No full-text available
To read the full-text of this research,
you can request a copy directly from the author.
Differential Gene Expression after Emotional Freedom Techniques (EFT) Treatment: A Novel Pilot Protocol for Salivary mRNA Assessment
Abstract
Biopsychology is a rapidly expanding field of study since the completion of the Human Genome Project in 2003. There is little data measuring the effect of psychotherapeutic interventions on gene expression, due to the technical, logistical, and financial requirements of analysis. Being able to measure easily the effects of therapeutic experiences can validate the benefits of intervention. In order to test the feasibility of gene expression testing in a private practice setting, this study compared messenger ribonucleic acid (mRNA) and gene expression before and after psychotherapy and a control condition. With four non-clinical adult participants, it piloted a novel methodology using saliva stored at room temperature. A preliminary test of the interleukin-8 (IL8) gene in both blood and saliva was performed in order to determine equivalency in the two biofluids; convergent validity was found. Following saliva test validation, a broad, genome-wide analysis was performed to detect differential gene expression in samples collected before and after treatment with Emotional Freedom Techniques (EFT), an
evidence-based practice combining acupressure and cognitive exposure. The control treatment was non-therapeutic social interaction. To establish a baseline, participants received the control first, followed a week later by EFT. Analysis of samples was performed at three time points: immediately before treatment, immediately after, and 24 hours later. Differential expression between EFT and control was found in numerous genes implicated in overall health (p < 0.05). Further, the differentially expressed genes in this study were shown to be linked to immunity, pro or anti-inflammatory, as well as neuronal processes in the brain. Ten of the 72 differentially expressed genes are identified as promising targets for downstream research. The data show promise for the future use of salivary samples to determine the effects of therapy; this pilot protocol also illustrated the challenges and limitations of novel technologies employed in biopsychology.
Keywords: epigenetics, DNA, mRNA, gene expression, protein synthesis, brain plasticity, neurogenesis, biopsychology
... Six of these studies (Brown et al., 2017;Morina et al., 2017;Purgato et al., 2018;Bangpan et al., 2019;Mavranezouli et al., 2020;van Ginneken et al., 2021) included TFT or EFT in their comparisons. Both approaches demonstrated significant positive outcomes and favorable comparisons with other therapies. ...
... For this reason, the single tapping study considered in Brown et al. might have been an outlier. Another comprehensive meta-analysis, in which 32 studies investigated 17 different interventions for treating traumatized youth with PTSD, lends corroboration (Mavranezouli et al., 2020). In this comparison, EFT was one of the two statistically most effective of the 17 therapies in reducing PTSD symptoms at the end of treatment, and it was statistically the most effective intervention in maintaining improvements in PTSD symptoms on follow-up. ...
... This was first reported in a 2016 pilot study with four participants who received a 1-h EFT session. Changes were found in gene expression that is associated with desirable shifts in learning, emotional regulation, neuroplasticity, synaptic connectivity, and building white matter in the brain (Maharaj, 2016). Two years later, investigators of a 10-session EFT program treating 16 veterans with PTSD and related health conditions reported that the treatment favorably increased the expression of six genes, including one that influences immunity (Church et al., 2018b). ...
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.
... 51 Each represents a unified body-mind perspective, based on the complementary premises that physical conditions affect mental health and mental conditions affect physical health. Acupoint tapping is a gentle somatic intervention that has been shown to mitigate stress-related hormonal states, 27 facilitate shifts in gene expression associated with improved health and mental health, 76 and produce electrical signals that rapidly disrupt the neurological underpinnings of psychological symptoms. 112 Such findings, discussed later in greater detail, illustrate potential strengths of somatic interventions in treating emotional difficulties. ...
... Although the title of the 1985 Five Minute Phobia Cure 14 was highly provocative and over-stated, evidence has since accumulated suggesting that the approach may be unusually rapid. After a single acupoint tapping session of 30 to 60 min, significant therapeutic changes-in relation to comparison conditions-have been measured in brain-wave patterns, 116 cortisol levels, 27 the expression of genes involved in learning and emotional regulation, 76 frozen shoulder, 24 fear of small animals, 123 agoraphobia, 68 PTSD, 30 and various other psychological conditions. 20 For instance, 16 abused male adolescents, all scoring above the PTSD range on a standardized symptom inventory, were randomly assigned to an EFT treatment group or a wait-list condition. ...
... A range of hormonal and neurological shifts reliably follows acupoint tapping sessions. For instance, reductions in cortisol production, 27 normalization of brain-wave patterns, 68,116 shifts in blood flow within the brain, 112 and changes in gene expression 28,76 have all, as previously discussed, been measured following energy psychology treatments. ...
... A pilot study comparing an hour-long EFT session with placebo in 4 nonclinical participants found differential expression in 72 genes. 46 These included genes associated with the suppression of cancer tumors, protection against ultraviolet radiation, regulation of type 2 diabetes insulin resistance, immunity from opportunistic infections, antiviral activity, synaptic connectivity between neurons, synthesis of both red and white blood cells, enhancement of male fertility, building white matter in the brain, metabolic regulation, neural plasticity, reinforcement of cell membranes, and the reduction of oxidative stress. The broad function of this suite of genes is similar to that found in Church et al, 10 confirming the association of EFT with the downregulation of inflammation and stress markers and the upregulation of immune markers. ...
... The results are consistent with previous research demonstrating improvements in endocrinal and genetic regulation. 10,42,46 The 74% reduction in cravings (P < .000) is typical of that found in other EFT research. 18,11,13,62 While not statistically significant, the trends toward improvement in HRV and HC allude to possible improvements in cardiovascular health and ANS function. ...
... Further research should also randomize participants between EFT and an active control treatment such as CBT and include at least 44 persons per group in order to identify statistically significant changes in all physiological markers. EFTs epigenetic effects could be further explored with use of salivary gene assays such as were used in Maharaj 46 and similar studies. A larger battery of psychological assessments could be used, and a second follow-up data point included to determine trends over time. ...
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.
... Therapies that are able to treat a wide range of disorders are presumably impacting a smaller set of underlying causes. Acupoint tapping protocols have been shown to facilitate shifts in gene expression associated with improved health and mental health [45,46], reduce the production of stress hormones [47,48], normalize brainwave patterns [49], and disrupt the neurological structure of stimulus-response relationships [50]. ...
