Feasibility of a Brief Biofeedback Protocol to Train Self-Regulation in Pediatric Patients

• Published in: Clinical practice in pediatric psychology 2024-03, Vol.12 (1), p.48-58
• Main Authors: Alioto, Anthony, David, Jennie G., Gramszlo, Colette
• Format: Article
• Language: English
• Subjects: Biofeedback; Female; Heart Rate Variability; Human; Male; Outpatients; Pediatrics; Respiration
• ISSN: 2169-4826; 2169-4834
• DOI: 10.1037/cpp0000479

Objective: The extant pediatric biofeedback literature has several shortcomings, including small sample sizes, inconsistent methodology, and variable means to determine outcomes. The purpose of the current study was to build upon the existing literature and examine the feasibility of a brief, semi-structured, biofeedback intervention with a larger outpatient pediatric sample. Methods: Via chart review, we explored 2 years of referrals (N = 79) to our biofeedback program. We examined feasibility in terms of recruitment, program completion, and patient/caregiver satisfaction. Secondary aims included examination of changes in physiological and self-report data. Results: Seventy-three percent of referrals to the biofeedback program attended a first session, with 67% of those that attended a first session completing the program. The majority of patients who completed the program (N = 39, Mage = 13.4 years, 69% female) were referred for anxiety as their presenting problem. Both patients and parents were found to be highly satisfied with the program. By the end of treatment, almost all youth were able to demonstrate a lower respiration rate, accompanied by both improvements in heart rate variability (HRV) indices and self-reported somatic symptoms. The majority of patients, however, did not achieve the goal of a respiration rate lower than 8.0 breaths per minute. Conclusions: The current study demonstrated that a brief, semi-structured biofeedback protocol was feasible in terms of recruitment, retention, and satisfaction with an outpatient pediatric sample. Moreover, youth who completed the program demonstrated improvements as evidenced by physiological and self-report indices. Implications for Impact StatementThis work holds important implications for pediatric psychology care, including that a brief psychology trainee-delivered, semi-structured biofeedback program was found to be feasible and acceptable to patients and families delivered in an outpatient setting. The program was found to be acceptable by participants with diverse diagnoses (e.g., anxiety and pain-related disorders). The current study contributes to the pediatric biofeedback literature by providing further direction around both implementation and outcome measurement in pediatric biofeedback.