Can Matrix Reimprinting be effective in the treatment of emotional conditions
in a public health setting? Results of a UK pilot study
Keywords: Matrix Reimprinting, EFT, therapy, emotion, trauma, anxiety.
Description of objectives
A pilot study was carried out to establish the feasibility and effectiveness of Matrix
A dedicated MR/ EFT service, within the National Health Service (NHS) in the district
of Sandwell, UK.
Method including assessments
Over a 15 month period, clients accessing the EFT service for a range of emotional
conditions were invited to participate in the pilot study. Those who gave consent
were entered into the study. At the start and end of their treatment, clients were
asked to complete the CORE10 (main outcome variable), WEMWBS, Rosenberg
Self Esteem and HADS measurement scales.
Twenty-four clients were included in the MR pilot study. A total of 92% were female,
and 79.2% were White British. The mean age was 47 years (range 18-66 years),
and mean number of sessions attended was 8.33 (median 6.5). CORE10,
Rosenberg Self-Esteem and HADS Depression scores showed both statistically and
clinically significant improvements, with statistically significant improvement for
WEMWBS. Mean CORE10 scores improved from 21.9 at start to 10.5 at end
(SD=6.1, p<0.001) and all MR clients showed improvements.
Despite the limited sample size and other limitations, significant improvements were
shown. The results support the potential of MR as a cost-effective treatment to
reduce the burden of a range of physical and psychological disorders. Further larger
studies are called for, with protocols to minimise drop-outs.
Matrix reimprinting (MR) is a recently developed technique that can improve health
and wellbeing by allowing clients to access and transform painful memories about
traumatic events (Dawson & Allenby, 2010). It was evolved from Emotional Freedom
Techniques (EFT), a gentle therapy that can be used for a variety of issues.
Subjects gently tap with their fingertips on acupressure points (mainly on the head
and hands) and relate this to the voicing of specific statements (Craig 2011). MR is
an energy psychology technique which incorporates EFT, parts/inner child work,
referred to in MR as ECHOs (Energy Consciousness Holograms) and also integrates
recent understanding from quantum and epigenetic science. Using MR, the client
works with the ECHO to release the stress or trauma. A new and positive picture is
then created and highlighted, which is used to reprogram the mind with the new
information, indicating that the trauma is over (Dawson & Allenby 2010).
MR is particularly effective in helping clients to overcome a variety of serious health
and emotional challenges, including traumatic memories, sexual abuse, addictions
and phobias (Dawson & Allenby 2010). Although MR, like EFT, can be easily taught
and self-administered, MR clients are not advised to use the technique by
themselves for extreme issues (Dawson & Allenby, 2010).
Research suggesting that EFT may be an efficient and effective intervention for a
range of psychological disorders has grown exponentially over the past decade and
two systematic reviews have been recently published (Feinstein 2012, Boath et al.,
2012a). Although there are a growing number of MR practitioners (around 2,500
worldwide) and anecdotal evidence demonstrating the effectiveness of MR for a wide
range of issues including: trauma, fibromyalgia, allergies, phobias, pain
management, depression, anxiety and, stress reduction, a literature search of
nursing, medical and psychological electronic databases using the key terms ‘matrix
reimprinting’ revealed no published clinical studies of MR to date. Other than an
unpublished study using MR for civilian survivors of war in Bosnia (Rolling et al
2012), the authors are not aware of any other research ongoing or published. This
report is therefore the first ever published study of MR.
Sandwell, an urban district comprising six Towns in the West Midlands, UK,
introduced a formal EFT/MR service in November 2010. The service was launched
as part of Sandwell’s Confidence and Wellbeing Team Service (CWBT, Sandwell,
2012). The Team offers a range of services, aiming to create opportunities for clients
to maintain and improve their own wellbeing and provide community and primary
health care mental health services that are flexible and meet the emotional needs of
those living and working in Sandwell. An evaluation of this service was carried out in
2012 (Stewart et al, in press). The evaluation was conducted by AS over a 15
month period. Though regarded as a pilot study, it was undertaken in the NHS as a
“Service Evaluation”. In the UK, Service Evaluation is recognised as a method to
investigate how well current services or initiatives are working and produce internal
recommendations for service development or improvement (NHS Direct 2013).
Although EFT had previously been used by some therapists within Sandwell and
elsewhere in the National Health Service (NHS) on an ad-hoc basis, to the authors’
knowledge, this was the first service explicitly dedicated to offering EFT/MR within
the NHS. As MR is related to EFT (Dawson & Allenby, 2010), it was considered
appropriate and acceptable to incorporate it into some of the sessions, especially for
patients with more serious issues, such as traumatic memories, sexual abuse,
bereavement , self-harm and other conditions at the discretion of the practitioner.
This pilot study was therefore undertaken to establish the feasibility and
effectiveness of MR in this setting.
This MR pilot study was part of the larger EFT pilot (Stewart et al 2013). Clients who
received MR were identified and analysed separately. The MR clients had already
given informed consent.
