Clinical EFT as an Evidence-Based Practice for the Treatment of Psychological and Physiological Conditions

Abstract

Emotional Freedom Techniques (EFT) has moved in the past two decades from a fringe therapy to widespread professional acceptance. This paper defines Clinical EFT, the method validated in many research studies, and shows it to be an “evidence-based” practice. It describes standards by which therapies may be evaluated, such as those of the American Psychological Association (APA) Division 12 Task Force, and reviews the studies showing that Clinical EFT meets these criteria. Several research domains are discussed, summarizing studies of: 1) psychological conditions such as anxiety, depression, phobias, and posttraumatic stress disorder (PTSD); 2) physiological problems such as pain and autoimmune conditions; 3) professional and sports performance; and 4) the physiological mechanisms of action of Clinical EFT. The paper lists the conclusions that may be drawn from this body of evidence, which includes 23 randomized controlled trials and 17 within-subjects studies. The three essential ingredients of Clinical EFT are described: exposure, cognitive shift, and acupressure. The latter is shown to be an essential ingredient in EFT’s efficacy, and not merely a placebo. New evidence from emerging fields such as epigenetics, neural plasticity, psychoneuroimmunology, and evolutionary biology confirms the central link between emotion and physiology, and points to somatic stimulation as the element common to emerging psychotherapeutic methods. The paper outlines the next steps in EFT research, such as smartphone-based data gathering, large-scale group therapy, and the use of biomarkers. It concludes that Clinical EFT is a stable and mature method with an extensive evidence base. These characteristics have led to growing acceptance in primary care settings as a safe, rapid, reliable, and effective treatment for both psychological and medical diagnoses.

Share and Cite:

Church, D. (2013). Clinical EFT as an Evidence-Based Practice for the Treatment of Psychological and Physiological Conditions. Psychology, 4, 645-654. doi: 10.4236/psych.2013.48092.

Conflicts of Interest

The authors declare no conflicts of interest.

