Skip to main content
Log in

Common Factors in Biofeedback Administered by Psychotherapists

  • Published:
Applied Psychophysiology and Biofeedback Aims and scope Submit manuscript

Abstract

Common factors are nonspecific therapeutic elements common across different varieties of psychotherapy. In a recent study, 68 expert psychotherapy researchers with a variety of allegiances collectively rated biofeedback as being negatively associated with many common factors (Tschacher et al. in Clin Psychol Psychother 21(1):82–96, 2014), including the therapeutic alliance. However, it seems implausible that biofeedback could benefit so many people while being incompatible with the therapeutic alliance and other common factors. The present study investigated the experiences of biofeedback clients who participated in a brief heart rate variability biofeedback protocol in order to explore the potential roles of common factors in biofeedback. The results of this study offer preliminary evidence that many common factors—including therapeutic alliance, self-efficacy expectation, mastery experiences, provision of explanatory scheme, mindfulness, and even cognitive restructuring—may play a role in biofeedback outcomes. Future research on this topic should include mediation and moderation models investigating the role of specific common factors on outcome and process studies to help determine what clinician behaviors are most helpful. Deeper investigation of common factors in biofeedback may benefit future biofeedback research and practice and address the concerns of colleagues outside of the biofeedback community who believe that biofeedback is at odds with common factors.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  • Burkard, A. W., Knox, S., & Hill, C. E. (2012). Data collection. In C. E. Hill (Ed.), Consensual qualitative research (pp. 83–101). Washington, DC: American Psychological Association.

    Google Scholar 

  • Hill, C. E. (Ed.). (2012). Consensual qualitative research. Washington, DC: American Psychological Association.

    Google Scholar 

  • Holdroyd, K. A., Penzien, D. B., Hursey, K. G., Tobin, D. L., Rogers, L., Holm, J. E., et al. (1984). Change mechanisms in EMG biofeedback training: Cognitive changes underlying improvements in tension headache. Journal of Consulting and Clinical Psychology, 52(6), 1039–1053.

    Article  Google Scholar 

  • Khazan, I. Z. (2013). The clinical handbook of biofeedback: A step-by-step guide for training and practice with mindfulness. Chichester, UK: John Wiley & Sons.

    Book  Google Scholar 

  • Kim, S., Roth, W. T., & Wollburg, E. (2015). Effects of therapeutic relationship, expectancy, and credibility in breathing therapies for anxiety. Bulletin of the Menninger Clinic, 79(2), 116–130. https://doi.org/10.1521/bumc.2015.79.2.116.

    Article  PubMed  Google Scholar 

  • Kokicki, L. A., Holyroyd, K. A., France, C. R., Lipchik, G. L., France, J. L., & Kvaal, S. A. (1997). Change mechanisms associated with combined relaxation/EMG biofeedback training for chronic tension headache. Applied Psychophysiology & Biofeedback, 22, 21–41. https://doi.org/10.1023/A:1026285608842.

    Article  Google Scholar 

  • Ladany, N., Thompson, B. J., & Hill, C. E. (2012). Cross-analysis. In C. E. Hill (Ed.), Consensual qualitative research (pp. 117–134). Washington, DC: American Psychological Association.

    Google Scholar 

  • Lehrer, P. M., & Gevirtz, R. (2014). Heart rate variability biofeedback: How and why does it work? Frontiers in Psychology, 5(176), 1–9.

    Google Scholar 

  • Levitt, H. M., Pomerville, A., & Surace, F. I. (2016). A qualitative meta-analysis examining clients’ experiences of psychotherapy: A new agenda. Psychological Bulletin, 142(8), 801–830.

    Article  Google Scholar 

  • Penzien, D. B., & Holroyd, K. A. (2008). A response: Change mechanisms in EMG biofeedback training revisited. Headache: The Journal of Head and Face Pain, 48, 736–737.

    Article  Google Scholar 

  • Pfammatter, M., & Tschacher, W. (2012). Wirkfaktoren der Psychotherapie–eine Übersicht und Standortbestimmung. Zeitschrift für Psychiatrie, Psychologie und Psychotherapie, 60, 1–10.

    Article  Google Scholar 

  • Sim, W., Huang, T. C., & Hill, C. E. (2012). Biases and expectations. In C. E. Hill (Ed.), Consensual qualitative research (pp. 59–69). Washington, DC: American Psychological Association.

    Google Scholar 

  • Taub, E., & School, P. J. (1978). Some methodological considerations in thermal biofeedback training. Behavior Research Methods & Instrumentation, 10(5), 617–622.

    Article  Google Scholar 

  • Thomas, C. (2010). A mixed methods investigation of heart rate variability training for women with irritable bowel syndrome. Saybrook University. Proquest Dissertations, # 3445129.

  • Thompson, B. J., Vivino, B. L., & Hill, C. (2012). Coding the data: Domains and core ideas. In C. E. Hill (Ed.), Consensual qualitative research (pp. 103–116). Washington, DC: American Psychological Association.

    Google Scholar 

  • Tschacher, W., Junghan, U. M., & Pfammatter, M. (2014). Towards a taxonomy of common factors in psychotherapy - results of an expert survey: Taxonomy of common factors in psychotherapy. Clinical Psychology and Psychotherapy, 21(1), 82–96.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Sheilagh T. Fox.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Fox, S.T., Ghelfi, E.A. & Goates-Jones, M.K. Common Factors in Biofeedback Administered by Psychotherapists. Appl Psychophysiol Biofeedback 46, 151–159 (2021). https://doi.org/10.1007/s10484-021-09504-4

Download citation

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10484-021-09504-4

Keywords

Navigation