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The very nature of biofeedback makes it difficult to establish good criteria for clinical outcomes by which results can be compared among practitioners and among a variety of approaches. First of all, the criteria of success should only be applied to those who have in fact completed a significant number of training sessions. In our experience, the number of sessions required ranges from twenty to forty. On the other hand, those who are not progressing with the training for one reason or another are not usually encouraged to continue to that point. Hence, the group to which criteria of success may be properly applied has already become “selected for success” to some degree. Given that caveat, it is our experience that on the order of 90% of those who stay committed to the program do in fact benefit significantly in terms of symptom relief, and that these benefits are retained for the long term (months to years).
If one asks the question about what fraction of those who enter the training program achieve a satisfactory outcome, the success rate is lower. We observe that adults are much more difficult to retain in the program than children, and this is true regardless of the diagnosis, be it epilepsy, traumatic brain injury, depression, alcoholism, or PMS. Adults are much more likely to see to the needs of their children than to their own needs. We observe this in families who are also bringing their children. Although a parent may bring her child faithfully, she will be less likely to follow through on training for herself. We observe that this has little to do with the intrinsic efficacy of biofeedback. In any case, the success rate by this criterion is approximately 70 percent.
The symptom relief experienced by those who successfully complete the program includes all of the emotional symptoms associated with PMS, and the physical symptoms, including migraines. Some reach the point where they are essentially symptom-free, and do not experience the usual prior notice of the onset of menses. Favorable experience has also been observed with dysmenorrhea, and with such symptoms as excessive bleeding. The data on such phenomena are isolated, and not yet subject to statistical treatment.
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