To be considered Level 5 (“efficacious and specific”) modified alpha-theta training would need to be shown to be superior to sham or bona fide treatment. It has not been demonstrated that the Peniston type alpha-theta feedback is more efficacious than sham treatment (Trudeau 2000, 2005a, b; Lowe 1999; Moore and Trudeau 1998) or alternative treatment that involves meditation (Taub and Rosenfeld 1994).