References

[1] Baker, A. H. (2010). A re-examination of Church’s (2009) study into the effects of Emotional Freedom Techniques (EFT) on basketball free-throw performance. Energy Psychology: Theory, Research, & Treatment, 2, 39-44.
[2] Baker, A. H., & Siegel, M. A. (2010). Emotional freedom techniques (EFT) reduces intense fears: A partial replication and extension of Wells et al. Energy Psychology: Theory, Research, and Treatment, 2, 13-30.
[3] Beautler, L. E., Norcross, J. C., & Beutler, L. E. (2005). Evidencebased practices in mental health: Debate and dialogue on the fundamental questions. Washington DC: American Psychological Association.
[4] Beck, A. T., Steer, R. A., & Carbin, M. G. (1988). Psychometric properties of the beck depression inventory: Twenty-five years of evaluation. Clinical Psychology Review, 8, 77-100. doi:10.1016/0272-7358(88)90050-5
[5] Benor, D. J., Ledger, K., Toussaint, L., Hett, G., & Zaccaro, D. (2009). Pilot study of emotional freedom techniques, wholistic hybrid derived from eye movement desensitization and reprocessing and emotional freedom techniques, and cognitive behavioral therapy for treatment of test anxiety in university students. Explore: The Journal of Science and Healing, 5, 338-340. doi:10.1016/j.explore.2009.08.001
[6] Boath, E., Stewart, A, & Carryer, A. (2013). Tapping for success: A pilot study to explore if emotional freedom techniques (EFT) can reduce anxiety and enhance academic performance in university students. Innovative Practice in Higher Education, 1.
[7] Bougea, A. M., Spandideas, N., Alexopoulos, E. C., Thomaides, T., Chrousos, G. P., & Darviri, C. (2013). Effect of the emotional freedom technique on perceived stress, quality of life, and cortisol Salivary levels in tension-type headache sufferers: A randomized controlled trial. Explore: The Journal of Science and Healing, 9, 91-99. doi:10.1016/j.explore.2012.12.005
[8] Brattberg, G. (2008). Self-administered EFT (emotional freedom techniques) in individuals with fibromyalgia: A randomized trial. Integrative Medicine: A Clinician’s Journal, 7, 30-35.
[9] Burk, L. (2010). Single session EFT (emotional freedom techniques) for stress-related symptoms after motor vehicle accidents. Energy Psychology: Theory, Research, and Treatment, 2, 65-71.
[10] Callahan, R. J. (2001). The impact of thought field therapy on heart rate variability. Journal of Clinical Psychology, 57, 1153-1170. doi:10.1002/jclp.1082
[11] Chambless, D. L., Sanderson, W. C., Shoham, V., Bennett Johnson, S., Pope, K. S., Crits-Christoph, P., & McCurry, C. (1996). An update on empirically validated therapies. Clinical Psychologist, 49, 5-18.
[12] Chambless, D., & Hollon, S. D. (1998). Defining empirically supported therapies. Journal of Consulting and Clinical Psychology, 66, 7-18. doi:10.1037/0022-006X.66.1.7
[13] Chambless, D., Baker, M. J., Baucom, D. H., Beutler, L. E., Calhoun, K. S., Crits-Christoph, P., & Woody, S. R. (1998). Update on empirically validated therapies, II. Clinical Psychologist, 51, 3-16.
[14] Church, D. (2010a). The treatment of combat trauma in veterans using EFT (Emotional Freedom Techniques): A pilot protocol. Traumatology, 16, 55-65. doi:10.1177/1534765609347549
[15] Church, D. (2010b). Your DNA is not your destiny: Behavioral epigenetics and the role of emotions in health. Anti-Aging Therapeutics, 13, 35-42.
[16] Church, D. (2013). The EFT mini-manual. Santa Rosa, CA: Energy Psychology Press.
[17] Church, D. (2013a). The EFT manual (3rd ed.). Santa Rosa, CA: Energy Psychology Press.
[18] Church, D. (2013b). Pain, depression, and anxiety after PTSD symptom remediation in veterans. Explore: The Journal of Science and Healing, in Press.
[19] Church, D., & Brooks, A. J. (2010). The effect of a brief EFT (emotional freedom techniques) self-intervention on anxiety, depression, pain and cravings in healthcare workers. Integrative Medicine: A Clinician’s Journal, 9, 40-44.
[20] Church, D., & Brooks, A. J. (2013a). CAM and energy psychology techniques remediate PTSD symptoms in veterans and spouses. Explore: The Journal of Science and Healing, in Press.