... In a pioneering study by Church et al. [47], a single one-hour energy psychology session was significantly more effective in lowering cortisol levels than a supportive counseling session, a finding that was recently replicated [48]. Acupoint tapping treatments were also shown to alter, in clinically desirable directions, the expression of genes that influence immunity, inflammation, and stress response [45,46]. An investigation of positive changes in physiological markers of health following acupoint tapping sessions found that decreases in blood pressure, resting heart rate, and cortisol levels corresponded with reductions in anxiety, depression, PTSD, chronic pain, and cravings [62]. ...
he impact of psychological factors on illness is, in recent years, being biochemically mapped. The subspecialties of psychosomatic medicine, health psychology, psychoneuroimmunology, and integrative medicine work with mind and body in concert to promote health and healing. A specialized set of mind-body approaches, collectively called “energy psychology,” is being utilized within these and related clinical frameworks to facilitate beneficial changes in the neurological underpinnings of (1) mental states that impede immune function, (2) emotional influences that contribute to illness, and (3) inner resources that promote healing. Combining practices from time-honored healing traditions, particularly acupressure, with concepts and techniques drawn from contemporary psychology, practitioners using one of the most popular variations of the approach teach patients to tap on a prescribed series of acupuncture points while repeating phrases that activate areas of the brain that are involved with the issue receiving attention. Preliminary evidence supports speculation, which is consistent with more than a hundred peer-reviewed clinical trials, that the procedure can send deactivating signals to areas of the limbic system that are in hyperarousal and can send activating signals to regions of the prefrontal cortex that support executive functions such as planning and managing stressful situations. Ways of utilizing the approach for addressing emotional and cognitive aspects of physical illness are discussed. While utilizing the best medical interventions available remains the first line of treatment, the potential value of working with the psychological aspects of disease is frequently underestimated. Energy psychology is proving to be a powerful tool for addressing this dimension of illness and healing. The paper closes with a detailed case history.
... 51 Each represents a unified body-mind perspective, based on the complementary premises that physical conditions affect mental health and mental conditions affect physical health. Acupoint tapping is a gentle somatic intervention that has been shown to mitigate stress-related hormonal states, 27 facilitate shifts in gene expression associated with improved health and mental health, 76 and produce electrical signals that rapidly disrupt the neurological underpinnings of psychological symptoms. 112 Such findings, discussed later in greater detail, illustrate potential strengths of somatic interventions in treating emotional difficulties. ...
... A range of hormonal and neurological shifts reliably follows acupoint tapping sessions. For instance, reductions in cortisol production, 27 normalization of brain-wave patterns, 68,116 shifts in blood flow within the brain, 112 and changes in gene expression 28,76 have all, as previously discussed, been measured following energy psychology treatments. ...
The most well known forms of “energy psychology” combine cognitive and exposure techniques with the stimulation of selected acupuncture points (acupoints) by tapping on them. Most clinicians who learn and utilize an acupoint tapping protocol integrate the approach within their existing clinical frameworks rather than using it as a stand-alone therapy. The method has been highly controversial, with its efficacy, purported speed, and explanatory models all questioned. Nonetheless, its utilization within clinical settings and as a self-help method has continued to expand since it was introduced more than three decades ago. This paper reviews the most salient criticisms of the method and presents research and empirically based theoretical constructs that address them. More than 100 peer-reviewed outcome studies—51 of which are randomized controlled trials—provide an evidential base for evaluating the claims and criticisms surrounding the approach. This review concludes that a growing body of evidence indicates that acupoint-based energy psychology protocols are rapid and effective in producing beneficial outcomes in the treatment of anxiety, depression, PTSD, and possibly other conditions. Mechanisms by which acupoint tapping might bring about these treatment outcomes are also proposed.
... Cognitive-Behaviour Therapy (CBT), Behavior Therapy, relaxation therapy, and hypnotherapy have all been indicated as beneficial in improving weight loss [11]. More recently, Energy Psychology (EP) strategies have emerged as techniques which can improve emotional, behavioural, and cognitive concerns by combining physical interventions with a cognitive element [12,13,14,15]. ...
... Functional magnetic resonance imaging (fMRI) and positron emission tomography (PET) scan investigations of neurological shifts following acupoint stimulation consistently produced prominent decreases of activation in the amygdala, hippocampus, and other brain areas associated with fear and pain [20,21,22]. EFT also results in a number of biomarker changes, including stress hormones [23], gene expression [15,23], electroencephalogram (EEG) activity [24,25], and fMRI-detected brain activation patterns [26]. Finally, EFT has also been found to be an "evidence-based" practice for anxiety, depression, phobias and PTSD when measured against the standards of the American Psychological Association's Division 12 Task Force on Empirically Validated Treatments [14]. ...
... Changes in gene expression were first reported in a pilot study involving four individuals who underwent a 1-hr EFT session. Alterations were observed in the expression of 72 genes (Maharaj, 2016). A later investigation of an EFT program treating 16 veterans with post-traumatic stress disorder (PTSD) and associated health issues found that the treatment positively impacted the expression of six genes (Church et al., 2018). ...
In a blistering critique of Feinstein (2023) and the practice of energy psychology in general, Boness et al. (this issue) address four concerns, asserting that: (a) the rationale for energy psychology is based on premises that are not supported by reliable evidence; (b) the claim that tapping on acupuncture points is an active ingredient in energy psychology is based on insufficient evidence; (c) the quality of efficacy evidence is low; and (d) the approach is not compatible with ethical practice. While acknowledging the validity of several of the commentators’ points, this rejoinder provides evidence that soundly refutes each of these assertions. It concludes that Boness et al. “have provided a scholarly commentary on energy psychology as the field’s evidence base arguably existed a decade ago and represent it as being current while neglecting the compelling efficacy evidence that has been published in the most recent decade.”
... session than after a session of talk therapy, a finding replicated by Stapleton et al. (2020). More sophisticated designs have measured changes in gene expression (Church et al., 2016;Maharaj, 2016) as well as epigenetic signaling molecules named microRNAs (Yount et al., 2019). Yount et al. (2019) identified three microRNAs with expression levels that correlated significantly with psychological tests of PTSD. ...
Introduction
Clinical Emotional Freedom Techniques (EFT) is a psychophysiological intervention that includes cognitive and somatic elements, utilizing techniques from both Cognitive Behavioral Therapy (CBT) and Prolonged Exposure therapy (PE). Because only a single meta-analysis existed examining EFT for PTSD, this systematic review and meta-analysis represents an update.
Method
Ten databases were searched for quantitative reviews and randomised clinical trials, and six met inclusion criteria.