All Sandwell GPs and health professionals were given information about the nature
and availability of the service. Clients were also able to self-refer. Referrals were
accepted for any condition, providing that clients were aged over 18, and not classed
as “vulnerable adults”, defined as adults who are at greater than normal risk of abuse
(NHS Choices 2013).
The therapy was delivered by AS, an AAMET accredited (AAMET 2013) and highly
experienced EFT and MR practitioner and health researcher. Prior to the launch of
the EFT service, ethical approval for the Pilot Study as a Service Evaluation was
secured from both Sandwell PCT and Staffordshire University. All clients were
invited to give informed consent to their data being used, but agreeing to participate
in the study was not a condition of treatment.
At the start and end of their treatment, clients were asked to complete each of the
following measurement scales: CORE-10 (the main outcome variable) for
psychological distress covering anxiety, depression, trauma, physical problems,
functioning and risk to self (CORE IMS, 2012), Hospital Anxiety and Depression
Scale (HADS; Zigmond & Snaith 1983), Rosenberg Self-Esteem Scale (Rosenberg
1989) and the Warwick-Edinburgh Mental Well-being Scale (WEMWBS, 2012).
Sandwell CWBT used the online CORE NET system (CORE IMS 2012), and
required CORE-10 and WEMWBS scales to be electronically administered at each
appointment to track progress and gather routine data; this was part of routine data
collection, and separate from the pilot study.
Each client was given a 10-15 minute introduction to EFT initially, then MR was
incorporated during the course of therapy. Clients receiving MR were guided though
the process by AS. Initial appointments were of up to 90 minutes duration, with each
subsequent appointment lasting up to 60 minutes.
Data analysis was undertaken using SPSS v19 (IBM 2010). Mean pre, post and
follow-up scores for each measurement scale were compared using paired t-tests (or
Wilcoxon Signed-Rank tests for non-normally distributed variables). Further t-test
and correlation analysis was carried out to test for differences in scores by gender
and age. Data for all clients who gave consent were entered into the evaluation and
analysed irrespective of whether they had completed their therapy.
A total of 24 clients received MR, and 19 (79%) of them completed their therapy.
Only 2 clients were male and the remaining 22 (92%) were female. The mean age
for all clients receiving MR was 47(SD=12, range 18-66 years). In all, 19 (79.2%) of
clients were White British, two clients were Indian and one client each were: Black
British, Pakistani and Mixed Race. The mean number of clinical sessions attended
was 8.33 (SD = 9.2, median 6.5; range 3-49). N=21 clients received 9 sessions or
less, one client received 12, one received 17 sessions and one received 49
sessions. The main presenting conditions were: anxiety (14; 58.3%) and depression
(5; 20.8%). Clients identified up to four additional issues, including traumatic
memories, sexual abuse, depression, bereavement and anger. These conditions
were not mutually exclusive.
Most of the measurement scales used in this pilot have acknowledged thresholds for
clinical “cases”, shown in Table 1.
Normal Case Range Notes
CORE-10 <10 11-30 0-30 Higher score = higher psychological distress
20-24=”moderate severe”; 25-30=”severe”
Clinically significant change = <10 at start & >10 at
WEMWBS n/a n/a 14-70 No threshold for “caseness”;
higher score = higher mental wellbeing
Rosenberg Self-Esteem 15-25 0-14 0-30 Higher score = higher self-esteem
HADS Anxiety <8 8-21 0-21 0-7: Normal
8-10: Cause for concern; monitor for change
11-12: Probable clinical case requiring assessment
HADS Depression <8 8-21 0-21 0-7: Normal
8-10: Cause for concern; monitor for change
11-12: Probable clinical case requiring assessment
Table 1. Thresholds for clinical cases.
MR was used with all clients who reported traumatic memories (7), sexual abuse (3),
bereavement (2) and self-harm (1), plus 13 who reported depression. Clinical results
are shown in Table 2:
CORE-10 21.9 10.5 6.1 <0.001 *23
WEMWBS 34.8 49.6 10.8 <0.001 *22
Rosenberg Self-Esteem 11.0 20.4 6.6 <0.001 *16
HADS Anxiety 16.1 10.5 4.1 <0.007 *10
HADS Depression 11.1 7.4 5.7 0.07 10
HADS Total 26.8 17.8 8.9 <0.017 *10
Table 2. Results of inferential analysis pre and post-therapy.
CORE-10 has a 'clinical cut-off' score of 10; mean CORE-10 scores were far in
excess of 10 (caseness) at start and only a little over 10 (normal) at end. HADS
scores (for anxiety and depression domains individually) of 0-7 are considered
normal, 8-10 indicates cause for concern, while 11-12 represent probable clinical
cases requiring assessment. Both HADS anxiety and depression domains were
over 8 at start, but HADS Depression was under 8 at end; this effect was not
statistically significant, however. Mean Rosenberg Self-Esteem scores were less
than 15 at the start (indicative of low self-esteem), but were in the normal range (15-
25) at the end. WEMWBS scores (where higher scores represent higher mental
wellbeing) also increased significantly. The limited sample size prevented further
Figure 1 shows CORE-10 scores at the start of therapy, plotted against scores at the
end. Each dot represents a client seen by the service who gave consent. CORE-10
scores at the start (left-hand side) are plotted against those at the end of treatment
(bottom). Clients shown above the diagonal line improved, while any below the line
deteriorated. It can be seen that all clients improved between the two time points.
