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What Is the Value of Biofeedback Certification of America Certification?

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 Biofeedback
Volume 36, Issue 3, pp. 92–94
PROFESSIONAL ISSUES
What Is the Value of Biofeedback Certification of
America Certification?
Randy Neblett, MA, LPC, BCIAC,1 Fred Shaffer, PhD, BCIAC,2 and Judy Crawford3
Productive Rehabilitation Institute of Dallas for Ergonomics, Dallas, TX; 2Truman State University, Kirksville, MO; 3BCIA Director of Certification, Wheat Ridge, CO
1
Keywords: biofeedback, neurofeedback, certification
Biofeedback Certification Institute of America (BCIA)
certificants use biofeedback in a variety of applications and
settings, from pain management to optimal performance
training for athletes and business executives. BCIA
certification provides standards for the education and
training for all providers of biofeedback services. Recently,
BCIA conducted a survey of their certificants. One of the
most important questions asked was about the value of
BCIA certification.
Introduction
Most Biofeedback Certification Institute of America
(BCIA) certificants use biofeedback in a clinical setting.
Approximately 82% are licensed professionals in health-
related fields. Of those, 62% are licensed in mental health
fields (including psychology, counseling, and social work) and
20% are licensed in medical fields (including chiropractic,
nursing, occupational, physical, and speech therapy). The
remaining 18% of our certificants are unlicensed. Some
of these individuals work under clinical supervision of
a licensed health care provider, and some work outside
of the clinical health care model. BCIA certificants who
treat medical and psychological disorders, whether they
are licensed or unlicensed and practicing under clinical
supervision, can legally and ethically use clinical biofeedback
without certification. So why did these professionals choose
to become certified? What is the value of BCIA certification
Fall 2008  Biofeedback
and recertification for these health care professionals?
Why do health care professionals who incorporate clinical
biofeedback and neurofeedback in the treatment of
medical and psychological disorders seek and maintain this
credential?
92
©Association for Applied Psychophysiology & Biofeedback
www.aapb.org
Certificant Survey Results
We posed two critical questions to our certificants: “What
were your primary reasons for initially seeking certification?”
and “If you have gone through a BCIA recertification, what
were your primary reasons for recertifying?” Tables 1 and
2 summarize the responses of approximately 35% of our
certificants.
Certificants initially sought certification for credibility
(96%), validation of skills and knowledge (86%), professional
satisfaction (85%), to ensure proper training (84%), and
promotion of the field (65%). They were less motivated
by opportunities for career advancement (44%), listing on
the BCIA Web site (41%), help justifying insurance claims
Table 1. The primary reasons for initially seeking
biofeedback certification
Credibility 96%
To validate my skills and knowledge 86%
Professional satisfaction 85%
To ensure that I was properly trained 84%
To promote and support the field of biofeedback 65%
It was an opportunity for career advancement 44%
Listing on the BCIA “Find a practitioner” search 41%
To help justify my insurance claims 33%
It was required by my employer 13%
Note. BCIA = Biofeedback Certification Institute of America. This table
shows percentages of respondents who either “somewhat agreed” or
“strongly agreed” with these responses to the question “What were your
primary reasons for initially seeking biofeedback certification?”