Results
Study quality and effect size were evaluated and the results demonstrated that treatment with Clinical EFT, when compared to wait list, usual care, or no treatment controls, resulted in significant and large effect sizes, ranging from 1.38 to 2.51. When compared to active controls, effect sizes ranged from −0.15 to 0.79, producing treatment results similar to other evidence-based therapies.
Discussion
Limitations are presented and considerations for further research are proposed.
... In another study, gene expression was modified for 72 genes post EFT. These were the genes that functioned to suppress tumors, increase immunity, increase synaptic connectivity, increase plasticity (Maharaj, 2016). ...
... Otherwise identical protocols with and without the acupoint tapping component were compared, and those which included tapping produced a larger effect size than those with the other components but without tapping. Finally, clinically favorable shifts after acupoint tapping sessions have also been reported for a number of biomarkers (Church, 2013;Church et al., 2012) and include reductions in cortisol production, normalization of brain-wave patterns, shifts in blood flow within the brain, and changes in gene expression (Church et al., 2018;Maharaj, 2016;Stapleton et al., 2019a). ...
This clinical trial investigated the effect of an Emotional Freedom Techniques (EFT) intervention on brain activation in chronic pain sufferers using functional magnetic resonance imaging (fMRI). EFT is a brief stress reduction technique which combines stating a cognitive statement with somatic tapping on acupressure points. Twenty-four adults were allocated to a six-week online group EFT treatment and underwent resting-state fMRI pre and post the intervention. A repeated measures MANOVA indicated significant differences in the levels of pain severity (−21%), pain interference (−26%), quality of life (+7%), somatic symptoms (−28%), depression (−13.5%), anxiety (−37.1%), happiness (+17%), and satisfaction with life (+8.8%) from pre-to post-test. Cohen's effect sizes ranged from small (0.2) to large (0.75) values suggesting significance for the intervention. fMRI analysis showed post-EFT treatment significantly decreased connectivity between the medial prefrontal cortex (a pain modulating area) and bilateral grey matter areas in the posterior cingulate cortex and thalamus, both areas being related to the modulating and catastrophizing of pain. There were no brain areas that showed significantly increased connectivity post-EFT treatment. Coupled with the psychological measures the findings support the effects of the EFT intervention in reducing chronic pain and its impacts. Recommendations for future research are discussed.
... It changes arousal patterns in brain areas associated with addictive behavior . It also reduces cortisol levels (Church et al., 2012; and facilitates positive changes in gene expression Feinstein & Church, 2010;Maharaj, 2016), blood pressure (Bach et al., 2019), heart rate variability (a measure of cardiac flexibility in response to autonomic distress; Morikawa et al., 2021), and lymphocyte production (Babamahmoodi et al., 2015). ...
Integrando la estimulación manual de los puntos de acupuntura a la psicoterapia: una revisión sistemática con recomendaciones clínicas
La integración a la psicoterapia de los protocolos con estimulación de los puntos de acupuntura con un suave tapping, un modo de acupresión, está surgiendo ampliamente en la práctica clínica. Una premisa subyacente es que el procedimiento genera señales activadoras y desactivadoras que, en tiempo real, impactan las zonas del cerebro excitadas por el foco de atención del cliente. Esto posibilita que el terapeuta pueda velozmente facilitar cambios cognitivos y neurológicos por cambiar la redacción y las imágenes que acompañan al tapping. El abordaje ha sido controversial, con entusiastas promotores y obstinantes críticos. Un total de 309 artículos revisados por homólogos, de revistas en inglés, se han enfocado en este desarrollo. El objetivo de este artículo es poner estos informes en contexto usando un modelo basado en la “jerarquía de evidencia”. En una jerarquía de evidencia, juicios sobre la eficacia de un abordaje clínico se forman en base a la fortaleza relativa de los tipos de estudios que apoyan el método. La jerarquía de evidencia para las psicoterapias que usan el tapping sobre los puntos de acupuntura incluye 28 revisiones sistemáticas o meta análisis, 125 pruebas clínicas, 25 casos de estudio, 26 informes describiendo observaciones sistemáticas, 17 pruebas clínicas de método mixto con un componente de tapping y 88 artículos abordando procedimientos clínicos, teoría, mecanismos, o cuestiones parecidas. Se remarca la consistencia en resultados positivos posterior al tapping de selectos puntos de acupuntura para un rango de condiciones, y los puntos débiles en los diseños de los estudios se discuten. Se consideran los mecanismos de acción y se presentan sugerencias para integrar protocolos de acupoint tapping a la práctica clínica. El artículo concluye en que, aunque se necesita más investigación, la base creciente de evidencia que documenta la efectividad, velocidad y durabilidad del abordaje es promisoria.
... In a study of individuals receiving psychotherapy, 72 genes were found to be upregulated after a single EFT session. 35 The function of those genes included insulin regulation, inflammation suppression, increases to immunity, metabolic efficiency, and cancer suppression. ...
Context:
With obesity a mounting global issue, efficacious treatments can make a contribution to both personal and public health. Prior clinical trials have demonstrated that an evidence-based method, Clinical Emotional Freedom Techniques (EFT), can produce a durable weight reduction.
Objective:
The study evaluated whether Skinny Genes, a six-week online program applying EFT to emotional eating, was associated with behavioral change and reductions in weight.
Design:
A pre-post outcome study design evaluated the results of a convenience sample of participants enrolled in an online weight loss course.
Participants:
Participant were recruited through EFT websites. Pre, post and follow-up measures were available for 72 participants and all analysis was performed on this sample.
Intervention:
Participants used EFT to address cognitions, behaviors, and adverse experiences that could contribute to binge eating, intermittent dieting, and resistance to exercise.
Outcome measures:
Behaviors to restrain eating were measured using the Revised Restraint Scale (RRS); the association of food with reward using the Power of Food Scale (PFS); anxiety and depression using the Hospital Anxiety and Depression Scale (HADS). Weight was measured pre and postintervention and at six-month follow-up.
Results:
Postintervention, a 36.8% reduction in anxiety (P < .001) and a 48.5% reduction in depression (P < .001) were found. The perceived power of food decreased significantly as did restraint behaviors. Participants lost an average of 12.9 lbs during the six weeks of the program (P < .001), and at follow-up, a further 2.6 lbs. All psychological gains were maintained (P < .001).
Conclusions:
The findings are consistent with those of other clinical trials studying the benefits of EFT for weight loss, demonstrating simultaneous reductions in both weight and psychological distress. The continued weight reduction found on follow-up was consistent with other EFT studies but counter to the pattern of weight regain noted in the literature. Addressing emotional issues using an online delivery format was associated with durable weight-loss maintenance as well as improved mental health. App-based and virtual programs such as Skinny Genes have the potential to bring effective therapies to underserved populations.
