Stress assessment using biofeedback – knowing where you stand

Preparing for biofeedback treatment

Preparation for biofeedback treatment usually begins with a detailed analysis of the patient’s or client’s individual stress responses. Two diagnostic approaches can be particularly valuable here: short-term assessment and long-term monitoring.

Short-term diagnostics: the stress test

Biofeedback diagnostics primarily involve measuring short-term physiological responses to specific stimuli, such as heart rate, skin conductance and muscle activity. In addition to recording these parameters at rest (baseline), it is particularly insightful to record the physiological responses to various stress stimuli. Another important aspect is the observation of the recovery phase – that is, the time the body needs to return to its initial state following a stressful situation. This duration can provide insight into the client’s stress resilience and ability to cope with stress.

As well as providing the participant with an initial understanding of the link between stress, physiological effects and possible consequences for their symptoms, further insights and objectives can often be derived from the data collected during this initial diagnostic session¹.

Stress test using the Neuromaster

A typical stress test using the Neuromaster system consists of several phases that simulate everyday stressful situations, such as mental arithmetic, viewing distressing images or videos, imagining distressing scenarios, or listening to unpleasant noises. Between the stress phases, there are relaxation phases lasting 1–3 minutes each.

During the test, not only are the immediate physiological responses to these stressors recorded, but also the time it takes for the body to return to a state of rest following the stress. This recovery time is an important indicator of the client’s ability to cope with stress.

Analysing stress test data provides valuable insights into individual stress mechanisms and can serve as a motivational tool. Recognising the links between stress and physiological responses can be a „lightbulb moment“ for patients and encourage them to make changes.

Long-term monitoring: Storage mode

In addition to short-term analysis, the Neuromaster system long-term monitoring. In what is known as ‘storage mode’, the device can be worn for a whole day to record various physiological parameters. The data collected is stored on an SD card and analysed at a later date.

Long-term monitoring provides important information about stress-related pressures in working and everyday life. It is suitable for sleep analyses, including Heart rate variability analysis, as well as for longer periods of data collection in everyday life. This method also enables therapists to experience anxiety-inducing situations alongside their clients and to discuss the recorded parameters afterwards.

Identifying the right relaxation technique

Given the wide range of relaxation techniques available, the question often arises as to which method is most effective for each individual client. Personal preferences play an important role here and are often something clients are not aware of.

Woman Diana Sicher Fritsch has written a dissertation on this topic³ and states as follows:

Conclusion and tips

Every biofeedback treatment begins with a comprehensive assessment, which helps to identify relevant factors, determine the client’s current condition and select the most appropriate technique. In this context, biofeedback often serves as an „eye-opener“, making clients aware of their heightened stress responses.

Practical tips

When carrying out biofeedback diagnostics, it is crucial that users are fully familiar with the measured parameters and how to interpret them. Whilst standard values exist for some parameters, such as muscle tension, skin conductance requires individual assessment as it cannot be interpreted directly.