[21] Church, D., & Brooks, A. J. (2013b). The effect of EFT (emotional freedom techniques) on psychological symptoms in addiction treatment: A pilot study. International Journal of Scientific Research and Reports, 2.
[22] Church, D., & Downs, D. (2012). Sports confidence and critical incident intensity after a brief application of emotional freedom techniques: A pilot study. Sport Journal, 15.
[23] Church, D., & Feinstein, D. (2013). Energy psychology in the treatment of PTSD: Psychobiology and clinical principles. In T. Van Leeuwen, & M. Brouwer (Eds.), Psychology of trauma (pp. 211-224). Hauppage, NY: Nova Science Publishers.
[24] Church, D., & Marohn, S. (2013). The clinical EFT handbook: A definitive resource for practitioners, scholars, clinicians and researchers . Santa Rosa, CA: Energy Psychology Press.
[25] Church, D., & Palmer-Hoffman, J. (2012). TBI symptoms improve after PTSD remediation with emotional freedom techniques. Presented at the Conference Veterans, Treatment, and Trauma, Omega Institute, Rhinebeck, New York, Submitted for Publication.
[26] Church, D., & Wilde, N. (2013). Emotional eating and weight loss following Skinny Genes, a six week online program. Reported at the annual conference of the Association for Comprehensive Energy Psychology (ACEP), Reston, VA.
[27] Church, D., De Asis, M. A., & Brooks, A. J. (2012). Brief group intervention using EFT (emotional freedom techniques) for depression in college students: A randomized controlled trial. Depression Research and Treatment, 2012, 1-7. doi:10.1155/2012/257172
[28] Church, D., Geronilla, L., & Dinter, I. (2009). Psychological symptom change in veterans after six sessions of EFT (Emotional Freedom Techniques): An observational study. International Journal of Healing and Caring, 9.
[29] Church, D., Hawk, C., Brooks, A., Toukolehto, O., Wren, M., Dinter, I., & Stein, P. (2013). Psychological trauma symptom improvement in veterans using EFT (emotional freedom techniques): A randomized controlled trial. Journal of Nervous and Mental Disease, 201, 153-160. doi:10.1097/NMD.0b013e31827f6351
[30] Church, D., Pina, O., Reategui, C., & Brooks, A. (2012). Single session reduction of the intensity of traumatic memories in abused adolescents after EFT: A randomized controlled pilot study. Traumatology, 18, 73-79. doi:10.1177/1534765611426788
[31] Church, D., Yount, G., & Brooks, A. J. (2012). The effect of emotional freedom techniques (EFT) on stress biochemistry: A randomized controlled trial. Journal of Nervous and Mental Disease, 200, 891-896. doi:10.1097/NMD.0b013e31826b9fc1
[32] Craig, G. (2010). The EFT manual. Santa Rosa, CA: Energy Psychology Press.
[33] Craig, G., & Fowlie, A. (1995). Emotional freedom techniques: The manual. Sea Ranch, CA: Gary Craig.
[34] Craig, G., Bach, D., Groesbeck, G., & Benor, D. J. (2009). Emotional freedom techniques (EFT) for traumatic brain injury. International Journal of Healing and Caring, 9.
[35] Dohrenwend, B. P., Turner, J. B., Turse, N. A., Adams, B. G., Koenen, K. C., & Marshall, R. (2006). The psychological risks of Vietnam for U.S. veterans: A revisit with new data and methods. Science, 313, 979-982. doi:10.1126/science.1128944
[36] Eley, T. C., & Plomin, R. (1997). Genetic analyses of emotionality. Current Opinion in Neurobiology, 7, 279-284. doi:10.1016/S0959-4388(97)80017-7
[37] Energy Psychology Journal (2012). Research-supported psychological treatments. http://energypsychologyjournal.org/div12
[38] Fang, J., Jin, Z., Wang, Y., Li, K., Kong, J., Nixon, E. E., & Hui, K. K.-S. (2009). The salient characteristics of the central effects of acupuncture needling: Limbic-paralimbic-neocortical network modulation. Human Brain Mapping, 30, 1196-1206. doi:10.1002/hbm.20583
[39] Feinstein, D. (2008) Energy psychology in disaster relief. Traumatology, 14, 124-137. doi:10.1177/1534765608315636
[40] Feinstein, D. (2009). Controversies in energy psychology. Energy Psychology: Theory, Research, Practice, Training, 1, 45-56.
[41] Feinstein, D. (2010). Rapid treatment of PTSD: Why psychological exposure with acupoint tapping may be effective. Psychotherapy: Theory, Research, Practice, Training, 47, 385-402. doi:10.1037/a0021171
