Global Initiatives Position BCIA as an International Resource for Biofeedback Certification and Training Standards
The mission of the Biofeedback Certification International Alliance (BCIA) is to certify individuals who meet education and training standards in biofeedback and progressively recertify those who advance their knowledge through continuing education. In strategic recognition of the growing international interest in biofeedback research and practice, BCIA has launched a number of programs in support of worldwide biofeedback certification and global standards for training and education. This article discusses BCIA's international efforts in support of its mission.
What's in a name? For the Biofeedback Certification International Alliance (BCIA), the answer is, “quite a lot.” BCIA was founded in 1981 when the science and clinical practice of biofeedback had evolved to a point at which there was compelling evidence in support of its efficacy as a health care and optimum performance methodology. At that time, the epicenter of interest in the field was the Biofeedback Society of America (now the Association for Applied Psychophysiology and Biofeedback [AAPB]), and much of the published research originated in the United States and Canada. It followed that a certifying body, to be established for consumer protection and to standardize training in the field, would be called the Biofeedback Certification Institute of America. In March of last year, BCIA fittingly replaced “Institute of America” with “International Alliance” in recognition of today's global interest in biofeedback research and practice and to emphasize its mission to promote and support international standards in education and training.
BCIA's name change is much more than symbolic, however. Through an International Task Force commissioned this year, it has aggressively launched a number of initiatives to export its rigorous Blueprints of Knowledge for biofeedback and neurofeedback education and to facilitate certification worldwide. The Task Force initiatives include an Affiliate Program that allows for collaboration between biofeedback organizations in other countries and BCIA in the development of culturally relevant certification programs, a University Initiative that promotes the teaching of courses based on BCIA blueprints at internationally recognized universities, the inclusion of an international section on the BCIA Web site (http://www.bcia.org), distance learning and mentoring programs, and online access to continuing education and testing. As the result of its evolution as an international organization and the impact of these recent initiatives, BCIA certificants now represent some 24 countries on five continents (see the Table).
Affiliate Program
BCIA's Affiliate Program was developed in recognition of the fact that cultural and regulatory differences in other countries affect the adoption of international standards for biofeedback training, continuing education, and board certification. The BCIA Board Certification program was built and anchored in the United States and drafted in accordance with U.S. health care standards. These standards, although fundamentally sound, may not always allow for a seamless fit with current health care models in other jurisdictions. The affiliate program provides an opportunity for partnership between BCIA and a professional biofeedback organization outside of the United States and Canada, allowing the two organizations to collaborate on the development of standards and requirements that make sense for a particular country while upholding educational and training rigor. The affiliate organization must endorse and comply with the foundational principles of BCIA, and its training and certification program may not be specific to a particular brand of equipment or biofeedback theory.
The affiliate certification follows the basic BCIA format that requires (a) a prerequisite educational degree, (b) human anatomy/physiology and didactic course work, (c) mentoring to learn the application of clinical skills, and (d) a psychometrically validated written certification exam. All affiliate certifications are based on the BCIA Blueprints of Knowledge and exams but may allow for variations in other standards in order to be culturally relevant. For example, these variations might involve allowing the board of the affiliate biofeedback organization to establish its own prerequisites for education or license/credential for independent practice. Also, the affiliate may elect to use BCIA Professional Standards and Ethical Principles of Biofeedback or some version of this document or may decide to draft its own as fits with the regulatory and health care model of their jurisdiction. BCIA's vision for the Affiliate Certification is that it will encourage biofeedback certification worldwide, maintain the integrity of the credential, and allow it to become internationally relevant and recognized.
The model for BCIA's Affiliate Program was based on a successful pilot collaboration with the Applied Neurosciences Society of Australasia (ANSA) and ultimately produced “BCIA–Australasia.” This affiliation evolved from an ANSA subcommittee's recommendation to initiate a certification process to protect the public and to help ensure professional competence. In addition, ANSA believed that the process of certification would encourage neurofeedback providers to maintain a learning ethic. Representatives from BCIA and ANSA met and corresponded over several months to draft an agreement that would outline how the two organizations would collaboratively develop standards that upheld educational and professional rigor while existing in accordance with their current health care system. ANSA's strong commitment to the program, their hard work toward its realization, and a common language and health care system facilitated the success of this pilot affiliation. BCIA has begun talks with a number of other countries and anticipates the addition of more affiliates within the year.