... Only later were the physiological mechanisms of action elucidated. However, many of these mechanisms now have been measured, including gene expression (Church et al., 2018a(Church et al., , 2018bMaharaj, 2016), stress hormone reduction (Church et al., 2012;Stapleton et al., 2020), and physiological regulation (Bach et al., 2019;Bougea et al., 2013). Among the technologies used to measure EFTs mechanisms are PCR gene sequencing, MRI and EEG scans, hormone assays, heart rate variability monitors, and immune marker tests. ...
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.
... Documented beneficial changes in hormone production, cardiovascular function, immune response, gene expression, brain wave patterns, and blood flow in targeted brain areas provide an evidential base for Premise 4. Several of these changes were brought about by a single tapping session, 41,56,57,59,63 offering additional confirmation of Premise 2 regarding the method's speed. ...
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, (c) 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.
... In effect, it is suggested that the emotion derived from the original trauma is interrupted via impacts across neural pathways; in fMRI studies, acupuncture needling quiets activity in the amygdala and other areas of the limbic system (Dhond, Kettner, & Napadow, 2007;Fang et al., 2009;Hui et al., 2000Hui et al., , 2005Hui, Marina, Liu, Rosen, & Kwong, 2010). EFT has been shown to reduce levels of the stress hormone cortisol (Bougea et al, 2013;Church, Yount, & Brooks, 2012;Maharaj, 2016;Stapleton, Crighton, Sabot, & O'Neill, 2020). Research has also demonstrated that EFT exerts epigenetic effects, specifically the differential expression of genes related to immunity and inflammation (Church, Yount, Rachlin, Fox, & Nelms, 2016). ...
Purpose: The aim of this experimental study was to investigate the post-intervention effects of group-based positive psychology and mindful diaphragmatic breathing on anxiety and testtaking success in male college students.
Method: A randomized controlled trial (RCT) was conducted across the undergraduate male students at a university in Montana. Participants (aged 18–32 years) were randomly assigned to two intervention groups (mindfulness and positive psychology) and a control (delayed intervention) group. The study included a group of 34 male
participants with 10 in the mindfulness group, 12 in the positive psychology group, and 12 in the waiting group. Both intervention programs consisted of five 120-minute group sessions delivered over 10 weeks. All three groups were required to complete an assessment prior to the interventions and a second assessment after the interventions
(mindfulness and positive psychology) or the waiting time (control group) were completed. The control group also received five 120-minute interventions after all measurements were taken. The constructs of self-care, test anxiety, and anxiety
symptomatology were measured.
Results: There were no significant baseline differences between the three groups on the
demographic and dependent variables. The results showed no significant differences between the two intervention groups’ and the control group’s self-care pre and post scores. Results showed a significant difference between the treatment groups’ and control group’s scores on pretest and posttest in test anxiety. The results showed a significant difference between the two intervention groups’ and control group’s
scores on pretest and posttest in total anxiety. Anxiety levels were noted to be different for ethnic groups. An explanation for observed differences in race is discussed.
Conclusion: The study does not provide evidence that mindfulness and positive psychology interventions can reduce test anxietysignificantly. The results show a significant difference between the two intervention groups’ and control group’s scores on pretest and posttest in total anxiety. Importantly, descriptive analysis has shown a positive impact on test anxiety and total anxiety in participants of varied ethnic groups.
... One review concluded that tapping on acupressure points during imaginal exposure "quickly and permanently reduces maladaptive fear responses to traumatic memories and related cues" ( [28] p. 385). Additionally, empirical support has been found for EFT treatment and associated improvements in a range of physiological indicators of health such as heart rate variability (HRV), blood pressure, and cortisol levels [29][30][31][32] and regulation of inflammation and immunity genes [33,34]. ...
... A randomized controlled trial of veterans with PTSD found that after 10 sessions of EFT, the expression of stress-related genes had changed significantly (Church, Yount, Rachman, Fox, & Nelms, 2016). A pilot study using a whole-genome array found 72 genes differentially expressed after a one-hour EFT session (Maharaj, 2016). Broadly characterized, the genes identified in these two studies regulated inflammation and were implicated in heightened immunity. ...
... Hormonal shifts have been identified, including reductions in cortisol production that were statistically greater than cortisol reductions following a supportive counselling session [37]. Changes in blood flow patterns within the brain have been identified in pre-and post-treatment fMRI readings [38]. Studies examining the epigenetic effects of EFT treatment have found regulation of a range of genes related to health and mental health [37,39,40]. ...
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.
... In a 10-year research program conducted at Harvard Medical School, brain imaging experiments showed that the needling or electronic stimulation of specified acupoints consistently produced prominent decreases of activation in the amygdala, hippocampus, and other brain areas associated with fear and pain (Fang et al., 2009;Hui et al., 2005;Napadow et al., 2007). Clinically favorable shifts after acupoint tapping sessions have also been reported for a number of biomarkers, including stress hormones (Church et al., 2012), gene expression (Church et al., 2016b;Feinstein and Church, 2010;Maharaj, 2016), electroencephalogram activity (Lambrou et al., 2003;Swingle et al., 2004), and fMRI-detected brain activation patterns (Gaesser and Karan, 2017). For instance, in an Australian study, 15 obese adult patients selfadministered an EFT protocol at regular intervals over a 4-week period (Stapleton, 2017). ...
Emotional Freedom Techniques (EFTs) combine elements of cognitive restructuring and exposure techniques with acupoint stimulation. Meta-analyses indicate large effect sizes for posttraumatic stress disorder, depression, and anxiety; however, treatment effects may be due to components EFT shares with other therapies. This analysis reviewed whether EFTs acupressure component was an active ingredient. Six studies of adults with diagnosed or self-identified psychological or physical symptoms were compared (n = 403), and three (n = 102) were identified. Pretest vs. posttest EFT treatment showed a large effect size, Cohen's d = 1.28 (95% confidence interval [CI], 0.56 to 2.00) and Hedges' g = 1.25 (95% CI, 0.54 to 1.96). Acupressure groups demonstrated moderately stronger outcomes than controls, with weighted posttreatment effect sizes of d = -0.47 (95% CI, -0.94 to 0.0) and g = -0.45 (95% CI, -0.91 to 0.0). Meta-analysis indicated that the acupressure component was an active ingredient and outcomes were not due solely to placebo, nonspecific effects of any therapy, or nonacupressure components.