[42] Feinstein, D. (2012). Acupoint stimulation in treating psychological disorders: Evidence of efficacy. Review of General Psychology, 16, 364-380. doi:10.1037/a0028602
[43] Feinstein, D., & Church, D. (2010) Modulating gene expression through psychotherapy: The contribution of non-invasive somatic interventions. Review of General Psychology, 14, 283-295. doi:10.1037/a0021252
[44] Flint, G. A., Lammers, W., & Mitnick, D. G. (2005). Emotional Freedom techniques: A safe treatment intervention for many trauma based issues. In J. Garrick, & M. B. Williams (Eds.), Trauma treatment techniques: Innovative trends (pp. 125-150). New York: Routledge.
[45] Food and Drug Administration (1998). Guidance for industry: Providing clinical evidence of effectiveness for human drug and biological products. Rockville, MD: US Department of Health and Human Services.
[46] Fox, L., & Malinowski, P. (2013). Improvement in study-related emotions in undergraduates following emotional freedom techniques (EFT): A single-blind controlled study. Energy Psychology: Theory, Research, and Treatment, in Press.
[47] Fraga, M. F., Ballestar, E., Paz, M. F., Ropero, S., Setien, F., Ballestar, M. L., & Esteller, M. (2005). Epigenetic differences arise during the lifetime of monozygotic twins. Proceedings of the National Academy of Sciences USA, 102, 10604-10609. doi:10.1073/pnas.0500398102
[48] Fydrich, T., Dowdall, D., & Chambless, D. L. (1992). Reliability and validity of the Beck Anxiety Inventory. Journal of Anxiety Disorders, 6, 55-61. doi:10.1016/0887-6185(92)90026-4
[49] Google Trends (2013). http://www.google.com/trends/explore#q=eft&cmpt=q
[50] Gorman, J. M. (1998). Comorbid depression and anxiety spectrum disorders. Depression and Anxiety, 4, 160-168. doi:10.1002/(SICI)1520-6394(1996)4:4<160::AID-DA2>3.0.CO;2-J
[51] Hartung, J., & Stein, P. (2012). Telephone delivery of EFT (emotional freedom techniques) remediates PTSD symptoms in veterans: A randomized controlled trial. Energy Psychology: Theory, Research, & Treatment, 4, 33-42.
[52] Hodge, P. M., & Jurgens, C. Y. (2011). A pilot study of the effects of Emotional Freedom Techniques in psoriasis. Energy Psychology: Theory, Research, & Treatment, 3, 13-24.
[53] Hui, K. K. S., Liu, J., Marina, O., Napadow, V., Haselgrove, C., Kwong, K. K., & Makris, N. (2005). The integrated response of the human cerebro-cerebellar and limbic systems to acupuncture stimulation at ST 36 as evidenced by fMRI. NeuroImage, 27, 479-496. doi:10.1016/j.neuroimage.2005.04.037
[54] Institute of Medicine, Committee on Treatment of Posttraumatic Stress Disorder (2007). Treatment of posttraumatic stress disorder: An assessment of the evidence. Washington DC: Institute of Medicine. http://www.nap.edu/catalog/11955.html
[55] Jain, S., & Rubino, A. (2012). The effectiveness of emotional freedom techniques (EFT) for optimal test performance: A randomized controlled trial. Energy Psychology: Theory, Research, and Treatment, 4, 13-24.
[56] Jirtle, R. L., & Skinner, M. K. (2007). Environmental epigenomics and disease susceptibility. Nature Reviews. Genetics, 8, 253-262. doi:10.1038/nrg2045
[57] Jones, S., Thornton, J., & Andrews, H. (2011). Efficacy of EFT in reducing public speaking anxiety: A randomized controlled trial. Energy Psychology: Theory, Research, and Treatment, 3, 19-32.
[58] Kanter, E. (2007). Shock and awe hits home. Washington DC: Physicians for Social Responsibility.
[59] Karatzias, T., Power, K., Brown, K., McGoldrick, T., Begum, M., Young, J., & Adams, S. (2011). A controlled comparison of the effectiveness and efficiency of two psychological therapies for posttraumatic stress disorder: Eye movement desensitization and reprocessing vs. emotional freedom techniques. Journal of Nervous and Mental Disease, 199, 372-378. doi:10.1097/NMD.0b013e31821cd262
[60] Lambrou, P. T., Pratt, G. J., & Chevalier, G. (2003). Physiological and psychological effects of a mind/body therapy on claustrophobia. Subtle Energies and Energy Medicine, 14, 239-251.
[61] Lane, J. (2009). The neurochemistry of counterconditioning: Acupressure desensitization in psychotherapy. Energy Psychology: Theory, Research, and Treatment, 1, 31-44.