University Initiative
The University Initiative, which promotes the creation of biofeedback and neurofeedback courses at leading colleges and universities, has been an important component of the BCIA global outreach. A cornerstone of the international effort was the development of the first BCIA-accredited neurofeedback curriculum offered entirely in French. This course is offered at the Institut of Neurofeedback du Quebec by Drs. Vincent Paquette and Johanne Levesque. Sigmund Freud University of Vienna also offers BCIA blueprint-based biofeedback and neurofeedback courses taught by Monika Fuhs. Both universities have chosen student completion of BCIA certification as a program objective.
Distance Education
Technology has allowed BCIA to expand distance access to education programs that teach didactic coursework based on its Blueprints of Knowledge. This improved accessibility of biofeedback training is particularly important for the success of BCIA's global expansion. There are currently four distance-based didactic programs for General Biofeedback (offered by AAPB, the Behavioral Medicine Research and Training Foundation, Saybrook University, and Widener University), two for Neurofeedback (offered by the Behavioral Medicine Research and Training Foundation and New Mind Neurofeedback), and one for Pelvic Muscle Dysfunction Biofeedback (also offered by the Behavioral Medicine Research and Training Foundation). BCIA has also launched a “study on your own” option that allows applicants to read selected chapters in Marieb and Hoehn's Human Anatomy and Physiology at their own pace and pass an exam based on this content. In further support of distance education, a number of BCIA's master instructors, including Drs. Don Moss, Erik Peper, Lynda and Michael Thompson, and John Demos, have taken their didactic programs abroad and have also provided distance mentoring.
Distance Mentoring
The mentoring component of BCIA certification requires applicants to acquire clinical biofeedback skills through the guidance of an experienced clinician. The clinician mentors the applicant in the learning of personal self-regulation and clinical skills. The advent of distance mentoring that employs Internet-based technologies such as Skype® and GoToMeeting® allows applicants to directly observe the demonstration of skills such as electrode placement and identification of artifact while interacting with their mentor in another location. This has been particularly helpful to international applicants who may not have access to a qualified mentor in their country. A listing of qualified mentors is available via the BCIA Web site.
Online Continuing Education
In September 2009, BCIA launched affordable online continuing education through collaborations with the AAPB and the International Society for Neurofeedback and Research. The online continuing education program provides domestic and international access to pertinent articles from Biofeedback, Applied Psychophysiology and Biofeedback, and the Journal of Neurotherapy. Certificants must pass a brief online exam covering main learning objectives for each article to receive continuing education credit toward recertification. Other continuing education programs available to international certificants include AAPB's teleseminars, equipment vendor courses, and self-study programs.
Online Testing
BCIA has successfully delivered online exams for all three certification programs since 2009 to applicants in countries as diverse as Canada, Mexico, the Netherlands, and South Africa. Secure online testing has benefited both American and international colleagues by eliminating their travel costs, making it easier to arrange for exam proctoring, and significantly reducing their special exam fee. BCIA also offered its first official onsite exam outside of the United States and Canada that took place in Amsterdam on September 27, 2010.
Conclusions: The Future of International Certification
Through its global initiatives, BCIA has made significant progress in establishing an internationally recognized standard for biofeedback and neurofeedback didactic training and education. BCIA has helped to promote international growth in biofeedback, neurofeedback, and pelvic muscle dysfunction biofeedback through its Affiliate Program, University Initiative, distance education, distance mentoring, online continuing education, and online testing. These efforts have strengthened recognition of BCIA Board Certification as a credential that identifies its holder as having met a universally validated standard of training and clinical competence.
The future of international certification indeed appears bright. It is, however, not without its challenges. Perhaps the greatest of these is the translation of BCIA's core reading lists and exams into applicants' native languages. Translation applications are improving but are not yet completely reliable and remain expensive. There must be sufficient demand for BCIA Board Certification and supporting educational materials to justify the cost of translation. The international alliances BCIA fosters will be critical to its success in promoting the value of Board Certification worldwide, creating necessary demand, and scaling the cost of international certification through these collaborations. The early success of its global efforts appears an indication that BCIA is up to these challenges and that its new international identity will make its brand, “More than qualified, BCIA Board certified,” universally recognized and endorsed.
Citation: Biofeedback 39, 1; 10.5298/1081-5937-39.1.02
Citation: Biofeedback 39, 1; 10.5298/1081-5937-39.1.02
Citation: Biofeedback 39, 1; 10.5298/1081-5937-39.1.02
Contributor Notes