Emotional Freedom Techniques (EFT) to reduce the side effects associated with tamoxifen and aromatase inhibitor use in women with breast cancer: A service evaluation

The Effects of Emotional Freedom Techniques Implemented During Early Pregnancy on Nausea-Vomiting Severity and Anxiety: A Randomized Controlled Trial

Objective: This randomized controlled trial investigated the effect of emotional freedom techniques (EFT) on the severity of nausea-vomiting and anxiety in early pregnancy. Design: The sample consisted of 131 pregnant women in the experimental and control groups between 6 and 16 weeks of pregnancy attending an antenatal clinic. Participants were randomly assigned to receive training on EFT or a control group. Data were collected using a personal information form, subjective experiences, the Pregnancy-Related Anxiety Questionnaire, and the Pregnancy-Unique Quantification of Emesis. Both groups attended two visits, a week apart. The participants in the EFT group received a session of EFT at each visit and completed two EFT sessions as home assignments, 2 and 4 days after the first visit. The participants in the control group attended two visits a week apart and completed assessments but did not receive EFT. Results: There were 55 women in each group who completed the study, and the groups were similar in terms of baseline measures, including socioeconomic status, smoking status, previous pregnancy, severity of nausea-vomiting, and total pregnancy-related anxiety. EFT significantly reduced anxiety levels from the baseline to the second session (fear of delivery, worries about bearing a handicapped child, concern about one's own appearance) and total pregnancy-related anxiety (total pretest 29.85 ± 9.87, post-test 20.67 ± 8.38; p < 0.001), while the control group showed no reduction in pregnancy-related anxiety (total pretest 26.1 ± 7.79, post-test 25.98 ± 8.49; p = 0.933). Although nausea-vomiting was reduced in both groups over the two-session period, at the end of treatment, the EFT group had significantly lower nausea intensity (EFT group 4.4 ± 1.81, control group 5.36 ± 2.48; p = 0.02). Conclusions: EFT is a nonpharmacologic intervention that can be effective in reducing nausea, vomiting, and anxiety in early pregnancy. Clinical Trials Registration Number: NCT05337852.

Effect of Emotional Freedom Technique Applied to Patients Before Laparoscopic Cholecystectomy on Surgical Fear and Anxiety: A Randomized Controlled Trial

PURPOSE

No studies have investigated the effect of the Emotional Freedom Technique (EFT) on the surgical fears and anxieties of patients before laparoscopic cholecystectomy. This study aimed to determine the effect of EFT on patients' surgical fears and anxieties before laparoscopic cholecystectomy.

DESIGN

The research was conducted using a pretest, post-test, and randomized controlled experimental research design.

METHODS

A total of 112 patients (56 in the intervention group and 56 in the control group) were included in the study. While routine care and treatment practices were applied to the control group, EFT was applied to the intervention group. A Patient Information Form, an Anxiety Specific to Surgery Questionnaire, a Surgical Fear Questionnaire, and Subjective Units of Disturbance (SUD) were used to collect the research data.

FINDINGS

There was no significant difference between the groups in terms of descriptive and clinical features (P > .05). The post-test score averages of EFT group in the Surgical Fear Questionnaire, Anxiety Specific to Surgery Questionnaire, and SUD were significantly lower than in the control group (P < .001). The EFT significantly reduced the SUD scores of the patients by 54.4% (η2 = 0.544, P < .001).

CONCLUSIONS

EFT was found to be useful in clinical practice in the preoperative period, reducing surgery-specific anxiety and surgical fear. EFT can be recommended for application during the preoperative period in clinics.

Using energy psychology to remediate emotional wounds rooted in childhood trauma: preliminary clinical guidelines

Adverse childhood experiences (ACEs) are potentially traumatic events that occur in childhood, such as violence, abuse, severe neglect, or mental health problems in caregivers. The negative physical and mental health consequences of severe or multiple ACEs provide a major challenge for the health care community. Psychotherapies that utilize a mind-body approach in treating ACE-related conditions are seen by their proponents as having advantages for bringing healing and restoration compared with talk, introspective, interpersonal, and exposure therapies that do not intervene at the body level, as famously encapsulated by Bessel van der Kolk's observation that "the body keeps the score." A mind-body approach whose use has been rapidly increasing in clinical settings as well as on a self-help basis is called "energy psychology." Energy psychology combines conventional therapeutic techniques such as cognitive restructuring and psychological exposure with the stimulation of acupuncture points (acupoints) by tapping on them. A review of the development, efficacy, and plausible mechanisms of energy psychology is presented, and several strengths are enumerated, such as how integrating acupoint tapping into conventional exposure methods enhances the speed and power of outcomes. The impact of energy psychology protocols on the three brain networks most centrally involved with ACEs is also examined. Finally, recommendations are offered for using an energy psychology approach at each stage of therapy with individuals who have endured severe or multiple ACES, from establishing a therapeutic alliance to assessment to treatment to follow-up.

