Welcome to HRV Biofeedback Tutor!

This multimedia tutorial covers the Biofeedback Certification International Alliance's Blueprint of Knowledge for its Heart Rate Variability Biofeedback Certification and is BCIA-accredited as an online training course.

We encourage you to use our Mentor GPT as your personal coach. We have extensively trained Mentor GPT on this tutorial, the peer-reviewed scientific literature, and our deeply researched posts.

HRV Biofeedback Tutor is one of the Biofeedback Certification International Alliance's Recommended Readings for its HRV Biofeedback Certification exam.

These Units and Exams Are Optional

Neither BCIA nor the Veterans Administration requires you to complete the following units and their corresponding exams: CORE (Psychophysiology, Stress, and Relaxation), ANATOMY (CNS), HARDWARE (Artifacting), and MEASUREMENT (Nonlinear).

Ethics

Ethics satisfies the Professional Standards and Ethical Principles requirement for the Certificate of Completion and Certification.

Recognition

Shawn, one of my finest Lab Managers, is a tenured professor of I/O Psychology at Appalachian State University. His university has recognized Shawn's distinguished leadership of one of the finest I/O Psychology programs in the nation and the productivity of his graduate/undergraduate research program.

Fred Shaffer, PhD, BCB, BCB-HRV, is the author of this tutorial. He is a Biological Psychologist and Professor of Psychology, and former Department Chair at Truman State University, where he has taught since 1975 and has served as Director of Truman's Center for Applied Psychophysiology since 1977.

In 2008, he received the Doris and Walker Allen Fellowship for Academic Excellence. In 2013, he received Truman's Outstanding Research Mentor of the Year award. In 2018, he received the Association for Applied Psychophysiology and Biofeedback's (AAPB) Distinguished Scientist award.

John Foley, a Truman State University graduate and software and server engineer, redesigned Biofeedback Tutor's code and registration application. He moved our distribution of this product to the cloud to ensure that you have the latest version. John set-up and management of our servers is the reason we have industry-leading reliability. John is brilliant, generous, and focused on providing the best possible user experience.

Max McDermott (Neuroscience PhD) started modeling for HRV Biofeedback Tutor in his freshman year. He was one of my brightest and most personable undergraduates. I value his friendship immensely.

Christopher Zerr (Cognitive Neuroscience PhD) and former Assistant Director of the Truman Center for Applied Psychophysiology, has made countless contributions to the refinement of this product, from curating the studies reviewed in these units to supervising the research cited in its applied sections. He was the finest undergraduate I've mentored in 50 years of teaching.

Zachary Meehan earned his PhD in Clinical Psychology from the University of Delaware and serves as the Clinic Director for the university's Institute for Community Mental Health (ICMH). His clinical research focuses on improving access to high-quality, evidence-based mental health services, bridging gaps between research and practice to benefit underserved communities. Zachary is actively engaged in professional networks, holding membership affiliations with the Association for Behavioral and Cognitive Therapies (ABCT) Dissemination and Implementation Science Special Interest Group (DIS-SIG), the BRIDGE Psychology Network, and the Delaware Project. Zachary joined the staff at Biosource Software to disseminate cutting-edge clinical research to mental health practitioners, furthering his commitment to the accessibility and application of psychological science.

Dedication

We dedicate this tutorial to Dr. Paul Lehrer and Dr. Richard Gevirtz. They are dear friends and two of the central architects of modern HRV biofeedback. Paul M. Lehrer, PhD, is Professor Emeritus of Psychiatry at Rutgers Robert Wood Johnson Medical School, where he built a long career integrating psychophysiology, psychiatry, and behavioral medicine. Richard Gevirtz, PhD, is a Distinguished Professor of Psychology at the California School of Professional Psychology, Alliant International University, San Diego, where he has trained generations of clinicians in applied psychophysiology and biofeedback. Both have combined academic leadership, clinical practice, and sustained research programs focused on autonomic regulation and cardiorespiratory physiology.

Paul Lehrer’s work established much of the modern scientific foundation for resonance-frequency HRV biofeedback. He led experimental and clinical studies showing that breathing at an individual resonance frequency enhances baroreflex function, improves indices of autonomic balance, and can ameliorate conditions such as asthma and stress-related disorders. He has been a leading figure in the Association for Applied Psychophysiology and Biofeedback, serving as president, receiving its highest scientific and service awards, and editing its flagship journal, Applied Psychophysiology and Biofeedback. As senior editor of major reference works on stress management and biofeedback, and author of well over a hundred peer-reviewed articles and chapters, he has defined core mechanisms, protocols, and standards that shape HRV biofeedback practice worldwide.

