Psychotherapy & Neurofeedback in Santa Rosa, California | (510) 868-2802

Silvia Costales, MFT, BCN

"Come for a visit!"

An Open Letter and Invitation to Mental Health Providers in Sonoma County

Dear colleagues,

Neurofeedback is so effective and powerful and yet frustratingly, still often unfamiliar to many mental health providers and omitted from most graduate school curricula. But because side effects are minimal and results are so durable (1), it should actually be the referral we consider first, before medication, in the majority of cases (at least if we take the dictum of first do no harm to heart).

For anxiety or insomnia for instance, we know that benzodiazepines are hugely problematic, and anxiolytics in general have too broad an action (2). While they quiet fear, they also dampen learning and memory (faculties that are often already compromised, as in trauma), effectively shutting down progress in therapy (3).

In contrast neurofeedback works with and enhances brain plasticity, and has a beautiful synergistic effect with the therapeutic process. Your clients will blossom. We see this over and over.

Similarly, and sadly, we know for certain now that the stimulants prescribed to children with attention issues don't actually have any lasting effects and do measurably stunt growth (4). What could be more opposite from therapeutic intent than stunting growth?

And finally, with depression, neurofeedback works almost immediately to start to significantly relieve symptoms and brighten mood. Within weeks or months the effect is robust and lasting. Antidepressant efficacy, on the other hand, is lukewarm at best (5). When they do "work" they take weeks to take effect, they may cause further disregulation and exacerbate suicidality, and withdrawal is often prolonged and difficult (6).

I urge you to inform yourself about neurofeedback so that you can make your clients aware of their alternatives and ensure that they can choose from the best available therapies. 

I welcome any mental health provider who is interested to come for a visit with me sometime in my office! I can show you my equipment and give you a better sense of the process and experience of neurofeedback for the client.

In service,



1. Ros T, Baars BJ, Lanius RA and Vuilleumier P (2014). “Tuning pathological brain oscillations with neurofeedback: a systems neuroscience framework.” Front. Hum. Neurosci. 8:1008.

2.  Merz, B. (2016, December 13). Benzodiazepine use may raise risk of Alzheimer's disease - Harvard Health Blog. Retrieved from

3. Benzodiazepines are Contraindicated in Post Traumatic Stress Disorder (PTSD) | Benzodiazepine Information Coalition. (2019, January 5). Retrieved from

4. Swanson JM , et al. (2017). Young adult outcomes in the follow‐up of the multimodal treatment study of attention‐deficit/hyperactivity disorder: symptom persistence, source discrepancy, and height suppression. J Child Psychol Psychiatr, 58: 663-678. doi:10.1111/jcpp.12684

5. Whitaker, R. (2018, December 6). Do Antidepressants Work? A People's Review of the Evidence - Mad In America. Retrieved from

6.Karter, J. (2016, July 30). Study Examines Experience of Long-Term Antidepressant Use. Retrieved from

7. Pigott, E. (2017). The Crisis in Psychopharmacology Provides an Opportunity for NeuroRegulation Treatments to Gain Widespread Acceptance. NeuroRegulation, 4(1), 28-36. doi:10.15540/nr.4.1.28

"Neurofeedback starts working immediately...and its effects are robust and lasting."

"Neurofeedback should be the referral we consider first, before medication, in the majority of cases."

"Your clients will blossom."