What is EFT ?
The question of “What is EFT Tapping?” is a common question that can elicit a brief or lengthy response. I will do my best to provide the essential information in response to this query.
EFT stands for the Emotional Freedom Techniques. It has also come to be commonly referred to as “tapping” as the techniques involve a gentle tapping or percussion of the fingertips on the skin. EFT is a form of psychological acupressure, based on the same energy meridians used in traditional acupuncture to treat physical and emotional ailments for over 5,000 years, but without the invasiveness of needles.
Studies on Emotional Freedom Techniques ( EFT )
Levels of Parents of Children with Autism Spectrum Disorder
Keppel, Hadas. Fielding Graduate University, ProQuest Dissertations Publishing, 2021. 28713632.
Abstract
The effects of a stress reduction Thought field therapy protocol vs. a control-stimulation protocol on general stress, parenting stress, and empathy (perspective taking) were explored in this mixed-model, randomized control study. Parents of children with autism, from Israel and the USA, showed reduced general stress and an increase in perspective taking following the intervention, as measured by self-reports. General stress partially mediated the effect of TFT on perspective taking. There were no additional changes during the follow-up period. Participants with personality characteristics of the broad autism phenotype presented at baseline higher general and parenting-related stress scores, and lower perspective taking scores, regardless of their intervention group. The finding suggests that perspective taking is part of the broad autism phenotype. TFT was effective, regardless of participants’ BAP status.
Multidisciplinary lifestyle intervention in children and adolescents — results of the project GRIT (Growth, Resilience, Insights, Thrive) pilot study
Hannah L. Mayr1,2,3*, Felicity Cohen2, Elizabeth Isenring1, Stijn Soenen4,5, Project GRIT Team2,6 and Skye Marshall1,7
Abstract
Background
During childhood and adolescence leading behavioral risk factors for the development of cardiometabolic diseases include poor diet quality and sedentary lifestyle. The aim of this study was to determine the feasibility and effect of a real-world group-based multidisciplinary intervention on cardiorespiratory fitness, diet quality and self-concept in sedentary children and adolescents aged 9 to 15 years.
Methods
Project GRIT (Growth, Resilience, Insights, Thrive) was a pilot single-arm intervention study. The 12-week intervention involved up to three outdoor High Intensity Interval Training (HIIT) running sessions per week, five healthy eating education or cooking demonstration sessions, and one mindful eating and Emotional Freedom Techniques psychology session. Outcome measures at baseline and 12-week follow-up included maximal graded cardiorespiratory testing, the Australian Child and Adolescent Eating Survey, and Piers-Harris 2 children’s selfconcept scale. Paired samples t‑test or Wilcoxon signed-rank test were used to compare baseline and follow-up outcome measures in study completers only.
Results
Of the 38 recruited participants (median age 11.4 years, 53% male), 24 (63%) completed the 12-week intervention. Dropouts had significantly higher diet quality at baseline than completers. Completers attended a median 58 (IQR 55–75) % of the 33 exercise sessions, 60 (IQR 40–95) % of the dietary sessions, and 42% attended the psychology session. No serious adverse events were reported. Absolute VO2peak at 12 weeks changed by 96.2 ± 239.4 mL/min (p = 0.06). As a percentage contribution to energy intake, participants increased their intake of healthy core foods by 6.0 ± 11.1% (p = 0.02) and reduced median intake of confectionary (− 2.0 [IQR 0.0–3.0] %, p = 0.003) and baked products (− 1.0 [IQR 0.0–5.0] %, p = 0.02). Participants significantly improved self-concept with an increase in average TScore for the total scale by 2.8 ± 5.3 (p = 0.02) and the ‘physical appearance and attributes’ domain scale by median 4.0 [IQR 0.5–4.0] (p = 0.02).
Conclusions
The 12-week group-based multidisciplinary lifestyle intervention for children and adolescents improved diet quality and self-concept in study completers. Future practice and research should focus on providing sustainable multidisciplinary lifestyle interventions for children and adolescents aiming to improve long-term health and wellbeing.
