A major use of biofeedback is to teach relaxation skills. A second use of biofeedback is to alter pathophysiological processes such as blood flow or SNS arousal for migraine headache patients, to decrease the flow of gastric juices for ulcer patients, to decrease muscle tension and increase proper posture for the chronic back-pain patient. Biofeedback should be considered as a therapeutic tool that can help introduce the client to therapy in a concrete and nonthreaten-ing manner. It can be especially useful for the patient who focuses on physical problems or insists his problems are not physiological. Biofeedback can also be used to increase feelings of self-efficacy and self-control. The client learns quickly the connection between emotions, thoughts, and physiological responses.
Biofeedback may be used when there are no viable medical alternatives, or when the physician determines that medication should not be used. Sometimes patients do not want to take medication and biofeedback may be a treatment alternative. For example, a chronic back-pain patient may have to use pain medication to control the pain for the rest of her life because there are no other medical treatments to reduce the pain. The patient may choose to try biofeedback to help cope and reduce the pain instead of taking pain medication, which is addictive and may have undesirable side effects.
Biofeedback has also been used in modifying behavioral problems. Two examples are hyperactivity that is associated with attention deficit disorder and maladaptive behaviors that are associated with mental retardation. Motor responses may be monitored using biofeedback; the child is rewarded as the problem behavior decreases.
Biofeedback should be used clinically only after a competent medical diagnosis has been made and the examining physician has decided that biofeedback may be valuable. Patients coming directly to psychologists for biofeedback or other behavioral treatments of physical disorders should be referred first to a medical specialist for a thorough medical examination. The need for medical consultation in any bio-
feedback case is both an ethical and legal responsibility of the psychological practitioner.
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