changer-for-mental-healthcare
Trauma Research Foundation. (2022, April 8). Neurofeedback for agencies serving the underserved [Blog]. https://traumaresearchfoundation.org/neurofeedback-for-agencies-serving-the-underserved/
Contact Information
- Christy Johnson, QMHP
- Agency/Affiliation: Neurofeedback Advocacy Project
- Website: www.neurofeedbackadvocacyproject.com
- Email: christy@neurofeedbackadvocacyproject.org
- Phone: (541) 554-7812
- Colette Melancon, LCSW
- Agency/Affiliation: Neurofeedback Advocacy Project
- Website: www.neurofeedbackadvocacyproject.com
- Email: colette@neurofeedbackadvocacyproject.org
- Phone: (985) 327-5427
Date Research Evidence Last Reviewed by CEBC: March 2025
Date Program Content Last Reviewed by Program Staff: November 2024
Date Program Originally Loaded onto CEBC: August 2025