Trial registration: ANZCTR, ACTRN12618001249246. Registered 24 July 2019 — Retrospectively registered
Keywords
Exercise, Physical activity, Diet quality, Self-concept, Children, Adolescents, Lifestyle intervention, Multidisciplinary
The Effectiveness of Emotional Freedom Techniques (EFT) for Improving The Physical, Mental, and Emotional Health of People with Chronic Diseases and/or Mental Health Conditions: A Systematic Review Protocol
2014, Kalla, M, Khalil, H, Pain and Physical Conditions, Phobias, PTSD & Trauma, Quality of Life, Research Reviews, Serious Disease, Stress
Kalla, M., & Khalil, H. (2014). The effectiveness of Emotional Freedom Techniques (EFT) for improving the physical, mental, and emotional health of people with chronic diseases and/or mental health conditions: A systematic review protocol. JBI Database of Systematic Reviews and Implementation Reports,12(2), 114–124. doi:10.11124/jbisrir-2014–1153
Abstract
The purpose of this systematic review is to:
Identify, summarize and synthesize evidence on the uses and perceived benefits of a meridian-based energy psychology intervention, Emotional Freedom Techniques (EFT) for enhancing physical, mental and emotional health of people with chronic diseases and/or mental health conditions.
Specifically, this systematic review will examine the available Level 1 scientific literature in order to examine the effectiveness of Emotional Freedom Techniques, as a tool to assist with improving people’s health. These will include:
- Specific changes occurring in the physical body, as a result of administering EFT to a subject; for example, changes in cortisol levels, reduced clumping in blood cells, or a reduction in somatization.
- Emotional and mental health benefits reported immediately and at a later follow-up time by subjects.
Background Emotional Freedom Techniques (EFT), also known as tapping, is an energy psychology technique that combines stimulation of acupressure points on the face and upper body with exposure to a specific traumatic memory or trigger.1 EFT uses the meridian energy system of the body, similar to traditional acupuncture, but it differs in the way it is administered.2 In traditional acupuncture, needles are used to stimulate the end points of meridians. In EFT, the subject gently taps acupressure points with his/her fingertips. While tapping on acupressure points, the subject also focuses on the emotions triggered by a stimulus (e.g. spiders, in the case of phobias), or a particular traumatic event, and voices statements of self-acceptance. EFT combines cognitive strategies with systems such as acupuncture which leads to a shift in the “cognitive, behavioral and neurochemical foundations of the psychological problem”. (p2)
Similar to cognitive behavioral therapy, EFT’s aspect of self-acceptance relies on the premise that acceptance, rather than resistance of a particular condition can reduce suffering.
Stimulation of acupoints is believed to send a signal to the limbic system and reduce limbic hyper-arousal.5 This in turn, leads to “rapid reciprocal inhibition” and “long-term counter-conditioning”. (p3)
EFT appears to decrease activity in the amygdala, which is part of the brain’s arousal pathway. It is also considered to have effects on the body’s physiology in relation to stress regulation, emotional intensity and neural transmission.
A randomized controlled trial (RCT) undertaken by Church et al. showed significant improvements in psychological distress symptoms and cortisol levels in 83 non-clinical subjects, who received one hour long EFT sessions. Participants were assigned to EFT, supportive interviews/psychotherapy, or no treatment groups. Salivary cortisol assays, which were undertaken prior to and 30 minutes post intervention, showed a reduction in cortisol level by over 24% in the group that received EFT, compared to a 14.25% decrease in the case of supportive interviews and about 14.44% in the case of no treatment.6 These decreases were in alignment with the perceived improvement in psychological distress symptoms. The EFT group demonstrated improvements in anxiety (58.34%), depression (49.33%) and overall symptom severity (50.5%).
Another clinical study conducted by Church et al. involved 238 first year psychology students who were randomly allocated to either EFT or no treatment groups. Four 90-minute long group EFT sessions were administered to the EFT group. At the end of the four sessions, the EFT group showed statistically significant improvements in their depression scores, which were assessed using the Beck Depression Inventory (BDI). The mean score was in the non-depressed range.
A number of studies have been undertaken to investigate the benefits of EFT for post-traumatic stress disorder (PTSD) patients, in particular veterans. In one RCT, veterans meeting clinical criteria for PTSD were randomly divided into EFT treatment and standard of care/wait list groups. Psychological distress and PTSD symptoms were compared after one month for the standard care group and after six EFT sessions for the EFT group. Not only were symptoms significantly improved, but also 90% of the subjects in the EFT group no longer met clinical PTSD criteria. At the end of the wait list period, the standard care group subjects received EFT. Sixty percent of the subjects became symptom free at the end of three sessions. Eighty six percent of the subjects were symptom free at the end of three months and 80% were symptom free at the end of six months. There have also been studies demonstrating some level of benefits of EFT for fibromyalgia, food cravings, and phobias.
