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           April 2011 CTA Newsletter
CTA Announces NEW NMT Certification Training Program
Understanding Neurofeedback

 BORN FOR LOVE:Paperback now available.




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Over the last year, The ChildTrauma Academy has been beta-testing a set of Clinical Practice Tools created to help clinicians who are using the CTA's Neurosequential Model of Therapeutics.  Our Partner Sites, Individual Certification Participants, Fellows, and NMT Series presenters have tested the tools and provided us with important feedback to improve its navigation, functioning, and overall quality. We are pleased to say that the Beta Testing Phase is nearing an end and that the tool will launch later this Spring.  Our new application, the NMT Clinical Practices Tools, will include the NMT Metric along with other clinical tools created for use with the NMT Program.  Many of you have expressed interest in gaining access to these tools (most specifically the "brain mapping" functions), which are currently only available through our NMT Training Certification Program.  However, in the Fall of 2011, we will be offering a newly revised NMT Training Certification Program that we believe make certification more accessible and streamlined.  A brief description of the new programs follow in this month's newsletter, but stay tuned for full details to come soon.

New NMT Individual and Site Training Certification Program to Begin This Fall 

Due to overwhelming interest in our Neurosequential Model of Therapeutics Training Certification Programs and the NMT Online Clinical Practice Tools (including the NMT Metric), CTA is pleased to announce that we have streamlined our Individual and Site Certification Training programs and will begin accepting applications soon for Phase I programs to begin this Fall.   We will offer two programs: Individual Certification, for a single registrant or for an organizational group with 6 or fewer participants, and Site Certification, for organizations who have 7 or more clinicians who wish to participate.  In order to participate, an applicant MUST have at least a master's degree in social sciences or equivalent, a current license (e.g., LPC, LMFT, LMSW, etc.) or similar designation (if outside of US), a current practice working with children and families, and have participated in at least 1 NMT Case-based Staffing Series (10 sessions) - may be waived if clinician can prove participation in live CTA trainings. 


More information on the New NMT Training Certification Programs will be available on our website in the coming month.  Stay tuned for further details and information on how to apply!

Understanding Neurofeedback 

What is Neurofeedback?

   Neurofeedback, a form of biofeedback, is also referred to as Neurotherapy or EEG-Biofeedback. Biofeedback is an age-old technique that is based on the principle of awareness: e.g., if a person concentrates on a bodily function, such as heart rate or pain, then he or she can change it. Neurofeedback is a more recent advancement with the goal to change the frequency of brain waves so that the brain's executive functions work more efficiently.

    Our cortex, or the "smart" part of our brain, mediates executive functions. They include attention, inhibition of inappropriate responses, planning, abstract thinking, and transitioning. These functions serve to "organize" our brain and help us perform up to our potential. Executive functions are compromised in those who have ADHD, developmental disorders, addictive disorders, and those who have experienced trauma-among many others.


What is a "Brain Wave"?

    Very simply, they a fragment of the summed and integrated electrical activity from millions of neurons depolarizing that is detected in  an area of the brain when using EEG (see below). Over decades, using a variety of EEG (and related techniques) certain patterns have been detected and analyzed.  Though a great deal remains speculative, certain behavioral and emotional states appear to be correlated with certain patterns of activity. In neurofeedback, the target of the biofeedback process are these patterns or "brain waves." 


 Why Change Brain Waves?  

    There are four general patterns of activity seen: beta, alpha, theta, and delta (in order from fastest to slowest). Beta waves are seen when the mind is the most engaged, as in when we are teaching or talking with others, and delta waves are seen when we are asleep. Alpha and theta waves are more commonly seen we are relaxed and disengaged from the present moment. For example, people are usually the most creative when theta waves are active. For those readers familiar with the "alarm/arousal" continuum that the CTA uses to teach, quite simply, these various patterns correspond to different stages along the arousal continuum.  These are reasonable reflections of the individual's "state."   


How Does it Work?  

   There are various protocols.  In general, however, neurofeedback treatment, involves connecting the individual to an EEG machine with electrodes placed on the scalp. The electrodes are connected to a computer, which can then manipulate the incoming signals to create some representation of activity. Diagnostic instruments such as the TOVA (Test of Variables of Attention) can be used to roughly localize various patterns of activity.

     At this point, a variety of techniques very similar to traditional biofeedback paradigms are used. There may be a computerized game, visual imagery or various cognitive or emotional exercises that can be used to see if the individual can begin to "shape" the activity of their pattern of neural activity.  While some practioners of  

    Next, a person plays a series of computer games that reward the brain for using the most adaptive brain waves. For example, the game might require a person to use more beta waves than alpha waves for a car to drive or to get points in a competition. When the correct brain waves are being used, the person will be successful at the game  - and when the correct brain waves are not being use, the person will fail at the game. Thus, Neurofeedback is based on principles of operant conditioning - or learning via reinforcement. Through a series of treatment sessions, a person's brain activity can change permanently.


What does it Treat?

   Unfortunately the body of well-controlled outcome studies with adequate numbers of subjects, suitable comparison groups and blinding is very small, the existing body of evidence is promising.  A review of recent scientific literature suggests that neurofeedback techniques have been promising in ADHD, substance abuse, the behavioral issues in developmental disorders, PTSD, anxiety disorders, mood disorders, and other psychological complications.  A few randomized controlled clinical trials show that neurofeedback may be as effective as stimulants in the treatment of ADHD (which themselves, unfortunately have questionable long-term efficacy), and that clinical improvements are enduring  (e.g., they last even when neurofeedback is no longer being used).  Obviously, as with all areas of research in child mental health, more research is needed to understand and outline the full benefits and limitations of this promising set of techniques. outcomes are promising.


For further reading:



CTA News - Upcoming NMT Training Series
Spring 2011 NMT Case-Based Training Series - Begins April 22, 2011
     We are currently accepting applications for our Spring 2011 NMT Training Series.   There are two ways to participate in this 10-week series - LIVE via the web or through RECORDINGS ONLY.  
      This training experience is part of an ongoing clinical care conference series offered by the CTA.  This teaching model has been useful for helping clinicians and front-line staff better understand the neurodevelopmental principles involved in many of the primary symptoms as well as strengths in the children they serve.  This practical teaching model provides an opportunity for ongoing capacity building within an institution or for individuals.
       We recommend this series as a complement to any more intensive training/program development projects that our partners have with the CTA. However, individual and institutional participation does not require any other program development activities or projects with the CTA and can serve as a good introduction to viewing maltreated and traumatized children through the "lens" of neurodevelopment.


See 2011 Spring Schedule & Enroll here. 

ALSO - Pre-register for the Fall 2011 NMT Case-Based Training Series
We are now able to pre-register participants for our Fall 2011 NMT Case-Based Training Series.
The Fall Series, also a 10-week training opportunity, begins September 2, 2011.  Choose to participate LIVE or via RECORDINGS ONLY.

See 2011 Fall Schedule & Enroll here.




Yes!  You can still order the RECORDINGS PACKAGE of the Winter 2011 NMT Series.  You will receive all ten 90-minute recordings plus case materials and handouts - all together.  This is an extremely convenient way to fulfill the NMT Series participation requirement for our Certification Training Program because you can complete the Series entirely at your own pace.  


See 2011 Winter Recordings Only Registration Form here.  


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Bruce D. Perry, M.D., Ph.D.
The ChildTrauma Academy