Exploring The Feasibility of Neurofeedback for Trauma-Affected Refugees – A Qualitative Study

Abstract

Background The use of Neurofeedback (NF) to assist individuals in learning to regulate their brain wave activity have shown promising results in reducing symptoms of posttraumatic stress disorder (PSTD). However, few studies have focused on the patient experience with NF and even fewer take on the perspective of refugees. Thus, this study aimed to evaluate the feasibility of an NF-based intervention for trauma-affected refugees focusing on aspects relevant for optimizing the NF experience and clinical practice. Methods This qualitative study was a part of an NF feasibility study carried out at CTP, offering 34 trauma-affected refugees 12 sessions of NF. In the qualitative part of the feasibility study, a subsample of eight participants was interviewed. Using in-depth semi-structured interviews, the participants’ thoughts and expectations prior to participating in NF treatment as well as their experiences with the treatment after a few training sessions were examined. The analysis was carried out in four steps, using a hermeneutic and phenomenological approach. Results The analysis resulted in three main themes: 1) Positivity despite unfulfilled expectations 2) Understanding of the NF treatment 3) Facilitating factors for feasible NF treatment. Conclusion The results show that facilitation of successful treatment was challenged by both the participants’ misaligned expectations of the treatment outcome as well as their comprehension of the NF equipment, which did not match the actual capabilities. This underlines the importance of clear communication, including the adjustment of participants’ expectations regarding what symptoms the NF treatment protocol is designed to treat. Furthermore, the importance of thorough, repetitive, and understandable information about the NF equipment’s capabilities was highlighted. Our results demonstrated how the participants found NF to be an acceptable and recommendable method of treatment even though they did not benefit from it. Finally, valuable knowledge regarding factors enhancing the feasibility was discovered, including prioritizing breathing exercises, a spacious NF treatment room and personalization of the NF treatment protocol. Trial registration: ClinicalTrials.gov ID: NCT05055037. Retrospectively registered on the 06/07-2021.