EFT in its current form emerged in the early 1990s. Whilst there have been a number of studies on various health conditions, as well as reviews of its evidence base, there seems to be only one review done systematically, which was a narrative review by Boath et al.1
The proposed systematic review will focus on summarizing and synthesizing evidence related to the perceived benefits of EFT for enhancing physical, mental and emotional health, in order to better understand how EFT can be used to support people suffering from chronic diseases and/or mental health conditions. A variety of scientific literature exists on the subject of EFT, ranging from RCTs to case reports. However, to ensure that studies falling in the higher ranks of evidence hierarchies are included in this review, only RCTs and cohort studies will be included.
Mounting Evidence for a Controversial Therapy. David Feinstein, PhD
Abstract
A database of peer-reviewed journal articles exploring the emerging sub-specialty known as “energy psychology” was assessed. This paper focuses on the 245 clinical trials, meta-analyses, systematic evaluations, and theory pieces examining energy psychology protocols that include tapping on acupuncture points (acupoints), the most frequently used and investigated intervention in energy psychology. The review derives 6 premises about the method’s efficacy, speed, durability, and physiologic effects that have enough empirical support (at least 6 clinical trials each) to serve in delineating and making claims about the approach. These include that acupoint tapping protocols (a) are effective in treating a range of clinical conditions, (b) are rapid compared to conventional treatments, © lead to durable benefits, (d) produce changes in biologic markers that corroborate the subjective assessments of clients, (e) are a critical ingredient for the demonstrated clinical effects and (f) send signals that can increase or decrease arousal in specific areas of the brain. Further consideration of the mechanisms that lead to the reported rapid, durable outcomes suggest that the approach has an unusual capacity for revising outdated mental models. Specifically, a hypothesis is developed proposing that acupoint tapping protocols are facile for producing vivid and emotionally intense experiences that contradict outdated mental models. Such mismatches between what is expected and what actually occurs, called “prediction errors,” have been shown to be an essential requirement for substantially altering a maladaptive mental model and reconsolidating a revised mental model into existing neural networks. (Adv Mind Body Med. 2021;35(2):17–32.).
How Do Energy Psychology Modalities Work?
An Energy-Based Theoretical Perspective
Debra Greene, PhD
Abstract
Energy Psychology (EP) modalities, integrative methods that strategically involve accessing human energy for therapeutic purposes, enjoy a rich and diverse evidence base. As such, many attempts have been made to explain how they work. Explanations have primarily utilized a biological basis for explicating the mechanisms by which EP may function. These contributions are extremely valuable; however, none have been able to offer a fully satisfactory understanding of the efficacy of EP. The currently accepted theoretical model is not robust enough to explain a number of EP effects, and acupoint stimulation remains a confounding factor even though research shows it is an essential component in predominant EP modalities. In many professional EP trainings, negative emotions are said to be caused by a block in the meridian system, so energy-based theory is invoked but not well explained.
Since acupoints are part of the meridian system that distributes vital energy (sometimes called qi) and are therefore energy-based, employing an energy-based perspective for modeling EP could advance theoretical understanding. In this paper I offer an energy-based perspective grounded in Tiller’s multidimensional model. I describe how main components of the model function and apply those to EP, specifically with regard to acupoint stimulation. The objective is to propose a perspective that includes existing theoretical models and extends our understanding of the mechanisms by which EP may work by expanding the theoretical base, contributing to a model with increased scope and explanatory power.
Key words: Energy psychology, EFT tapping, energy medicine, biofield, consciousness
Kalla, M. & Stapleton, P. (2016).
How Emotional Freedom Techniques (EFT) may be utilizing memory reconsolidation mechanisms for therapeutic change in neuropsychiatric disorders such as PTSD and phobia: A proposed model. Explore: The Journal of Science and Healing, in press.