... 12 Dismantling studies show that the somatic element of EFT, which includes fingertip percussion of 12 acupressure points, confers a treatment effect beyond that which can be explained by EFTs cognitive and exposure elements. [13][14][15] Studies of the physiological mechanisms of action of EFT find that it reduces levels of the stress hormone cortisol 16 ; regulates inflammation and immunity genes 17 ; alters the expression of a variety of genes implicated in cell repair, the immune response, tumor suppression, neural plasticity, and neurological signaling, 18 and regulates the autonomic nervous system as measured by EEG. 19,20 EFTs affect-regulation capability has also been assessed as a treatment for food cravings and the power of food in the external environment. ...
Background/objective:
Traditional methods of delivering therapeutic interventions have increasingly been supplemented by online courses. The current study investigated the effects of Clinical EFT (Emotional Freedom Techniques) in 76 participants enrolled in a six-week online course called Naturally Thin You. Weight, restraint, the power of food in the external environment, happiness, and posttraumatic stress disorder (PTSD) symptoms were assessed before and after the course and at one-year follow-up.
Method:
Participants received six live group teleclasses, access to online course materials and a private social media group, and a year of monthly support teleclasses. No particular diet was recommended; the course focused instead on controlling emotional eating, and using EFT to treat the emotional triggers associated with food. Clinical EFTs Borrowing Benefits protocol, in which the group facilitator works with a single participant while others simultaneously self-apply EFT, was used during the teleclasses.
Results:
Repeated measures ANOVA compared scores pre- to 12-month follow-up, and significant improvements were found for body weight (P < .001), depression symptoms (P = 0.010), restraint (P = 0.025), and the subjective power of food in the external environment (P = 0.018). Weight decreased an average of 1lb/week during the course, and 2lb/month between pretest and one-year follow-up. On follow-up, no change was observed in PTSD symptoms measured by a brief civilian trauma checklist, or anxiety, and increases in happiness were non-significant. The results indicate Clinical EFTs utility to address the influence of food in the external environment and assist weight loss, and to promote beneficial long-term change when delivered in an online format.
... CHURCH AND FEINSTEIN A subsequent study investigated whole-genome expression in saliva samples from four nonclinical participants who received first a placebo session and then a 1-hour EFT session. 41 The researchers identified differential expression in 72 genes following the EFT session. The functions of the genes affected by the EFT session revealed greater specificity than earlier studies. ...
Background: The U.S. military has seen dramatic increases in traumatic brain injuries (TBIs) among military personnel due to the nature of modern-day conflicts. Conventional TBI treatment for secondary brain injuries has suboptimal success rates, and patients, families, and healthcare professionals are increasingly turning to alternative medicine treatments. Objective: Effective treatments for the secondary injury cascades that occur after an initial brain trauma are unclear at this time. The goal of successful treatment options for secondary TBI injuries is to reduce oxidative stress, excitotoxicity, and inflammation while supporting mitochondrial functions and repair of membranes, synapses, and axons. Intervention: A new paradigm of medical care, known as functional medicine, is increasing in popularity and acceptance. Functional medicine combines conventional treatment methods with complementary, genetic, holistic, and nutritional therapies. The approach is to assess the patient as a whole person, taking into account the interconnectedness of the body and its unique reaction to disease, injury, and illness while working to restore balance and optimal health. Functional medicine treatment recommendations often include the use of acupuncture, Ayurveda, chiropractic manipulation, detoxification programs, herbal and homeopathic supplements, specialized diets, massage, meditation and mindfulness practices, neurobiofeedback, nutritional supplements, t'ai chi, and yoga. At present, some of these alternative treatments appear to be beneficial, but more research is needed to validate reported outcomes. Conclusions: Few clinical studies validate the effectiveness of alternative therapies for TBIs. However, further clinical trials and empirical studies warrant further investigation based on some reported positive results from research studies, case histories, anecdotal evidence, and widespread popularity of some approaches. To date, only nutritional therapies and hyperbaric oxygen therapy have shown the most promise and potential for improved outcomes for the treatment of secondary TBI injuries.
... A subsequent study investigated whole-genome expression in saliva samples from four nonclinical participants who received first a placebo session and then a 1-hour EFT session. 41 The researchers identified differential expression in 72 genes following the EFT session. The functions of the genes affected by the EFT session revealed greater specificity than earlier studies. ...
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.
... EFT is part of a broader genre of therapeutic approaches that has been termed Energy Psychology (Gallo, 1999), which has been shown, in a systematic review of 42 studies, to have wide application (Boath, Stewart, & Carryer, 2012), perhaps through the capacity of these methods to modify the biochemistry of stress (Church, Yount, & Brooks, 2012) and gene expression (Church, Yount, Rachlin, et al., 2016;Maharaj, 2016). Reports on the outcomes of Energy Psychology methods (e.g., Feinstein, 2012) have been both criticized and defended; see, for example, critical accounts by Gaudiano, Brown, and Miller (2012) and Bakker (2013) and rebuttals of these by Sise, Leskowitz, Stein, and Tranguch (2014) and Feinstein (2014). ...
This chapter presents Clinical Emotional Freedom Techniques (EFT) as a promising mind-body approach for treating post-traumatic stress disorder (PTSD). Through the compelling cases of Sarah and John, two individuals grappling with PTSD symptoms despite previous therapies, the chapter underscores the need for a more integrative treatment modality. It explores the foundations and principles of Clinical EFT, a technique that combines cognitive strategies with somatic acupressure point stimulation. The growing evidence base supporting EFT's efficacy is presented, and a detailed, step-by-step guide for clinicians is offered, including how clients can use at home, in and between sessions. Sarah and John's specific EFT protocol tailored to their cases is outlined, relating to repeated childhood trauma, and a single event military deployment trauma. With its emphasis on rapid symptom reduction, low dropout rates, and comparable efficacy to established therapies, Clinical EFT emerges as a valuable addition to the clinician's toolkit.
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.
Background
Cancer-related cognitive impairment (CRCI) is a prevalent source of comprised quality of life in cancer survivors. This study evaluated the efficacy of Emotional Freedom Techniques (EFT) on self-reported CRCI (sr-CRCI).
Methods
In this prospective multicentre randomised wait-list controlled study (ClinicalTrials.gov Identifier: NCT02771028), eligible cancer survivors had completed curative treatment, were 18 years or older and screened positive for sr-CRCI with ≥ 43 on the Cognitive Failures Questionnaire (CFQ). Participants were randomised to the immediate treatment group (ITG) or wait-list control (WLC) group, based on age (< or ≥ 65 years), gender, treatment (chemotherapy or not), and centre. The ITG started to apply EFT after inclusion and performed this for 16 weeks. The WLC group could only start the application of EFT after 8 weeks of waiting. Evaluations took place at baseline (T0), 8 weeks (T1) and 16 weeks (T2). The primary outcome was the proportion of patients with sr-CRCI according to the CFQ score.