Richard Gevirtz has been equally influential on the clinical and translational side of HRV biofeedback. As a clinician–researcher and supervisor at Alliant, he has applied HRV biofeedback and related psychophysiological methods to chronic pain, fibromyalgia, functional gastrointestinal disorders, cardiac rehabilitation, and anxiety and stress-related problems. His work has clarified how HRV biofeedback can be integrated into evidence-based treatment for patients with complex, medically unexplained, or stress-sensitive symptoms. Through long-standing leadership in AAPB, BCIA certification and fellowship, and a large body of empirical and clinical publications, he has helped codify best practices and train a broad community of practitioners in the thoughtful, mechanism-based use of HRV biofeedback.

Together, Lehrer and Gevirtz co-authored core theoretical and review papers that explain how and why HRV biofeedback works, linking baroreflex physiology, breathing patterns, and vagal regulation to emotional and physical health outcomes. Their combined contributions include foundational laboratory research, influential clinical trials, comprehensive reviews, and key chapters in practitioner handbooks that many clinicians rely on to guide daily practice. Dedicating HRV Biofeedback Tutor to Dr. Paul Lehrer and Dr. Richard Gevirtz acknowledges their decisive roles in creating, validating, and disseminating the very methods, concepts, and protocols that the Tutor seeks to teach.

Appreciation

Don Moss, Inna Khazan, and Erik Peper have played notable roles in HRV Biofeedback Tutor's development as consultants, collaborators, and generous friends. This multimedia tutorial has evolved because of my colleagues' insightful contributions.

Don Moss is a gifted co-author and co-instructor in AAPB, BCIA, and Biofeedback Foundation of Europe (BFE) workshops. Don has generously allowed me to feature his excellent case and ethics presentations in this tutorial.

Inna Khazan is the gifted author of The Clinical Handbook of Biofeedback and Biofeedback and Mindfulness in Everyday Life. She has been a remarkable co-instructor in AAPB and BFE workshops. Inna has also generously allowed me to include several of her case presentations and overview of mindfulness.

Erik Peper's instructive photographs and screenshots appear throughout this product. Erik has been a catalyst for many of Truman's undergraduate research team's early studies and organized two incredible workshops in Hong Kong in 2008 and 2010.

Evgeny Vaschillo, Bronya Vaschillo, and Paul Lehrer brought HRV biofeedback to the United States from the former Soviet Union. They provided the scientific foundation for HRV protocols widely used in clinical and performance practice today. "We stand on the shoulders of giants" (Isaac Newton, 1675).

Special thanks to my colleague Dr. Saul Rosenthal for his illuminating discussion of lessons we can learn from treatment failures.

Truman State University students who staff the Truman Center for Applied Psychophysiology are my inspiration and joy.

Visit the BioSource Software Website

BioSource Software offers Human Physiology, which satisfies BCIA's Human Anatomy and Physiology requirement, and HRV Biofeedback100, which provides extensive multiple-choice testing over the Biofeedback Blueprint.

Moss and Shaffer's (2019) Physiological Recording Technology and Applications in Biofeedback and Neurofeedback, Schwartz and Andrasik's (2016) Biofeedback: A Practitioner's Guide (4th ed.), and Khazan, Shaffer, Moss, Lyle, and Rosenthal's (2023) Evidence-Based Practice in Biofeedback and Neurofeedback (4th ed.) deserve a place on every practitioner's bookshelf.

Khazan's (2019) Biofeedback and Mindfulness in Everyday Life, Lagos' (2020) Heart breath Mind, and Lehrer and Woolfolk's Principles and Practice of Stress Management (4th ed.) provide valuable insights for clinicians and their clients.

Navigation

You can navigate through HRV Biofeedback Tutor's 22 units by clicking on a topic from the menu at the top of this page. You can take a 10-question multiple-choice test to check your mastery of its content at the end of each unit.

Audio Lectures

We feature full-length audio lectures covering each unit's major topics. Click on the podcast icon near the top of the page to hear them.

You may click on the three circles at the right of the podcast controls to reveal Download or Playback speed options.

Click on Download to play the lecture on your smartphone or pad.

About BioSource Software LLC

BioSource is owned by Fredric Shaffer, PhD, BCB, BCB-HRV. BioSource has developed educational resources for biofeedback, heart rate variability biofeedback, pelvic muscle dysfunction biofeedback, and neurofeedback professionals since 1978. We are a trusted government vendor listed with Dun & Bradstreet and the System for Award Management (SAM).

We teach the science of biofeedback and neurofeedback independent of equipment brands, software solutions, normative databases, or personal perspectives.

Copyright

Reproduction of the copyrighted images in this product is strictly prohibited as it violates their publishers' copyright. Reproduction of all images and video segments featured in this product on a website is also expressly forbidden. Biosource Software will permit non-commercial educational use of its images and video segments if you credit HRV Biofeedback Tutor as the source.

Please e-mail BioSource Software using the SEND icon if you have any questions or comments about this product. Check out our website, www.biosourcesoftware.com, for a detailed description of our other products.