Breathing biofeedback as an adjunct to exposure in cognitive behavioral therapy hastens the reduction of PTSD symptoms: A pilot study.

doi: http://dx.doi.org/10.1007/s10484-015-9268-y

By Polak, A. Rosaura; Witteveen, Anke B.; Denys, Damiaan; Olff, Miranda

Applied Psychophysiology and Biofeedback, Vol 40(1), Mar 2015, 25-31.

Although trauma-focused cognitive behavioral therapy (TF-CBT) with exposure is an effective treatment for posttraumatic stress disorder (PTSD), not all patients recover. Addition of breathing biofeedback to exposure in TF-CBT is suggested as a promising complementary technique to improve recovery of PTSD symptoms. Patients (n = 8) with chronic PTSD were randomized to regular TF-CBT or TF-CBT with complementary breathing biofeedback to exposure. PTSD symptoms were measured before, during and after TF-CBT with the Impact of Event Scale-Revised. The results show that breathing biofeedback is feasible and can easily be complemented to TF-CBT. Although PTSD symptoms significantly decreased from pre to post treatment in both conditions, there was a clear trend towards a significantly faster (p = .051) symptom reduction in biofeedback compared to regular TF-CBT. The most important limitation was the small sample size. The hastened clinical improvement in the biofeedback condition supports the idea that breathing biofeedback may be an effective complementary component to exposure in PTSD patients. The mechanism of action of breathing biofeedback may relate to competing working memory resources decreasing vividness and emotionality, similar to eye movement desensitization and reprocessing. Future research is needed to examine this. (PsycINFO Database Record (c) 2016 APA, all rights reserved)

Biofeedback for psychiatric disorders: A systematic review.

doi: http://dx.doi.org/10.1007/s10484-014-9246-9

By Schoenberg, Poppy L. A.; David, Anthony S.

Applied Psychophysiology and Biofeedback, Vol 39(2), Jun 2014, 109-135.

Neurofeedback.

By Wyckoff, Sarah; Birbaumer, Niels

Hofmann, Stefan G. (Ed); Dozois, David J. A. (Ed); Rief, Winfried (Ed); Smits, Jasper A. J. (Ed), (2014). The Wiley handbook of cognitive behavioral therapy (Vols. 1-3). , (pp. 273-309). Wiley-Blackwell, xx, 1439 pp.

http://digital.library.unt.edu/ark:/67531/metadc5428/m2/1/high_res_d/dissertation.pdf

I used to use a simple portable Galvanic Skin Response monitor to help clients learn to relax.  Nowadays, I use relaxation techniques to help people learn how to reduce anxiety and its physiological aspects.  They can use the relaxation techniques to slow down their incipient panic in anticipatory anxiety so that they can then address their racing thoughts through CBT.

The GSR monitor was cheap and easy to use, but is no longer being made, alas.  

I also use a Galvanic Skin Response monitor in CBT, CBC and stress management to demonstrate how a client or coachee can learn to become relaxed very quickly and also how negative cognitions/images can rapidly trigger the stress or arousal response. The biofeedback response demonstrates the ABCDEF model of CBT/REBT.