Findings
Between October 2016 and March 2020, 121 patients were recruited with CFQ ≥ 43 indicating sr-CRCI. At T1, the number of patients scoring positive on the CFQ was significantly reduced in the ITG compared to the WLC group (40.8% vs. 87.3% respectively; p<0.01). For the WLC group, a reduction in CFQ scores was observed at T2, comparable to the effect of the ITG at T1. Linear mixed model analyses indicated a statistically significant reduction in the CFQ score, distress, depressive symptoms, fatigue and also an improvement in quality of life.
Interpretation
This study provides evidence for the application of EFT for sr-CRCI in cancer survivors and suggests that EFT may be useful for other symptoms in cancer survivors.
Background:
Among a group of therapies collectively known as energy psychology (EP), emotional freedom techniques (EFT) is the most widely practiced. Clinical EFT is an evidence-based practice combining elements of cognitive and exposure therapies with the manual stimulation of acupuncture points (acupoints). Lacking is a recent quantitative meta-analysis that enhances understanding of the variability and clinical significance of outcomes after clinical EFT treatment in reducing depression.
Methods:
All studies (2005-2015) evaluating EFT for sufferers of depression were identified by electronic search; these included both outcome studies and randomized controlled trials (RCTs). Our focus was depressive symptoms as measured by a variety of psychometric questionnaires and scales. We used meta-analysis to calculate effect sizes at three time points including posttest, follow-ups less than 90 days, and follow-ups more than 90 days.
Results:
In total, 20 studies were qualified for inclusion, 12 RCTs and 8 outcome studies. The number of participants treated with EFT included N = 461 in outcome studies and N = 398 in RCTs. Clinical EFT showed a large effect size in the treatment of depression in RCTs. At posttest, Cohen׳s d for RCTs was 1.85 and for outcome studies was 0.70. Effect sizes for follow-ups less than 90 days were 1.21, and for ≥ 90 days were 1.11. EFT were more efficacious than diaphragmatic breathing (DB) and supportive interview (SI) in posttest measurements (P = .06 versus DB, P < .001 versus SI), and sleep hygiene education (SHE) at follow-up (P = .036). No significant treatment effect difference between EFT and eye movement desensitization and reprocessing (EMDR) was found. EFT were superior to treatment as usual (TAU), and efficacious in treatment time frames ranging from 1 to 10 sessions. The mean of symptom reductions across all studies was -41%.
Conclusions:
The results show that Clinical EFT were highly effective in reducing depressive symptoms in a variety of populations and settings. EFT were equal or superior to TAU and other active treatment controls. The posttest effect size for EFT (d = 1.31) was larger than that measured in meta-analyses of antidepressant drug trials and psychotherapy studies. EFT produced large treatment effects whether delivered in group or individual format, and participants maintained their gains over time. This meta-analysis extends the existing literature through facilitation of a better understanding of the variability and clinical significance of depression improvement subsequent to EFT treatment.
SCIENTIFIC Clinical EFT (emotional freedom techniques) combines acupoint stimulation with elements of cognitive and exposure therapy. Numerous studies have demonstrated the efficacy of EFT for depression, anxiety, phobias, PTSD, and other psychological conditions. The current study assesses whether acupoint stimulation is an active ingredient or whether treatment effects are due to nonspecific factors. Thirty-seven participants with “frozen shoulder” consisting of limited range of motion (ROM) and pain were randomized into a wait list, or 1 of 2 treatment groups. ROM, pain, and the breadth and depth of psychological conditions such as anxiety and depression were assessed before and after a 30-min treatment session, and 30 days later. One treatment group received clinical EFT, while the other received an identical cognitive/exposure protocol but with diaphragmatic breathing (DB) substituted for acupoint stimulation. No significant improvement in any psychological symptom was found in the wait list. Participants in both the EFT and DB groups demonstrated significant posttest improvement in psychological symptoms and pain. Follow-up showed that both groups maintained their gains for pain, with EFT superior to DB, but only the EFT group maintained gains for psychological symptoms (p
Purpose:
To assess the feasibility of measuring changes in gene expression associated with post-traumatic stress disorder (PTSD) treatment using emotional freedom techniques (EFT).
Design:
Participants were randomized into an EFT group receiving EFT and treatment as usual (TAU) throughout a 10-week intervention period and a group receiving only TAU during the intervention period and then receiving EFT.
Setting:
A community clinic and a research institute in California.
Participants:
Sixteen veterans with clinical levels of PTSD symptoms.
Intervention:
Ten-hour long sessions of EFT.
Measures:
Messenger RNA levels for a focused panel of 93 genes related to PTSD. The Symptom Assessment 45 questionnaire, Hospital Anxiety and Depression Scale, Insomnia Severity Scale, SF-12v2 for physical impairments, and Rivermead Postconcussion Symptoms Questionnaire.
Analysis:
Pre-, posttreatment, and follow-up mean scores on questionnaires were assessed using repeated measures 1-way analysis of variance. A Student t test and post hoc analyses were performed on gene expression data.
Results:
Post-traumatic stress disorder symptoms declined significantly in the EFT group (-53%, P < .0001). Participants maintained their gains on follow-up. Significant differential expression of 6 genes was found (P < .05) when comparing the expression levels before and after the intervention period in participants receiving EFT.
Conclusion:
Study results identify candidate gene expression correlates of successful PTSD treatment, providing guidelines for the design of further studies aimed at exploring the epigenetic effects of EFT.
Energy Psychology (EP) protocols use elements of established therapies such as exposure and cognitive processing and combine them with the stimulation of acupuncture points. EP methods such as EFT (Emotional Freedom Techniques) and TFT (Thought Field Therapy) have been extensively tested in the treatment of post-traumatic stress disorder (PTSD). Randomized controlled trials (RCTs) and outcome studies assessing PTSD and co-morbid conditions have demonstrated the efficacy of EP in populations ranging from war veterans to disaster survivors to institutionalized orphans. Studies investigating the neurobiological mechanisms of action of EP suggest that it quickly and permanently mediates the brain's fear response to traumatic memories and environmental cues. This review examines the published trials of EP for PTSD and the physiological underpinnings of the method. It concludes by describing seven clinical implications for the professional community. These are: (1) the limited number of treatment sessions usually required to remediate PTSD; (2) the depth, breadth, and longevity of treatment effects; (3) the low risk of adverse events; (4) the limited commitment to training required for basic application of the method; (5) its efficacy when delivered in group format; (6) its simultaneous effect on a wide range of psychological and physiological symptoms, and (7) its suitability for non-traditional delivery methods such as online and telephone sessions.