[62] LeDoux, J. (2002). Synaptic self: How our brains become who we are. New York: Penguin.
[63] Lee, J.-H, & Kim, J. W. (2013). Randomized controlled trial for the evaluation of the effects of EFT-Insomnia (EFT-I) for the elderly. Master’s Thesis, Korea: Kyung Hee University.
[64] Lee, J.-H, Suh, H.-U., Chung, S.-Y, & Kim, J. W. (2011). A preliminary study for the evaluation of the effects of EFT-I (EFT program for insomnia) for insomnia in the elderly. Journal of Oriental Neuropsychiatry, 22, 101-109.
[65] Llewellyn-Edwards, T., & Llewellyn-Edwards, M. (2012). The effect of emotional freedom techniques (EFT) on soccer performance. Fidelity: Journal for the National Council of Psychotherapy, 47, 14-21.
[66] Mavissakalian, M. (1986). The fear questionnaire: A validity study. Behaviour Research and Therapy, 24, 83-85. doi:10.1016/0005-7967(86)90154-3
[67] McCallion, F. (2012). Emotional freedom techniques for dyslexia. Energy Psychology: Theory, Research, and Treatment, 4, 35-46.
[68] Melnyk, B. M., & Fineout-Overholt, E. (2005). Making the case for evidence-based practice. Philadelphia, PA: Lippincott Williams & Wilkins.
[69] Mollon, P. (2007). Thought field therapy and its derivatives: Rapid relief of mental health problems through tapping on the body. Primary Care and Community Psychiatry, 12, 123-127.
[70] Napadow, V., Kettner, N., Liu, J., Li, M., Kwong, K. K., Vangel, M., & Hui, K. K. (2007) Hypothalamus and amygdala response to acupuncture stimuli in carpal tunnel syndrome. Pain, 130, 254-266. doi:10.1016/j.pain.2006.12.003
[71] National Institute for Clinical Excellence (2009). How NICE clinical guidelines are developed: An overview for stakeholders, the public and the NHS. http://www.nice.org.uk/media/62F/36/How_NICE_clinical_guidelines_are_developed_4th_edn_FIANL_LR.pdf
[72] Nemiro, A. (2013). EFT vs CBT in the treatment of sexual gender based violence in the Democratic Republic of the Congo. Presented at the conference of the Association for Comprehensive Energy Psychology (ACEP), San Diego, CA.
[73] Ornish, D., Magbanua, M. J. M., Weidner, G., Weinberg, V., Kemp, C., Green, C., & Carroll, P. R. (2008). Changes in prostate gene expression in men undergoing an intensive nutrition and lifestyle intervention. Proceedings of the National Academy of Sciences USA, 105, 8369-8374. doi:10.1073/pnas.0803080105
[74] Palmer-Hoffman, J., & Brooks, A. J. (2011). Psychological symptom change after group application of emotional freedom techniques (EFT). Energy Psychology: Theory, Research, & Treatment, 3, 33-38.
[75] Patterson, S. L. (2013). The effect of emotional freedom technique on stress and anxiety in nursing students. Presented at the conference of the Association for Comprehensive Energy Psychology (ACEP), San Diego.
[76] Pekrun, R., Goetz, T., Frenzel, A. C., Barchfeld, P., & Perry, R. P. (2011). Measuring emotions in students’ learning and performance: The Achievement Emotions Questionnaire (AEQ). Contemporary Educational Psychology, 36, 36-48. doi:10.1016/j.cedpsych.2010.10.002
[77] Phelps, E. A., & LeDoux, J. E. (2005). Contributions of the amygdala to emotion processing: From animal models to human behavior. Neuron, 48, 175-187. doi:10.1016/j.neuron.2005.09.025
[78] Rosenberg, M. (1989). Society and the adolescent self-image (Rev. ed.). Middletown, CT: Wesleyan University Press.
[79] Rotherham, M., Maynard, I., Thomas, O., Bawden, M., & Francis, L. (2012). Preliminary evidence for the treatment of type I “yips”: The efficacy of the emotional freedom techniques. Sports Psychologist, 26, 551-570.
[80] Rowe, J. E. (2005). The effects of EFT on long-term psychological symptoms. Counseling and Clinical Psychology, 2, 104-111.
[81] Ruggiero, K. J., Del Ben, K., Scotti, J. R., & Rabalais, A. E. (2003) Psychometric properties of the PTSD checklist-civilian version. Journal of Traumatic Stress, 16, 495-502. doi:10.1023/A:1025714729117
[82] Salas, M. M., Brooks, A. J., & Rowe, J. E. (2011). The immediate effect of a brief energy psychology intervention (Emotional Freedom Techniques) on specific phobias: A pilot study. Explore: The Journal of Science and Healing, 7, 255-260.
