Theta-beta training (Lubar)

Domain IX · Biomedical, neuro & digital · Joel F. Lubar · 1975 · Knoxville, Tennessee, USA

What it is

Theta/beta training is EEG biofeedback (neurofeedback) for attention-deficit/hyperactivity disorder (ADHD). It grew from Joel F. Lubar's work, which began with controlled studies in the mid-1970s and was taught through the Southeastern Neurofeedback Institute in Knoxville, Tennessee, where he was…

Format

• The course is outpatient and individual: a child, a trainer at the EEG station and a parent nearby. It runs in five phases. Session counts are given as sources publish them.
• Version followed: the Lubar-derived theta/beta protocol ("Protocol 3") as set out in the practice review by Monastra, Lynn, Linden, Lubar, Gruzelier and La Vaque (2005, Journal of Neurotherapy), with the Neurofeedback Collaborative Group double-blind trial (2021; 25-month follow-up 2023) as the…

Who practises it, and how they are trained or regulated

• Phase 2: Pre-treatment assessment (1–2 appointments). Goals: baseline measures and protocol selection. The 2005 review lists intelligence testing, behaviour rating scales, a continuous performance test (CPT) and a quantitative EEG (QEEG). It recommends QEEG before any protocol, to locate the type of EEG abnormality and guide protocol choice. In one cited trial, QEEG evidence of cortical slowing was an entry…
• Phase 3: Training (most of the course). Goal: learning, repeated reinforced change in the trained bands, practised across many sessions. Per Monastra et al. (2005), each session opens with a short baseline recording without feedback, followed by feedback segments that start short and lengthen, for about 30–45 minutes of feedback in total. Quantitative progress is reviewed after every session. Schedules may be massed…
• Phase 4: Transfer to school and home (overlaps Phase 3). Goals: carry attentional gains into class and homework through parent counselling in reinforcement strategies, teacher coordination and accommodations (IEP or Section 504 plans in the US). Social-skills training with contingency management is also suggested. In England, with consent, contact the school about the diagnosis, the treatment plan and reasonable…

Evidence status, as the guide reports it

• Phase 1: Intake and diagnostic confirmation (1–3 appointments). Goals: confirm an established ADHD diagnosis made by a qualified clinician from history, rating scales and observation, never from an EEG alone; screen out conditions that affect attention. The 2005 review lists exclusions such as age…

Questions to explore with your client

• What drew you to it, and what are you hoping it will change?
• Is there physical contact? Was it explained beforehand, and do you feel free to say no or stop at any point?
• 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?
• 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

• skills that do not transfer to real settings.
• sunk-cost continuation; families who feel they cannot stop.
• in-clinic success without school change; reliance on the screen.
• families stopping medication on their own; unexplained mood change; worsening sleep.
• on poor-sleep or unmedicated days, keep expectations flexible and record the context.

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.