Psychoanalytic Energy Psychotherapy is the outcome of one psychoanalyst's encounter with Thought Field Therapy and other forms of 'energy psychology'. This approach explores the interface of psychodynamic, bodily, and energetic phenomena as they manifest in human distress - and describes methods of alleviating such distress.
Objective: The aim of this study was to investigate whether self-administered Emotional Freedom Techniques (EFT) lead to reduced pain perception, increased acceptance and coping ability, and better health-related quality of life in individuals with fibromyalgia. Methods: Eighty-six women, diagnosed with fibromyalgia and on sick leave for at least 3 months, were randomly assigned to a treatment group or a wait-listed group. For those in the treatment group, an 8-week EFT treatment program was administered via the internet. Results: Upon completion of the program, statistically significant improvements were observed in the intervention group (n=26) in comparison with the wait-feted group (n=36) for variables such as pain, anxiety, depression, vitality, social function, mental health, performance problems involving work or other activities due to physical as well as emotional reasons, and stress symptoms. In addition, pain catastrophizing measures, such as rumination, magnification, and helplessness, were significantly reduced, and activity level was significantly increased in the treatment group compared to the wait-listed group. However, no difference in pain willingness between the groups was observed. The number needed to treat (NNT) regarding recovering from anxiety was 3. NNT for depression was 4. Conclusion: Self-administered EFT seems to be a good complement to other treatments and rehabilitation programs. The sample size was small and the dropout rate was high. Therefore the surprisingly good results have to be interpreted with caution. However, it would be of interest to further study this simple and easily accessible self-administered treatment method, which can even be taught over the internet.
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.
Acupressure is a Chinese medical technique that involves application of pressure to acupuncture points on the body. This study aimed to examine whether a four-week self-administered acupressure course could reduce depressive mood. Sixteen male and nine female college students (33.2 ± 10.0 years) who majored in acupuncture and moxibustion medicine were randomly assigned to either a self-administered acupressure group or a control group. The participants in the self-administered acupressure group were instructed to conduct five acupressure sessions three times a day (morning, midday, and night). Each session included applying pressure on three points on the left and right side of the neck for five seconds. The controls were asked to continue their daily routine. Depressive mood levels were measured at baseline, two weeks later, and following intervention. Depressive mood levels were similar between both groups at baseline. It decreased two weeks later and remained constant until the end of the intervention. Depressive mood levels were significantly lower in the self-administered acupressure group than in the control group at two weeks from baseline and after intervention. These results provide initial evidence that self-admin- istered acupressure may improve depressive mood.
An individual's genetic background affects their emotional behavior and response to stress. Although studies have been conducted to identify genetic predictors for emotional behavior or stress response, it remains unknown how prior stress history alters the interaction between an individual's genome and their emotional behavior. Therefore, the purpose of this study is to identify chromosomal regions that affect emotional behavior and are sensitive to stress exposure. We utilized the BXD behavioral genetics mouse model to identify chromosomal regions that predict fear learning and emotional behavior following exposure to a control or chronic stress environment. 62 BXD recombinant inbred strains and C57BL/6 and DBA/2 parental strains underwent behavioral testing including a classical fear conditioning paradigm and the elevated plus maze. Distinct quantitative trait loci (QTLs) were identified for emotional learning, anxiety and locomotion in control and chronic stress populations. Candidate genes, including those with already known functions in learning and stress were found to reside within the identified QTLs. Our data suggest that chronic stress history reveals novel genetic predictors of emotional behavior.
Clear and transparent standards are required to establish whether a therapeutic method is "evidence based." Even when research demonstrates a method to be efficacious, it may not become available to patients who could benefit from it, a phenomenon known as the "translational gap." Only 30% of therapies cross the gap, and the lag between empirical validation and clinical implementation averages 17 years. To address these problems, Division 12 of the American Psychological Association published a set of standards for "empirically supported treatments" in the mid-1990s that allows the assessment of clinical modalities. This article reviews these criteria, identifies their strengths, and discusses their impact on the translational gap, using the development of a clinical innovation called Emotional Freedom Techniques (EFT) as a case study. Twelve specific recommendations for updates of the Division 12 criteria are made based on lessons garnered from the adoption of EFT within the clinical community. These recommendations would shorten the cycle from the research setting to clinical practice, increase transparency, incorporate recent scientific advances, and enhance the capacity for succinct comparisons among treatments.
The identification of human body fluids or tissues through mRNA-based profiling is very useful for forensic investigations. Previous studies have shown mRNA biomarkers are effective to identify the origin of biological samples. In this study, we selected 16 tissue specific biomarkers to evaluate their specificities and sensitivities for human body fluids and tissues identification, including porphobilinogen deaminase (PBGD), hemoglobin beta (HBB) and Glycophorin A (GLY) for circulatory blood, protamine 2 (PRM2) and transglutaminase 4 (TGM4) for semen, mucin 4 (MUC4) and human beta defensin 1(HBD1) for vaginal secretion, matrix metalloproteinases 7 and 11 (MMP7 and MMP11) for menstrual blood, keratin 4(KRT4) for oral mucosa, loricrin (LOR) and cystatin 6 (CST6) for skin, histatin 3(HTN3) for saliva, statherin (STATH) for nasal secretion, dermcidin (DCD) for sweat and uromodulin (UMOD) for urine. The above mentioned ten common forensic body fluids or tissues were used in the evaluation. Based on the evaluation, a reverse transcription (RT) PCR multiplex assay, XCYR1, which includes 12 biomarkers (i.e., HBB, GLY, HTN3, PRM2, KRT4, MMP11, MUC4, DCD, UMOD, MMP7, TGM4, and STATH) and 2 housekeeping genes [i.e., glyceraldehyde-3-phosphate dehydrogenase (GAPDH) and 18SrRNA], was developed. This assay was further validated with real casework samples and mock samples (with both single source and mixture) and it was approved that XCYR1 is effective to identify common body fluids or tissues (i.e., circulatory blood, saliva, semen, vaginal secretion, menstrual blood, oral mucosa, nasal secretion, sweat and urine) in forensic casework samples.