Figure 1. Scatter Plot for CORE-10 scores at start and end of therapy.
The practitioner (AS) used MR for all clients who reported trauma (including sexual
abuse), bereavement and self-harm. These MR clients may therefore be considered
to have experienced emotional issues that were more severe than those who would
benefit from EFT alone. Nevertheless, all clients improved and statistically
significant differences were achieved for most measurements.
A general risk of having clients talk about trauma is that it will lead to
retraumatization rather than desensitization (Van der Kolk et al 1996). This safety
issue is minimized with MR as it is based on EFT which is considered safe
(Hartmann 2003) and no severe abreactions were experienced by this group of
Few reasons were given for dropout, though the dropout rate was similar to other
studies involving EFT on which MR is based (Karatzias et al 2011 (39%); Boath et
al 2012a (33%). However it is worthy of note that some clients declined a follow-up
appointment as they felt that their issue had been dealt with and that they no longer
needed treatment. Several clients contacted the service to say they would not be
attending further appointments because they felt that their issues had been resolved,
and were unwilling to attend for follow-up. Future studies should include a protocol
for minimising dropouts and loss to follow-up, such as a robust system of tracking,
reminders and contacting clients to elicit completion of all measurement instruments,
including reasons for drop out and other information where required.
Limitations of the Pilot Study
This pilot study was a “service evaluation” (NHS Direct 2013), so no control groups
were used. More robust research designs would address many of the limitations of
The fact that all clients also received EFT and may have used EFT between
sessions meant that it was not possible to evaluate the effect of using MR alone.
The small sample size of this pilot study did not permit subgroup analysis or the
ability to infer its results to the wider population. Sample size was restricted by the
fact that the clinic could only offer a limited number of weekly appointments, as well
as factors such as drop out and low attendance for follow-up. The diverse nature of
emotional issues reported and addressed during therapy has also limited the ability
to produce meaningful stratified analysis by condition. Future research, with larger a
larger sample could focus on particular conditions, such as MR for PTSD.
Clients were not followed up long term to see if they had remained symptom free.
However clients were aware that they could self-refer back to clinic if they required
further sessions, or if symptoms re-emerged. It is worthy of note that at the time of
writing (over 12 months after the end of treatment), none of the 24 clients in this
study had sought repeated treatment from the clinic. Informal contact with some of
the clients and their GPs suggested that they remained well.
Experience, training and professional background of practitioners is important, and
MR was carried out by a highly trained and experienced practitioner. Variability in
skills and experience of practitioners would however be expected in other settings.
AS delivered the MR and also collected the evaluation data; clients were aware that
he was evaluating the service, and this may have biased their responses. Also, AS’s
strong allegiance to EFT and MR may have influenced clients’ responses.
On average, just over 8 clinical sessions were required (with a median number of 6.5
sessions), suggesting that MR may be a very cost-effective treatment. In this
economically challenging era, this compares well with other therapies used for
serious disorders such as Cognitive Behavioural Therapy, where 6-20 sessions may
be required, depending on the condition and severity. (NICE 2008). Three clients,
however, required more than 10 sessions, and the highest number of sessions
attended (49) is extremely unusual in the authors’ experience. This was for a client
who had a range of issues including depression, anxiety, serious sexual and physical
abuse, self-harm and an eating disorder. This client is now completely rehabilitated,
has since completed a counselling course and undertakes voluntary work.
As previously discussed, both EFT and MR can be self-administered. Although it is
not recommended that clients use MR for serious issues and so clients were strongly
advised not to do this. However clients were encouraged to use EFT between
sessions. This is important, since clients need not wait until the next appointment if
they are experiencing emotional distress. This empowers the client and hopefully
reduces dependency on the therapist, further reducing demand upon the service
over a given time period.
Studies should be carried out using a wide variety of disease severity, following-up
clients for a period of up to 6 months to a year to assess long term outcome. Future
evaluations should also consider including qualitative assessments to provide insight
into participants’ views and experiences of MR.
As with EFT (Karatzias et al (2011), there is also much speculation out mechanisms
to explain the effectiveness of MR, and a dismantling study would therefore be
MR was delivered by the same practitioner (AS ) throughout and no provision was
made for this in the current study to assess treatment fidelity. Treatment fidelity is
critical to ensure the accuracy and consistency of the MR intervention and so future
research, should include treatment fidelity measures.
Conclusions and Recommendations
In conclusion, MR shows promise as a useful clinical tool, with possible applications
for a number of mental health services. However, larger studies (preferably clinical
trials) are required in order to provide definitive evidence of the long term
effectiveness of MR, its acceptability to clients and the economic implications.
Despite the limitations outlined above, the results of this small pilot evaluation
support the potential of MR to reduce the burden of a range of physical and
psychological disorders and highlight the need for further research in this area.
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