Link: https://evidencebasedeft.com/wp-content/uploads/2017/02/Meta-Reviews-EP_Review_Articles‑4.4.16.pdf
Abstract
Maladaptive fear memories attributed to Pavlovian associations are considered to be at the crux of neuropsychiatric disorders such as post-traumatic stress disorder and phobia. The memory reconsolidation theory suggests that upon retrieval, memories become labile for a few hours, during which yielding a prediction error can lead to therapeutic change. This article proposes that Emotional Freedom Techniques (EFT), a therapeutic intervention combining psychotherapy with a somatic acupoint stimulation component may be utilising memory reconsolidation mechanisms to facilitate therapeutic change. The EFT protocol combines three crucial elements of therapeutic change, namely, retrieval of fear memories, incorporation of new emotional experiences and learnings into the memory creating a prediction error, and finally reinforcement of the new learning.
Bach, D., Groesbeck, G., Stapleton, P., Sims, R., Blickheuser, K., & Church, D. (2019). Clinical EFT (Emotional Freedom Techniques) Improves Multiple Physiological Markers of Health
Bach, D., Groesbeck, G., Stapleton, P., Sims, R., Blickheuser, K., & Church, D. (2019). Clinical EFT (Emotional Freedom Techniques) Improves Multiple Physiological Markers of Health. Journal of Evidence-Based Integrative Medicine, 24. https://doi.org/10.1177/2515690X18823691
Abstract
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.
Stapleton, P. B., Trude, R., Mackintosh, G., Sparenburg, E., Sabot, D., & Carter, B. (2019). Online Delivery of Emotional Freedom Techniques in the Treatment of Food Cravings and Weight Management: A Randomised Controlled Trial
Stapleton, P. B., Trude, R., Mackintosh, G., Sparenburg, E., Sabot, D., & Carter, B. (2019). Online Delivery of Emotional Freedom Techniques in the Treatment of Food Cravings and Weight Management: A Randomised Controlled Trial. OBM Integrative and Complementary Medicine, 4(4). https://doi.org/10.21926/obm.icm.1904065
Abstract
Background: The combination of dietary restraint and physical exercise as a recommended treatment for weight loss has had limited long-term success. One factor proposed as limiting weight management techniques efficacy is the failure to target psychological processes linked with overeating. Consistent with prior research that has identified the efficacy of emotional freedom techniques (EFT) in reducing food cravings and aiding weight loss, this pilot randomised controlled trial (RCT) examined the impact of online delivery of EFT intervention on food cravings and weight management.
Methods: Participants were randomly assigned to an eight-week online EFT intervention group or waitlist control group. The sample comprised primarily of women (96%) aged between 41 and 60 years. Of the treatment group, 65% consumed their craved foods daily and had an average Body Mass Index in the obese range (33.3). Outcome measures assessed included food cravings, dietary restraint, subjective power of food, weight, somatic (body sensation), anxiety, and depressive symptoms.
Results: Post-intervention analyses revealed significant reductions on all measures for participants in the EFT condition (n = 314) with Cohen’s effect size values suggesting moderate to high practical significance for the online intervention. However, there were no significant differences for participants in the waitlist control group (n = 137). In this crossover study design, post-test waitlist data was then collapsed into the EFT treatment group data for follow-up analyses, which indicated treatment gains on all measures at 6‑month (n = 216) and 12-month (n = 145) follow-up.
Conclusions: Findings constitute preliminary support for the utility of online EFT as an accessible tool to assist the management of food cravings and body weight.
Levinge, E., Stapleton, P. B., & Sabot, D. (2020). Delineating the psychological and behavioral factors of successful weight loss maintenance. Heliyon, 6(1), [e03100]. https://doi.org/10.1016/j.heliyon.2019.e03100
Levinge, E., Stapleton, P. B., & Sabot, D. (2020). Delineating the psychological and behavioural factors of successful weight loss maintenance. Heliyon, 6(1), [e03100]. https://doi.org/10.1016/j.heliyon.2019.e03100
Abstract
Overweight and obesity present alarming global health problems including detrimental health risks that call for effective interventions. Considerable research has examined behavioral and psychological factors associated with weight loss to advance the field of obesity and overweight. In line with the literature, this study aimed to develop a behavioral and psychological profile based on factors of personality, eating behaviors, emotional functioning, physical well-being, and psychopathology. The sample consisted of 105 community participants who had reduced their bodyweight by at least 10% and had either successfully maintained their weight loss for a minimum 12-month period (n = 41) or had regained their weight loss within 12 months (n = 64). Participants completed an online survey comprising demographic items and four empirical measures (Mini Marker Personality Scale, Patient Health Questionnaire, Three-Factor Eating Questionnaire-Revised, and a food screening tool). Based on significant bivariate correlations results, four factors (fat intake, restrained eating, uncontrolled eating, and emotional eating) were entered into a binary logistic regression. Restrained eating was the only factor that significantly increased the likelihood of predicting successful long-term weight loss. Findings have implications for overweight and obesity future research, which may guide the direction of obesity and overweight treatments.