Clinical EFT as an evidence-based practice for the treatment of psychological and physiological conditions: A systematic review

Background

Since the turn of the century, Emotional Freedom Techniques (EFT) has come into widespread use in medical and psychological treatment settings. It is also used as self-help by tens of millions of people each year. Clinical EFT, the manualized form of the method, has been validated as an "evidence-based" practice using criteria published by the American Psychological Association (APA) Division 12 Task Force on Empirically Validated Therapies. Its three essential ingredients are exposure, cognitive framing, and acupressure.

Objectives

In 2013 we published a paper defining Clinical EFT and reviewing published research. It has been viewed or downloaded over 36,000 times, indicating widespread interest in this treatment modality. Here we update our findings based on subsequently published literature and propose directions for future research.

Method

We performed a systematic review of the literature to identify randomized controlled trials (RCTs) and meta-analyses. Retrieval of 4,167 results resulted in the identification of 56 RCTs (n = 2,013), 41 of which were published subsequent to our earlier review, as well as eight meta-analyses.

Results

RCTs have found EFT treatment to be effective for (a) psychological conditions such as anxiety, depression, phobias, and posttraumatic stress disorder (PTSD); (b) physiological issues such as pain, insomnia, and autoimmune conditions; (c) professional and sports performance; and (d) biological markers of stress. Meta-analyses evaluating the effect of EFT treatment have found it to be "moderate" to "large." Successful independent replication studies have been carried out for anxiety, depression, PTSD, phobias, sports performance, and cortisol levels. We outline the next steps in EFT research. These include determining its impact on cancer, heart disease, diabetes, and cognitive impairment; analysis of the large-scale datasets made possible by mobile apps; and delivery through channels such as virtual practitioner sessions, artificial intelligence agents, online courses, apps, virtual reality platforms, and standardized group therapy.

Conclusions

Subsequent research has confirmed the conclusions of earlier studies. These find Clinical EFT to be efficacious for a range of psychological and physiological conditions. Comparatively few treatment sessions are required, treatment is effective whether delivered in person or virtually, and symptom improvements persist over time. Treatment is associated with measurable biological effects in the dimensions of gene expression, brain synchrony, hormonal synthesis, and a wide range of biomarkers. Clinical EFT is a stable and mature method with an extensive evidence base. Its use in primary care settings as a safe, rapid, reliable, and effective treatment for both psychological and medical diagnoses continues to grow.

The effects of emotional freedom techniques on coping with premenstrual syndrome: A randomized control trial

PURPOSE

The present study evaluated the efficacy of Emotional Freedom Techniques (EFT), commonly called "tapping," for premenstrual (PMS) symptoms.

DESIGN AND METHODS

This study was conducted with the participation of 50 nursing students who scored 111 or higher on the Premenstrual Syndrome Scale (PMSS). The students in the experimental group were instructed to apply EFT.

FINDINGS

There were statistically significant differences between the mean depressive affect, fatigue, nervousness, sleep-related changes, and swelling subscale scores and the PMSS total scale score of the experimental group measured during the pretest and posttest (p < 0.05).

PRACTICE IMPLICATIONS

The results demonstrate the efficacy of EFT in reducing PMS symptoms. As a fast and efficient self-treatment method, EFT can be easily implemented as a nonpharmacological intervention.

Comparing the effect of emotional freedom technique on sleep quality and happiness of women undergoing breast cancer surgery in military and nonmilitary families: A quasi-experimental multicenter study

PURPOSE

The aim of this study was to compare the effect of emotional freedom technique (EFT) on sleep quality and happiness of women who underwent breast cancer surgery and lived in military and nonmilitary families.

DESIGN AND METHODS

The patients were randomly divided into four groups of military intervention (n = 34), nonmilitary intervention (n = 33), military control (n = 31), and nonmilitary control (n = 35). Data were collected using demographic information form, Pittsburgh Sleep Quality Index, and Oxford Happiness Questionnaire.

FINDINGS

The mean scores of sleep quality and happiness in military and nonmilitary intervention groups improved significantly immediately and 1 month after the intervention compared to control groups (p < 0.001). However, there was no statistically significant difference between the military and nonmilitary intervention groups regarding the mean scores of sleep quality and happiness before, immediately, and 1 month after the intervention (p > 0.05).

