Overview & Efficacy: Several small controlled studies and several moderate size clinical studies have shown that a variety of behavioral interventions centering on biofeedback / neurofeedback therapy can relieve depression related to alcohol abuse and can lead to control of alcohol / substance / drug abuse for at least five years.

This therapy is rated as probably efficacious (level 3 on a scale of 1 - 5 with 5 being the best).

Why biofeedback would help this problem: Numerous studies have shown that most people having drug / alcohol /substance abuse problems are depressed, have very poor self-images, and also do not think they have control over their bodies or what happens to them. Biofeedback can help these problems. Other studies have shown that people who have alcohol abuse problems produce different patterns of brain waves than do people who do not have these problems. Training using neurofeedback (brain wave biofeedback) techniques can result in the abnormal patterns becoming normal. Thus, the problem should be controlled to the extent the brain waves become and remain normal.

Brief summary of evidence supporting the efficacy of biofeedback for Alcoholism and Substance/Drug Abuse

Yucha and Gilbert (2004) state that researchers have used both biofeedback assisted relaxation training and neurofeedback (alpha-theta brainwave feedback) to deal with alcoholism and its accompanying symptoms (e.g., depression). In comparison to a control group, thermal biofeedback increased drinking related locus of control in a study of adolescent alcoholics (Sharp, Hurford, Allison, Sparks, Cameron, 1997). Alpha-theta brainwave training was accompanied by significant decreases in certain factors measured using the Millon Clinical Multiaxial Inventory (schizoid, avoidant, passive-aggression, schizotypal, borderline, paranoid, anxiety, somatoform, dysthymia, alcohol abuse, psychotic thinking, psychotic depression and psychotic delusional) in comparison to those receiving traditional medical treatment (Peniston Kulkosky, 1990). Taub and his colleagues (1994) studied 118 chronic alcoholics randomly assigned to 1 of 4 treatment conditions: 1) routine treatment of Alcoholics Anonymous and counseling (RTT), 2) RTT plus transcendental meditation, 3) RTT plus EMG biofeedback, and 4) RTT plus neurotherapy. Self-report of abstinence for the four groups were 25%, 65%, 55%, and 28%, respectively. This study suggests that the addition of meditation or EMG biofeedback enhances RTT, while neurotherapy does not.

A number of case studies and uncontrolled studies show benefit of neurofeedback for treating alcoholic depression (Kumano et al., 1996; Waldkoetter Sanders, 1997). A few controlled neurofeedback studies (Peniston Kulkosky, 1989; Saxby Peniston, 1995) provided further evidence for this reduction in depression and reported sustained prevention of relapse at 21-month follow-up in alcoholics who had completed the training (Saxby Peniston, 1995).

* Much of the information provided here is from Carolyn Yucha and Christopher Gilbert's 2004 book "Evidence Based Practice in Biofeedback Neurofeedback" AAPB, Wheat Ridge, CO.

Detailed information on biofeedback augmented treatment of Alcoholism

A. Citations to the papers summarized in the "brief summary":

Kumano, H., Horie, H., Shidara, T., Kuboki, T., Suematsu, H., & Yasushi, M. (1996).Treatment of a depressive disorder patient with EEG-driven photic stimulation. Biofeedback and Self-Regulation, 21(4), 323-334.

Peniston, E.G., & Kulkosky, P.J. (1989). Alpha-theta brainwave training and beta-endorphin levels in alcoholics. Alcoholism, Clinical and Experimental Research, 13(2), 271-279.

Peniston, E.G., & Kulkosky, P.J. (1990). Alcoholic personality and alpha-theta brainwave training. Medical Psychotherapy, 3, 37-55.

Richard, A.J., Montoya, I.D., Nelson, R., & Spence, R.T. (1995). Effectiveness of adjunct therapies in crack cocaine treatment. J Substance Abuse Treatment, 12(6), 401-413.

Saxby, E., & Peniston, E.G. (1995). Alpha-theta brainwave neurofeedback training: An effective treatment for male and female alcoholics with depressive symptoms. Journal of Clinical Psychology, 51(5), 685-693.

Schneider, F., Elbert, T., Heimann, H., Welker, A., Stetter, F., Mattes, R., et al. (1993). Self-regulation of slow cortical potentials in psychiatric patients: Alcohol dependency. Biofeedback and Self-Regulation, 18(1), 23-32.

Sharp, C., Hurford, D.P., Allison, J., Sparks, R., & Cameron, B.P. (1997). Facilitation of internal locus of control in adolescent alcoholics through a brief biofeedback-assisted autogenic relaxation training procedure. Journal of Substance Abuse Treatment, 14(1), 55-60.

Taub, E., Steiner, S.S., Weingarten, E., & Walton, K.G. (1994). Effectiveness of broad spectrum approaches to relapse prevention in severe alcoholism: A long term, randomized controlled trial of transcendental meditation, EMG biofeedback, and electronic neurotherapy. Alcoholism Treatment Quarterly, 11 (1/2), 187-220.

Waldkoetter, R.O., & Sanders, G.O. (1997). Auditory brainwave stimulation in treating alcoholic depression. Perceptual and Motor Skills, 84(1), 226.