Neurofeedback combined with trauma counselling for treatment-resistant PTSD in adult refugees: A case series.

Abstract

Objective: This study assessed the effectiveness and safety of neurofeedback combined with trauma counselling in a cohort of adult refugees with treatment-resistant posttraumatic stress disorder (TR-PTSD).

Method: A retrospective file audit was conducted for 71 clients seen at a specialized trauma rehabilitation center for refugees between 2017 and 2022. Clients met the diagnostic criteria for PTSD outlined in the Diagnostic and Statistical Manual of Mental Disorders, fifth edition and had not responded to combined psychological and pharmacological interventions. Clinical outcomes were measured using the Clinical Global Impression scale (CGI) and the Harvard Trauma Questionnaire (HTQ) before and after trauma counselling.

Results: Overall, 54% of clients exhibited clinically significant improvement, with a CGI-Improvement score of Mdn = 2 (p < .05). Effect sizes were large for CGI-severity (Cohen's d = 0.87) and CGI-improvement (Cohen's d = 0.91). Significant clinical change was observed, particularly in symptoms of intrusion, arousal, and numbing. Treatment quality, including adherence to protocols and therapist responsiveness, was crucial for better outcomes, whereas baseline factors like illness severity and trauma load did not predict treatment response. No serious adverse events observed.

Conclusions: Neurofeedback when combined with trauma counselling is an effective, safe, and well-tolerated approach that shows promise in alleviating TR-PTSD symptoms among refugees. These findings suggest neurofeedback could be a valuable adjunct treatment modality in trauma rehabilitation settings. However, further validation through prospective randomized controlled trials is essential to confirm its effectiveness and identify predictors of treatment response. (PsycInfo Database Record (c) 2025 APA, all rights reserved).