[83] Schulz, P. (2009). Integrating energy psychology into treatment for adult survivors of childhood sexual abuse. Energy Psychology: Theory, Research, and Treatment, 1, 15-22.
[84] Seligman, M. E. P. (1995). The effectiveness of psychotherapy: The consumer reports study. American Psychologist, 50, 965-974. doi:10.1037/0003-066X.50.12.965
[85] Sezgin, N., & Ozcan, B. (2009). The effect of progressive muscular relaxation and Emotional Freedom Techniques on test anxiety in high school students: A randomized controlled trial. Energy Psychology: Theory, Research, and Treatment, 1, 23-30.
[86] Sherman, J. J. (1998). Effects of psychotherapeutic treatments for PTSD: A meta-analysis of controlled clinical trials. Journal of Traumatic Stress, 11, 413-435. doi:10.1023/A:1024444410595
[87] Sojcher, R., Perlman, A., & Fogerite, S. (2012). Evidence and potential mechanisms for mindfulness practices and energy psychology for obesity and binge-eating disorder. Explore: The Journal of Science and Healing, 8, 271-276. doi:10.1016/j.explore.2012.06.003
[88] Stapleton, P. B., Sheldon, T., & Porter, B. (2012). Clinical benefits of Emotional Freedom Techniques on food cravings at 12-months follow-up: A randomized controlled trial. Energy Psychology: Theory, Research, and Treatment, 4, 1-12.
[89] Stapleton, P., Church, D., Sheldon, T., Porter, B., & Carlopio, C. (2013). Depression symptoms improve after successful weight loss with EFT (Emotional Freedom Techniques): A randomized controlled trial. Depression Research and Treatment, in Press.
[90] Stapleton, P., Sheldon, T., Porter, B., & Whitty, J. (2011). A randomised clinical trial of a meridian-based intervention for food cravings with six-month follow-up. Behaviour Change, 28, 1. doi:10.1375/bech.28.1.1
[91] Stein, P., & Brooks, A. J. (2011). Efficacy of EFT (emotional freedom techniques) provided by coaches vs. licensed therapists in veterans with PTSD. Energy Psychology: Theory, Research, & Treatment, 3, 11-17.
[92] Stewart, A., Boath, E., Carryer, A., Walton, I., Hill, L., Phillips, D., & Dawson, K. (2013). Can matrix reimprinting using EFT be effective in the treatment of emotional conditions? Energy Psychology: Theory, Research, & Treatment, in Press.
[93] Swingle, P. (2010). EFT in the neurotherapeutic treatment of seizure disorders. Energy Psychology: Theory, Research, & Treatment, 2, 27-38.
[94] Swingle, P. G., Pulos, L., & Swingle, M. K. (2004). Neurophysiological indicators of EFT treatment of posttraumatic stress. Subtle Energies and Energy Medicine, 15, 75-86.
[95] Traffic Estimate (2013). http://www.trafficestimate.com/eft.mercola.com
[96] University of Warwick and University of Edinburgh (2012). The Warwick-Edinburgh Mental Well-being Scale (WEMWBS). http://www.healthscotland.com/documents/1467.aspx
[97] Veterans Health Administration (2012). Report on VA facility specific Operation Enduring Freedom (OEF), Operation Iraqi Freedom (OIF), and Operation New Dawn (OND) veterans coded with potential PTSD. http://www.publichealth.va.gov/docs/epidemiology/ptsd-report-fy2012-qtr3.pdf
[98] Waite, L. W., & Holder, M. D. (2003). Assessment of the emotional freedom technique: An alternative treatment for fear. Scientific Review of Mental Health Practice, 2, 20-26.
[99] Weathers, F., Huska, J., & Keane, T. (1991). The PTSD checklist military version (PCL-M). Boston, MA: National Center for PTSD.
[100] Wells, S., Polglase, K., Andrews, H. B., Carrington, P., & Baker, A. H. (2003). Evaluation of a meridian-based intervention, emotional freedom techniques (EFT), for reducing specific phobias of small animals. Journal of Clinical Psychology, 59, 943-966. doi:10.1002/jclp.10189
[101] Zigmond, A. S., & Snaith, R. P. (1983). The hospital anxiety and depression scale. Acta Psychiatrica Scandinavica, 67, 361-370. doi:10.1111/j.1600-0447.1983.tb09716.x

Copyright © 2024 by authors and Scientific Research Publishing Inc.

Creative Commons License

This work and the related PDF file are licensed under a Creative Commons Attribution 4.0 International License.