Neuroenhancement for sale: assessing the website claims of neurofeedback providers in the United States

Abstract

Although electroencephalographic (EEG) neurofeedback is a technique that has been in existence for many decades, it has remained controversial, largely due to questions about efficacy. Yet neurofeedback is being widely offered to the public, often at great expense. To date, however, there has not been empirical data on which providers are utilizing neurofeedback, what they are offering it for, and how they are advertising the technique. The present study aimed to fill that gap by systematically analyzing the websites of neurofeedback practitioners in the United States. To that end, we obtained data from four directories of neurofeedback providers, extracting practitioner names, geographical locations, professional training, and website URLs. Only websites offering neurofeedback services (N=371) were included in the next step, wherein two coders independently coded the websites based on a codebook developed from preliminary analyses. We found that nearly all websites (97.0%) contained claims about at least one clinical indication, most commonly anxiety, ADHD/ADD, and depression; however, only 36.0% of providers had either a medical degree (MD) or a doctoral-level degree in psychology. The majority of websites advertised neurofeedback for cognitive (90.0%) or performance (67.9%) enhancement, and roughly three-quarters utilized language related to complementary and alternative medicine (CAM). In sum, there is a considerable divergence between the scientific literature on neurofeedback and the marketing of neurofeedback services to the general public, raising concerns regarding the misrepresentation of services and misleading advertising claims.

Keywords: EEG; cognitive enhancement; neuroethics; neurofeedback; neuroscience and society.

Fig. 1

Flow diagram depicting the process of identifying websites of neurofeedback providers based in the U.S.

Fig. 2

Geographic distribution of the neurofeedback clinics in the United States (N=378) that were included in our sample. The total number of clinics depicted is greater than the number of websites in our sample because 5 websites listed two geographic locations and one listed three locations.

Figure 3.

Degrees, licenses, and certifications of neurofeedback (NF) providers in our sample (N=390). Percentages are >100% because some providers listed more than one degree, license, or certification.

Fig. 4

Target audience of neurofeedback websites in our sample (N=371). Percentages are >100% because some websites had multiple target audiences. Audiences targeted by <10.0% of websites are not depicted.