Sensorimotor-rhythm training (Sterman)

Domain IX · Biomedical, neuro & digital · M. Barry Sterman · 1972 · UCLA, USA

What it is

Sensorimotor-rhythm (SMR) training is a form of EEG operant conditioning (neurofeedback). The client sees and hears real-time feedback and is rewarded for producing more of a 12–15 Hz rhythm recorded over the sensorimotor cortex, while unwanted slower activity is held down.

Format

• Sterman's programme describes one or two sessions a week, each 60–90 minutes, for at least 20 weeks. Each session is a series of short feedback trials.
• In Arns' open-label ADHD study, courses averaged about 30 sessions.

Who practises it, and how they are trained or regulated

• Move on when: there is a neurologist-confirmed diagnosis, written agreement from the neurologist that training may run alongside unchanged medical treatment, a baseline seizure log, and documented consent.
• An objective EEG assessment should come before training. The most thorough form is a multichannel QEEG compared against an age-appropriate normative database. Sterman and Egner recommend mapping before and after treatment, both to choose the strategy and to track movement towards normal EEG values.
• A licensed professional writes an individualised protocol. In Sterman's programme it then stays the same throughout treatment.

Questions to explore with your client

• What drew you to it, and what are you hoping it will change?
• Does it involve any substance, plant preparation, remedy or supplement? Has your doctor or prescriber been told, especially about any medication you take?
• Does it involve intense or unusual breathing? Have you been told about the medical conditions for which that is not advised?
• Is it a group, retreat or community? How do they respond if someone wants to leave or raises a concern?
• How do you and the practitioner understand what is happening, in spiritual or cultural terms? Is that a source of comfort, worry, or both?
• Who runs it, and what training or registration do they hold?
• What actually happens in a session or meeting, and how often?
• What does it cost, and is there pressure to commit to more?
• How do you feel afterwards, in the hours and days that follow?
• Does it fit with, or clash with, the work we do here?

What practitioners of it watch for

• performance anxiety and over-effort (see 4.7).
• sleepiness. SMR training should not slide into dozing.
• working beyond your training, and equipment that is not isolated or maintained.
• hopelessness after a poor response. Have a suicide-risk review and a crisis plan in place.
• pressure to reduce medicines after good results; route all such questions to the neurologist.

When to involve someone else

• New or worsening physical symptoms, or advice to stop or change prescribed medication: involve the client's doctor or prescriber.
• Signs of coercion, isolation from family and friends, escalating costs or secrecy: discuss openly and consider safeguarding.
• A crisis or thoughts of suicide: follow your crisis protocol. In the US, call or text 988; in the UK and Ireland, Samaritans on 116 123.

Drawn automatically from the guide's own sections. Stay curious: neither endorse nor dismiss what the client values, and check anything that matters against the full guide and its sources. Not medical advice.