Biofeedback Training for University Students:

Skills for a Lifetime of Health

Barbara Morrell, Ph.D.Michael L. Maughan, Ed.D.

Shannon Coetzee., B.S.Dianne Nielsen, Ph.D.

Russell Bailey, B.S.

Brigham Young University

American Psychological AssociationAnnual Convention

Boston, MassachusettsAugust 15, 2008

AbstractThe University is an ideal setting to teach stress

management skills, as college students cope with more difficult coursework and increasingly complex adult roles and responsibilities. Biofeedback training teaches students skills for better coping, functioning, and health in the present and may help to lay the foundation for a lifetime of health and wellness.

Research conducted in the BYU Counseling Center Stress Management and Biofeedback lab demonstrates that biofeedback and relaxation training is effective for decreasing levels of stress and improving coping, as demonstrated by Frontal EMG and Temperature readings, and by self-reports. Students also report satisfaction with their biofeedback training and that their practice between sessions is effective.

Brigham Young University Stress Management and Biofeedback Lab

• Operating since 1976

• Integral part of the Counseling and Career Center

• Utilize EMG, Thermal, GSR, HRV & Respiration modalities

• Staffed by Ph.D. Psychologists and Graduate Students.

• 470 students seen in 800 sessions per year

Purpose of Lab• To Provide Stress Management/Biofeedback training

to help students:

– Better manage school and other stressors

– Develop Skills to reduce unwanted tension

– Lessen interference of stress/anxiety with school performance & overall wellbeing

• To Provide an Adjunct to Psychotherapy

Relaxation Skills Training

• Body Scan• Autogenics• Diaphragmatic Breathing• Progressive Muscle Relaxation• Meditation• Visualization• Self-Hypnosis• Performance Rehearsal

Outreach

• Housing

• Campus classes

• Workshops offered in Counseling Center

• Health Fairs

• Community Groups

Purpose of Research

• To better understand the experience of stress of students referred to the lab

• To determine the effectiveness of biofeedback/relaxation training

• To increase effectiveness of biofeedback/relaxation training

Research Questions

• How effective is biofeedback/stress management training?– Pre-/Post- changes in EMG Readings?– Pre-/Post- change in Temp Readings?

• How do student self-reports of level of stress change pre- and post- session?

• Does practice between sessions improve effectiveness of training?

Subjective Measures

• Student rating of stress for past week• Student beginning and ending BF session

rating of stress level• Anonymous Student report of how useful,

relaxing and effective the session was• Student report of between-session practice– Skill(s) practiced – Frequency– Effectiveness

Objective Measures

• Frontal EMG and Temperature BF Readings

–Pre- and Post-treatment readings by session

Data Collection

• Data Collected from 09/2006 to 04/2008

• Participants: N =659

• BF Sessions: N = 1170

• Range: 1-13 sessions

• Modal session #: 1 session

Referral Sources to Lab

Gender

Year in School

Top Stressors

Stress Symptoms

Coping Strategies

Pre- and Post- Frontal EMG Readings

Mean change = 2.22, SD = 4.17, t = 15.78, p< .001

Pre- and Post- SkinTemperature Readings

Mean change = -1.34, SD = 3.05, t = -13.06, p. 001

Self-Report Rating of Stress Pre-and Post-Treatment

Mean change = 3.22, SD = 1.8, t = 54.114, p < .001

Satisfaction Survey

Students anonymously reported on average that their BF sessions were:

Not Informative Very Informative

0 1 2 3 4 5 6 7 8 9 10

Not Relaxing Very Relaxing

0 1 2 3 4 5 6 7 8 9 10

Not Useful Very Useful

0 1 2 3 4 5 6 7 8 9 10

Results of Home Practice

• Average Usefulness rating of those who practiced was 6.64 out of 10

(10 point scale: O = Least useful; 10 = useful)

• 49% of students reported they practiced relaxation techniques during the previous week

Preliminary Conclusions• BF sessions are effective in reducing stress level in

the short run based on subjective data and EMG/Temp readings

• Students overwhelmingly report BF sessions to be helpful

• Only half of BF trainees are engaging in home practice of relaxation techniques

• Those who practice relaxation techniques report it to be useful

Future Research

• Do Pre-Post EMG/Temp BF readings improve significantly over multiple sessions?

• Do weekly and pre-session subjective ratings decrease significantly over multiple sessions?

• Do Students who practice show significantly greater improvement compared to those who don’t?

• Does Biofeedback training improve subjective ratings of health and well-being over time?

Future Research

• How do therapy clients compare to non-clients on biofeedback readings pre-and post-session and in change over time?

• How does the outcome for clients using biofeedback as an adjunct to psychotherapy compare to those who don’t, as measured by the Outcome Questionnaire-45 (OQ-45).