EFT Research for Anxiety & OCD
The evidence for efficacy of EFT in treating Anxiety conditions
What is EFT?
Emotional Freedom techniques (EFT) – also known as Tapping – is a widely used modality within the larger field of ‘Energy Psychology’ [EP], a term proposed by an American clinical psychologist, Dr Fred Gallo [Gallo, 1998]. EFT builds upon the work of another clinical psychologist, Roger Callahan, who had reported the use of acupoint tapping as an aid to desensitising traumatic memories [Callahan & Callahan, 1996]. A student of Callahan’s method, Gary Craig, proposed a simplified variant, which he called EFT (Carrington & Craig, 2000).] In the EFT method, the client is guided to attend to a troubling memory, emotion, or cognition, while he or she taps on a series of acupoints. The effect of this is found to be generally calming, reducing the intensity of emotional distress attached to traumatic memories, and enabling a spontaneous reappraisal of beliefs and automatic thoughts (Clond, 2016). EFT is a hybrid method combining elements of exposure, mindfulness and cognitive restructuring with a somatic element. Dismantling studies have demonstrated that acupoint tapping is an active ingredient [Church, et al. 2016; Fox, 2013]. Much of the skill of the work is concerned with selecting appropriate targets for desensitisation and exploring these thoroughly for their sensory, affective, and cognitive components. There is some similarity with EMDR, which also has a tapping variant [Hartung & Galvin, 2003; Mollon,2005].
References
Callahan, R. & Callahan, J. 1996. Thought Field Therapy and Trauma. Treatment and Theory. Indian Well, CA. Published by the author.
Carrington, P. & Craig, G. 2000. A meridian-based intervention for the treatment of trauma.
Journal of the International Society for the Study of Subtle Energies and Energy Medicine. August. 148-151.
Church, D., Stapleton, P., Feinstein, D., Gallo, F., & Yang, A. (2016). Is acupressure an active ingredient in Emotional Freedom Techniques (EFT)? A meta-analysis of dismantling studies. Presented at Omega Institute, Rhinebeck, New York, October 18.
Clond, M., (2016). Emotional Freedom Techniques for Anxiety: A Systematic Review with Metaanalysis. Journal of Nervous and Mental Disease, 204(5), 388-395. doi:10.1097/NMD.0000000000000483.
Fox, L. 2013. Is acupoint tapping an active ingredient or an inert placebo in Emotional Freedom Technique (EFT)? A randomized controlled dismantling study. Journal of Energy Psychology, 5(2) doi 10.9769/EPJ.2013.5.2.LF.
Gallo, F. 1998. Energy Psychology: Explorations at the interface of energy, cognition, behavior and health. Boca Raton, FL. CRC Press.
Hartung, J.G., & Galvin, M.D. 2003. Energy Psychology and EMDR. Combining Forces to Optimize Treatment. New York. Norton.
Mollon, P. 2005. EMDR and the Energy Therapies: Psychoanalytic Perspectives. London. Karnac.
FAQ – EFT Research for Anxiety & OCD
Is there a substantial research base to prove that Energy Psychology / EFT work?
To summarise the larger field of research in Energy Psychology (EP), here are a few paragraphs from the ACEP website research landing page :
“While energy psychology as a field is still relatively young, its evidence base continues to grow in both quantity and quality. As of July 2019, over 100 research studies, 5 meta-analyses and 12 review articles have been published on EP methods in peer-reviewed journals. These modalities have been researched by more than 200 investigators in over 12 countries.
Over fifty randomized controlled trials have documented efficacy for these methods.
The results of these studies have been published in more than 15 different peer-reviewed journals, including the Journal of Clinical Psychology, the Journal of Nervous and Mental Disease and the APA journals Psychotherapy: Theory, Research, Practice, Training and Review of General Psychology. While questions about mechanism remain – specifically how these techniques work – a robust and growing body of research continues to document their efficacy.”
And here’s a quick facts download summarising the Science behind Energy Psychology.
But Wikipedia says EFT doesn't work?..
Wikipedia entries are not based on the expert opinion or facts, but merely on the opinion of editors of the page (some of whom are 12 y.o.). It usually promotes staunchily conservative views, and rabidly criticizes most of the frontier sciences. You can read on how censorship works on Wikipedia in Craig Weiler’s excellent book. For the real science on Energy Psychology, visit the Association for Comprehensive Energy Psychology and EFT International.
Does UK government recognise EFT?
At the moment, National Institute for Health and Care Excellence (NICE) has made EFT research for PTSD a national research priority in the UK. This is a potential precursor to mainstreaming EFT, and the world-first recognition of the robust research base that EFT has already accumulated. PTSD (Post Traumatic Stress Disorder) is an Anxiety condition. There is an element of complex PTSD (retraumatising) each time the person engages in a compulsive ritual following their obsessions. Hence, this is directly relevant to treatment of OCD.
Is there any research indicating that EFT works for Anxiety / OCD specifically?
At the time of writing, the EFT International website listed 31 research articles related to using EFT for Anxiety.