PRACTICE IMPLICATIONS

Given the efficacy of EFT in improving sleep quality and happiness, it is recommended that this technique be taught to nurses to implement in the entire process of providing nursing care to cancer patients.

Corrigendum Supports Therapeutic Contribution of Acupoint Tapping to EFTs' Observed Effects: Response to Spielmans (2021)

ABSTRACT

We published a meta-analysis of studies that examined the various components of an evidence-based therapy called emotional freedom techniques (EFTs). EFT uses elements of conventional therapies such as exposure and cognitive processing but includes the unique ingredient of acupoint stimulation using fingertip tapping. Six studies were identified, and three of these met the quality control criteria of the American Psychological Association's Division 12 Task Force for Empirically Validated Therapies. Meta-analysis found that the acupoint component of EFT was not an inert ingredient or inactive placebo but made an active contribution to the therapeutic effects noted in a research literature that now numbers over 100 clinical trials of EFT. Subsequent to publication, errors in the original analysis were identified, primarily incorrect standard deviations. A new analysis was performed by an independent statistician and found slightly greater effects than the original investigation. The results were published as a corrigendum, which was subsequently challenged by Spielmans. Here we examine the critiques of the corrigendum and original article. We find that although they may be of academic interest, they are irrelevant to the central research question of whether the acupoint component of EFT is inert or active. We reaffirm that the evidence clearly validates the contribution made by acupoint tapping to EFT's observed clinical effects.

Clinical EFT (Emotional Freedom Techniques) Improves Multiple Physiological Markers of Health

Emotional Freedom Technique (EFT) is an evidence-based self-help therapeutic method and over 100 studies demonstrate its efficacy. However, information about the physiological effects of EFT is limited. The current study sought to elucidate EFTs mechanisms of action across the central nervous system (CNS) by measuring heart rate variability (HRV) and heart coherence (HC); the circulatory system using resting heart rate (RHR) and blood pressure (BP); the endocrine system using cortisol, and the immune system using salivary immunoglobulin A (SigA). The second aim was to measure psychological symptoms. Participants (N = 203) were enrolled in a 4-day training workshop held in different locations. At one workshop (n = 31), participants also received comprehensive physiological testing. Posttest, significant declines were found in anxiety (-40%), depression (-35%), posttraumatic stress disorder (-32%), pain (-57%), and cravings (-74%), all P < .000. Happiness increased (+31%, P = .000) as did SigA (+113%, P = .017). Significant improvements were found in RHR (-8%, P = .001), cortisol (-37%, P < .000), systolic BP (-6%, P = .001), and diastolic BP (-8%, P < .000). Positive trends were observed for HRV and HC and gains were maintained on follow-up, indicating EFT results in positive health effects as well as increased mental well-being.

The Manual Stimulation of Acupuncture Points in the Treatment of Post-Traumatic Stress Disorder: A Review of Clinical Emotional Freedom Techniques

Background: The manual stimulation of acupuncture points has been combined with components of cognitive and exposure therapies into a clinical and self-help approach known as Emotional Freedom Techniques (EFT). More than 40 clinical trials and four meta-analytic reviews of EFT treatments have demonstrated large effect sizes with a range of conditions, including pain, PTSD (in both civilian and military veteran populations), phobias, anxiety, and depression. Objective: This review describes the approach, with a focus on PTSD in veterans and service members, provides an overview of how EFT is most commonly applied, and outlines obstacles and cautions related to its implementation. Methods: Peer-reviewed clinical trials and meta-analyses of EFT in the treatment of PTSD are assessed to identify the characteristics of the approach that render it suitable for the treatment of PTSD. Results: The literature demonstrates that remediation of PTSD and comorbid conditions is typically accomplished within brief time frames, ranging from one session for phobias to between four and ten sessions for PTSD. Clinical EFT has been shown to regulate stress hormones and limbic function and to improve various neurologic markers of general health. The epigenetic effects of EFT include upregulation of immunity genes and downregulation of inflammation genes. Six dismantling studies have indicated that the acupressure component of EFT is an active ingredient and not placebo. Conclusions: Seven empirically supported strengths of the approach were identified that make it especially suitable for use with veterans and active military: (1) the depth and breadth of treatment effects; (2) the relatively brief timeframes required for successful treatment; (3) the low risk of adverse events; (4) the minimal training time required for the approach to be applied effectively; (5) the simultaneous reduction of physical and psychologic symptoms; (6) the utility and cost-effectiveness of clinical EFT in a large group format; and (7) the method's adaptability to online and telemedicine applications.