Date of Award


Document Type


Degree Name

Doctor of Philosophy


School of Education


Counseling Psychology, Ph.D.

First Advisor

Marion J. Merchant

Second Advisor

Wilfred G. A. Futcher

Third Advisor

Robert Fadeley


Problem. Not all individuals who enter a biofeedback program obtain the relief that they are seeking from their various pain-related or anxiety-related complaints. Some individuals obtain little or no relief, whereas others may eliminate their pain-related or anxiety-related complaints completely. Understanding more clearly the reasons for such variance is considered important in that such understanding may encourage the development of techniques that elicit greater biofeedback efficacy rates.

This research study was an attempt to determine some of the factors that may help contribute to a successful biofeedback program. Specifically examined were interactional effects between levels of biofeedback confidence and measures of assertiveness on biofeedback treatment outcome.

Method. The population included 40 patients who were referred to the biofeedback program at a military hospital in south-central Missouri. These were subjects who presented with either an anxiety-related or pain-related complaint.

Subjects were administered the Gambrill Assertion Inventory, the Biofeedback Intervention Confidence Scale, and the Biofeedback Survey (pre-test/post-test). The pre-test, along with the first two instruments, were administered before treatment intervention and the post-test was administered after a standardized biofeedback treatment intervention ensued.

A two-way ANCOVA design, using a fixed effects model, was utilized in the analysis of the resulting data.

Results. No interactional effects between measures of assertiveness and biofeedback confidence on biofeedback treatment outcome were found. In addition, assertiveness levels did not appear to have a significant impact on biofeedback treatment outcome in terms of frequency or intensity of the presenting complaint. The only significant finding of the study, at the .05 level, was than an individual's confidence level in a biofeedback treatment program did have a significant impact upon treatment outcome in terms of "frequency" of presenting complaint. That is, a high level of biofeedback confidence had a significant impact on reducing the frequency of a presenting complaint.

Conclusion. It was concluded that if a high level of confidence in a biofeedback program can have a positive and significant impact on biofeedback outcome in terms of "frequency" of presenting complaint, then increasing an individual's level of confidence in such an intervention would be viewed as cost-effective in terms of treatment.

Subject Area

Feedback (Psychology), Biofeedback training, Operant conditioning

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