Examining the Integration of Biofeedback Treatment in Inpatient Mental Health Care, Specialized in Psychosomatic Medicine and Psychotherapy: A Mixed Methods Study

Although biofeedback (BFB) treatment has been well researched for different outpatient settings, relatively little information exists on the implementation process or the difficulties of applying this form of therapy in an inpatient setting. This study, therefore, focuses on the implementation of BFB in the inpatient setting and the potential barriers to its implementation and use. A mixed methods approach was chosen. Medical professionals in hospitals for inpatient mental health care, specializing in psychosomatic medicine and psychotherapy in Germany, were surveyed on the use of BFB via an online questionnaire. Hospitals that use BFB were then invited to take part in a semistructured interview. Participants were asked about the BFB treatment process and difficulties faced during implementation and application. Twenty-four hospitals participated in the quantitative part, and seven hospitals participated in the qualitative part of the study. The analysis of the data revealed that BFB implementation varied from hospital to hospital. The greatest differences were found primarily in the parameters surveyed, session frequency, and duration. Common features included the use of an introductory session, an evaluation, and a discussion of the benefits for patients. The obstacles included staff shortages, technical problems, and the high organizational effort required for BFB use. The data obtained confirm the benefits of BFB treatment in the inpatient setting and reveal which criteria are necessary for successful implementation. Sufficient resources (staff, time, equipment) must be provided for successful BFB implementation. Consistent integration into patients' timetables could minimize organizational effort, and therapist training could improve handling and implementation.