Page 1 Page 2 Page 3 Page 4 Page 5 Page 6 Page 7 Page 8 Page 9 Page 10 Page 11 Page 12 Page 13 Page 14 Page 15 Page 16 Page 17 Page 18 Page 19 Page 20 Page 21 Page 22 Page 23 Page 24 Page 25 Page 26 Page 27 Page 28 Page 29 Page 30 Page 31 Page 32 Page 33 Page 34 Page 35 Page 36 Page 37 Page 38 Page 39 Page 40 Page 41 Page 42California Biofeedback — Fall 2016 12 HRV and EMG shows promise as per- formance feedback measures. Changes in HRV (due to food, stress, exercise, performance-based behaviors, or post performance recovery) could be a key metric with which to mold individual performance (Makivic et al., 2013). Such metrics are one avenue for the profession- al and client to collaborate as they create real-time and quantifiable guidelines that both can track over time. As professionals who understand these metrics, we inte- grate biopsychosocial factors, such as cog- nitive, affective, social, and physiological factors, to improve the client’s athletic and musical performance in a cohesive manner. Behavioral Interventions and Performance The effects of biofeedback interven- tions can be amplified by integrating behavioral and cognitive strategies to im- prove physical functioning. This is highly relevant for the specialist who desires to apply non-pharmacological, self-manage- ment interventions to address the chronic condition and performance/functional variables simultaneously. The special- ist’s ability to hold a theoretical frame of thinking about behavioral interventions can also make it easier for both the cli- ent and practitioner to make sense out of multiple behavioral approaches. Multiple studies have demonstrated the utility of cognitive-behavioral thera- py (CBT), acceptance and mindfulness based therapies, motivational interview- ing, and psychodynamic therapy (PT) in improving performance-based behaviors. Classically CBT has been an efficacious approach to improve athletic and musical performance by using multiple cognitive and behavioral strategies (Whelan, Ma- honey, & Meyers, 1991). These include goal setting, rehearsal, imagery, arous- al management, and thought and affect self-regulation (Meyers, Whelan, & Mur- phy, 1996). Figure 5 lists the core inter- ventions used in the different CBT phases to improve performance. Repeat Figure 5. Rehearsal & Imagery • Graded rehearsal • Practicing skills in dif- ferent enviroments • Visualizing perfor- mance-based behav- iors while regulating arousal and affect Arousal and Thought Management • Recognizing signs of, and modifying, hy- per- or hypo-arousal • Identifying unhelpful thinking • Reframing thinking to goal orieted thinking