Making sense of chronic disease using Emotional Freedom Techniques (EFT): An existential view of illness
Kalla, M., Simmons, M., Robinson, A. and Stapleton, P., 2020. Making sense of chronic disease using Emotional Freedom Techniques (EFT): An existential view of illness. EXPLORE, 16(4), pp.214–224.
Kalla, M., Simmons, M., Robinson, A. and Stapleton, P., 2020. Making sense of chronic disease using Emotional Freedom Techniques (EFT): An existential view of illness. EXPLORE, 16(4), pp.214–224.
https://doi.org/10.1016/j.explore.2020.03.006
Abstract
Objective
This article explores chronic disease patients’ personal symbolic meanings of their diseases, as emergent from their experience of Emotional Freedom Techniques (EFT) therapy. The present study is part of a larger study that explored chronic disease patients’ and EFT practitioners’ experiences of using EFT to support chronic disease healthcare.
Design
Eight chronic disease patients who had received EFT were interviewed for this study. Semi-structured interviews were conducted face to face, or via telephone, or the online videoconferencing platform, Zoom. Interviews were transcribed verbatim and data was analyzed using Interpretative Phenomenological Analysis methodology.
Results
Three themes emerged, namely ‘illness as an embodiment of unresolved emotional issues’, ‘illness as body’s call for time-out and attention’, and ‘illness as a boundary from other people’.
Conclusion
EFT offers promise as a suitable therapeutic approach to help chronic disease patients make sense of their life stories and lived experiences, and consequently, symbolic meanings of diseases. The exploration of illness symbology and meaning-making may offer therapeutic value to patients, from both an existential and a health behaviors perspective.
Portion perfection and Emotional Freedom Techniques to assist bariatric patients post surgery: A randomised control trial
Stapleton, P., Clark, A., Sabot, D., Carter, B. and Leech, K., 2020. Portion perfection and Emotional Freedom Techniques to assist bariatric patients post surgery: A randomised control trial. Heliyon, 6(6), p.e04058.
Stapleton, P., Clark, A., Sabot, D., Carter, B. and Leech, K., 2020. Portion perfection and Emotional Freedom Techniques to assist bariatric patients post surgery: A randomised control trial. Heliyon, 6(6), p.e04058.
https://doi.org/10.1016/j.heliyon.2020.e04058
Abstract
Background
Although significant health improvements are indicated from weight-loss following bariatric surgery, many individuals are unable to lose weight or maintain their weight-loss. The current study aimed to assess whether post-surgery care comprising Emotional Freedom Techniques (EFT), an emerging energy psychology intervention, combined with a behaviour-based nutrition and portion control eating plan in an online self-guided delivery would aid weight-loss and maintenance in bariatric patients.
Methods
A 6‑month randomised controlled parallel-group trial. Participants (N = 343; aged 21–69 years; BMI ≥30 kg/m2) had undergone bariatric surgery (12 + months prior) and were randomly assigned to one of three treatment groups: Portion Perfection for Bariatric Patients (PPBP; n = 109), PPBP combined with an eight-week online self-paced EFT treatment (n = 107), and a treatment as usual (TAU) control (n = 127). Participants completed measures of BMI, emotional eating, uncontrolled eating, food cravings, and self-esteem at 8‑week post-treatment (n = 158) and 6‑month follow-up (n = 109).
Results
Mixed-design analyses of variances were conducted to examine the effect of the interventions on outcome measures (pre-intervention, 8‑week post-intervention, and 6‑month follow-up). Emotional eating decreased significantly from pre-intervention to post-intervention for the PPBP and PPBP with EFT groups, and at 6‑month follow-up for the TAU group only. There were no statistically significant between-group differences in other outcome variables. However, at 6‑months the PPBP with EFT group experienced the greatest improvements in emotional eating (-16.33%), uncontrolled eating (-9.36%), and self-esteem (+4.43%), compared to PPBP only or TAU.
Conclusion
The effect of EFT combined with the eating plan on psychological variables was largely inconsistent with prior research and discussion of how this may be optimised in future trials is discussed.