Here are some relevant examples:
Emotional Freedom Techniques for Anxiety: A Systematic Review With Meta-analysis. Clond M. J Nerv Ment Dis. 2016 May;204(5):388-95. doi: 10.1097/NMD.0000000000000483.
Abstract
Emotional Freedom Technique (EFT) combines elements of exposure and cognitive therapies with acupressure for the treatment of psychological distress. Randomized controlled trials retrieved by literature search were assessed for quality using the criteria developed by the American Psychological Association’s Division 12 Task Force on Empirically Validated Treatments. As of December 2015, 14 studies (n = 658) met inclusion criteria. Results were analyzed using an inverse variance weighted meta-analysis. The pre-post effect size for the EFT treatment group was 1.23 (95% confidence interval, 0.82-1.64; p < 0.001), whereas the effect size for combined controls was 0.41 (95% confidence interval, 0.17-0.67; p = 0.001). Emotional freedom technique treatment demonstrated a significant decrease in anxiety scores, even when accounting for the effect size of control treatment. However, there were too few data available comparing EFT to standard-of-care treatments such as cognitive behavioral therapy, and further research is needed to establish the relative efficacy of EFT to established protocols.
How Therapeutic Tapping Can Alter Neural Correlates of Emotional Prosody Processing in Anxiety. König N, Steber S, Seebacher J, von Prittwitz Q, Bliem HR, Rossi S. Brain Sci. 2019 Aug 19;9(8). pii: E206. doi: 10.3390/brainsci9080206.
Abstract
Anxiety disorders are the most common psychological disorders worldwide resulting in a great demand of adequate and cost-effective treatment. New short-term interventions can be used as an effective adjunct or alternative to pharmaco- and psychotherapy. One of these approaches is therapeutic tapping. It combines somatic stimulation of acupressure points with elements from Cognitive Behavioral Therapy (CBT). Tapping reduces anxiety symptoms after only one session. Anxiety is associated with a deficient emotion regulation for threatening stimuli. These deficits are compensated e.g., by CBT. Whether Tapping can also elicit similar modulations and which dynamic neural correlates are affected was subject to this study. Anxiety patients were assessed listening to pseudowords with a different emotional prosody (happy, angry, fearful, and neutral) prior and after one Tapping session. The emotion-related component Late Positive Potential (LPP) was investigated via electroencephalography. Progressive Muscle Relaxation (PMR) served as control intervention. Results showed LPP reductions for negative stimuli after the interventions. Interestingly, PMR influenced fearful and Tapping altered angry prosody. While PMR generally reduced arousal for fearful prosody, Tapping specifically affected fear-eliciting, angry stimuli, and might thus be able to reduce anxiety symptoms. Findings highlight the efficacy of Tapping and its impact on neural correlates of emotion regulation.
Guidelines for the Treatment of PTSD Using Clinical EFT (Emotional Freedom Techniques).
Church D, Stapleton P, Mollon P, Feinstein D, Boath E, Mackay D, Sims R. Healthcare (Basel). 2018 Dec 12;6(4). pii: E146. doi: 10.3390/healthcare6040146.
Abstract
Clinical EFT (Emotional Freedom Techniques) is an evidence-based method that combines acupressure with elements drawn from cognitive and exposure therapies. The approach has been validated in more than 100 clinical trials. Its efficacy for post-traumatic stress disorder (PTSD) has been investigated in a variety of demographic groups including war veterans, victims of sexual violence, the spouses of PTSD sufferers, motor accident survivors, prisoners, hospital patients, adolescents, and survivors of natural and human-caused disasters. Meta-analyses of EFT for anxiety, depression, and PTSD indicate treatment effects that exceed those of both psychopharmacology and conventional psychotherapy. Studies of EFT in the treatment of PTSD show that (a) time frames for successful treatment generally range from four to 10 sessions; (b) group therapy sessions are effective; (c) comorbid conditions such as anxiety and depression improve simultaneously; (d) the risk of adverse events is low; (e) treatment produces physiological as well as psychological improvements; (f) patient gains persist over time; (g) the approach is cost-effective; (h) biomarkers such as stress hormones and genes are regulated; and (i) the method can be adapted to online and telemedicine applications. This paper recommends guidelines for the use of EFT in treating PTSD derived from the literature and a detailed practitioner survey. It has been reviewed by the major institutions providing training or supporting research in the method. The guidelines recommend a stepped-care model, with five treatment sessions for subclinical PTSD, 10 sessions for PTSD, and escalation to intensive psychotherapy or psychopharmacology or both for nonresponsive patients and those with developmental trauma. Group therapy, social support, apps, and online and telemedicine methods also contribute to a successful treatment plan.
Is EFT better than other techniques in treating OCD?
While this may be a relevant research question to compare EFT with other modalities, for example CBT / ERP, I think that’s the more relevant question is: what is the optimal combination of methods that allows to treat OCD most effectively in clinical practice. CBT / ERP are industry-standard in treatment of OCD, and it’d be foolish to overlook those proven, effective methods. Hence, in my work, I combine EFT with CBT / ERP as well as other modalities.