Table 2. The primary reasons for recertifying
Credibility
Professional satisfaction
To ensure that my skills were updated through CE
To promote and support the field of biofeedback
To validate my skills and knowledge
Listing on the BCIA “Find a Practitioner” search
To help justify my insurance claims
It was an opportunity for career advancement
It was required by my employer
Note. CE = continuing education, BCIA = Biofeedback Certification Institute
of America. This table shows percentages of respondents who either
“somewhat agreed” or “strongly agreed” with each of these responses to
the question “If you have gone through a BCIA recertification, what were
your primary reasons for recertifying?”
(33%), and requirements by employers (13%). These results
suggest that our certificants were initially more strongly
motivated by internal gains (credibility and professional
satisfaction) than by external gains (career advancement or
to help with insurance reimbursement).
The reasons for recertification were very similar to the
initial reasons for certification, with a high percentage of our
sample reporting internal rewards from their certification.
The perceived external value of recertification increased in
two areas: help with insurance claims increased from 31%
to 37%, and listing on the BCIA Web site increased from
41% to 58%. This suggests that some BCIA certificants have
found their certification useful for clinical referrals and for
payment of insurance claims.
BCIA recertification is required every 4 years. Our 72%
to 80% retention rate is very high because many of the
professionals who do not recertify have retired, left their
field, or have passed away. We are encouraged that BCIA
certificants value their credential even though they are not
ethically or legally required to be certified to practice in their
states.
Benefits of BCIA Certification to the
Field of Biofeedback
A dichotomy exists in the field of clinical biofeedback.
There are many professionals, licensed and unlicensed, with
and without BCIA certification, who are well-trained, use
efficacious clinical protocols, and effectively treat medical
and psychological disorders with biofeedback. There are also
inadequately trained and unethical providers who misuse
the term biofeedback, make fraudulent claims about the
efficacy of their protocols, and incompetently treat the same
Neblett, Shaffer, Crawford
disorders. This second group of individuals damages both
the credibility of biofeedback and biofeedback professionals.
94%
How can the consumer determine who is a competent service
81% provider? How do scams involving false claims and sham
77% treatments affect public perception of biofeedback? How does
patient unhappiness with inept and unethical biofeedback
74%
treatment affect the perceptions of referral sources such as
73% primary care physicians?
58% The solution to these problems is for all competent
37%
biofeedback professionals to become BCIA certified.
Certification demonstrates to consumers, referral sources, and
14% insurance companies that an individual has at least satisfied
11% minimal education and training competency standards in the
clinical use of biofeedback and are held to ethical standards
by an outside source. Certificants must demonstrate mastery
of didactic content; proper sensor placement, equipment
use, and interpretation of physiological readings; and basic
assessment and treatment protocols. Every 4 years, all BCIA
certificants must document that they have completed 80
additional hours of relevant continuing education to become
recertified. We created this requirement to progressively
increase our certificants’ knowledge base and competency in
their use of biofeedback.
Why BCIA Certification?
BCIA was formed in 1981 to be the gold standard for
biofeedback certification. The Association for Applied
Psychophysiology and Biofeedback, the International
Society for Neurofeedback and Research, and the Mayo
Clinic have endorsed BCIA certification. Biofeedback was
named as a proficiency by the American Psychological
Association (APA) as a result of BCIA’s petitioning efforts.
To date, the APA has not built its own certification nor has
it ever endorsed another credentialing body for the addition
of this modality into clinical practice for psychologists. BCIA
certification requirements and blueprint curricula have been
adopted by most university and vendor-based biofeedback
training programs.
Currently, BCIA offers three certifications, including
general biofeedback, neurofeedback, and pelvic muscle
dysfunction biofeedback. BCIA has developed an
international presence with approved training programs
in Canada, Hong Kong, Japan, and Taiwan and certification
exam administration at the annual Biofeedback Foundation
of Europe meeting. To date, we have certificants from nine
countries. You may have been contacted by short-lived
Biofeedback  Fall
entities offering certification for cash without evidence
of competency, but we have served our field for nearly
three decades and are the clear choice of health care
professionals.
93
 The Value of BCIA Certification

Conclusion
As a licensed or unlicensed health care professional, you don’t
need BCIA certification to offer or bill for clinical biofeedback
services in most cases. BCIA certificants pursue certification
and recertification for personal satisfaction, credibility with
referral sources, and development of biofeedback knowledge.
They also recognize that BCIA certification of all competent
professionals who use clinical biofeedback and neurofeedback Fred Shaffer Randy Neblett Judy Crawford

helps strengthen our field. Our certificants proudly identify Correspondence: Fred Shaffer, PhD, Department of Psychology, McClain 229,
Truman State University, 100 E Normal, Kirksville, MO 63501, email: fshaffer@
themselves with BCIAC and exemplify our slogan, “More
truman.edu.
than qualified—BCIA certified!”
Fall 2008  Biofeedback

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