The serotonin transporter (SERT) gene-linked polymorphic region (5-HTTLPR) has been implicated in moderating the link between life stress and depression. However, respective molecular pathways of gene-environment (GxE) interaction are largely unknown. Sustained alterations in SERT gene expression profiles, possibly mediated by epigenetic modifications, are a frequent correlate of depression and may thus constitute a putative mediator of GxE interaction. Here, we aimed to investigate joint effects of 5-HTTLPR and self-reported environmental adversity throughout the lifespan (prenatal, early and recent stress/trauma) on in vivo SERT mRNA expression in peripheral blood cells. To further evaluate whether environmentally induced changes in SERT expression are mediated by epigenetic modifications, we analyzed 83 CpG sites within a 799-bp promoter-associated CpG island of the SERT gene using the highly sensitive method of bisulfite pyrosequencing. Participants were 133 healthy young adults. Our findings show that both the 5-HTTLPR S allele and maternal prenatal stress/child maltreatment are associated with reduced in vivo SERT mRNA expression in an additive manner. Remarkably, individuals carrying both the genetic and the environmental risk factors exhibited 32.8% (prenatal stress) and 56.3% (child maltreatment) lower SERT mRNA levels compared with those without any risk factor. Our data further indicated that changes in SERT mRNA levels were unlikely to be mediated by DNA methylation profiles within the SERT CpG island. It is thus conceivable that the persistent changes in SERT expression may in turn relate to altered serotonergic functioning and possibly convey differential disease vulnerability associated with 5-HTTLPR and early adversity.
Dab2 is a multifunctional adapter protein which is frequently under-expressed in a variety of cancers. It is implicated in many critical functions, including several signaling pathways, cell arrangement, differentiation of stem cells, and receptor endocytosis. Transforming growth factor-β (TGF-β) is a secreted multifunctional protein that controls several developmental processes and pathogenesis of many diseases. It has been documented that Dab2 played an important role in TGF-β receptors endocytosis. Here, we present evidence that re-expression of Dab2 in SK-BR-3 cell partially restored its ability to deplete TGF-β in surrounding medium by normalizing the trafficking of TGF-β receptors. We also demonstrate that the difference in TGF-β depletions produced by Dab2 expression was sufficient to impact on the conversion of naive CD4+ T cells to regulatory T cells (Tregs), and thus inhibited the proliferation of T cells. This work revealed a critical result that breast cancer cell was deficient in Dab2 expression and related receptor endocytosis-mediated TGF-β depletion, which may contribute to the accumulation of TGF-β in tumor microenvironment and the induction of immune tolerance.
The present study reports on the first ever controlled comparison between eye movement desensitization and reprocessing (EMDR) and emotional freedom techniques (EFT) for posttraumatic stress disorder. A total of 46 participants were randomized to either EMDR (n = 23) or EFT (n = 23). The participants were assessed at baseline and then reassessed after an 8-week waiting period. Two further blind assessments were conducted at posttreatment and 3-months follow-up. Overall, the results indicated that both interventions produced significant therapeutic gains at posttreatment and follow-up in an equal number of sessions. Similar treatment effect sizes were observed in both treatment groups. Regarding clinical significant changes, a slightly higher proportion of patients in the EMDR group produced substantial clinical changes compared with the EFT group. Given the speculative nature of the theoretical basis of EFT, a dismantling study on the active ingredients of EFT should be subject to future research.
Irreversible processes are the source of order: hence 'order out of chaos.' Processes associated with randomness (openness) lead to higher levels of organisation. Under certain conditions, entropy may thus become the progenitor of order. The authors propose a vast synthesis that embraces both reversible and irreversible time, and show how they relate to one another at both macroscopic and minute levels of examination.-A.Toffler
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.
Book synopsis: Research Methods in Psychology has been substantially revised in its fourth edition. Continuing to offer enviable coverage of the research methods that psychology students at intermediate levels need to cover in their course, the textbook has now been broadened to cover the full suite of beginner level research methods too. The result is extensive coverage of psychological methods, both quantitative and qualitative, and a textbook that will serve students perfectly from day one in their course at university.
Psychotherapy that regularly yields liberating, lasting change was, in the last century, a futuristic vision, but it has now become reality, thanks to a convergence of remarkable advances in clinical knowledge and brain science. in Unlocking the Emotional Brain, authors Ecker, Ticic and Hulley equip readers to carry out focused, empathic therapy using the process found by researchers to induce memory reconsolidation, the recently discovered and only known process for actually unlocking emotional memory at the synaptic level. Emotional memory's tenacity is the familiar bane of therapists, and researchers have long believed that emotional memory forms indelible learning. Reconsolidation has overturned these views. It allows new learning to erase, not just suppress, the deep, unconscious, intensely problematic emotional learnings that form during childhood or in later tribulations and generate most of the symptoms that bring people to therapy. Readers will learn methods that precisely eliminate unwanted, ingrained emotional responses—whether moods, behaviors or thought patterns—causing no loss of ordinary narrative memory, while restoring clients' well-being. Numerous case examples show the versatile use of this process in AEDP, Coherence Therapy, EFT, EMDR and IPNB.
Results from recent studies of retrograde amnesia following damage to the hippocampal complex of human and non-human subjects have shown that retrograde amnesia is extensive and can encompass much of a subject's lifetime; the degree of loss may depend upon the type of memory assessed. These and other findings suggest that the hippocampal formation and related structures are involved in certain forms of memory (e.g. autobiographical episodic and spatial memory) for as long as they exist and contribute to the transformation and stabilization of other forms of memory stored elsewhere in the brain.
Component studies, which involve comparisons between a treatment package and the treatment package without a theoretically important component or the treatment package with an added component, use experimental designs to test whether the component is necessary to produce therapeutic benefit. A meta-analysis was conducted on 27 component studies culled from the literature. It was found that the effect size for the difference between a package with and without the critical components was not significantly different from zero, indicating that theoretically purported important components are not responsible for therapeutic benefits. Moreover, the effect sizes were homogeneous, which suggests that there were no important variables moderating effect sizes. The results cast doubt on the specificity of psychological treatments.
Emotional Freedom Techniques (EFT) is a type of therapy involving the stimulation of acupuncture points while using a spoken affirmation to target a psychological issue. While some studies cite data indicating EFT is highly efficacious, findings in other studies are unconvincing. The aim of this meta-analysis was to examine the effect of EFT, particular acupoint stimulation, in the treatment of psychological distress.
A systematic review of the literature identified 18 randomised control trials published in peer reviewed journals involving a total of 921 participants.
A moderate effect size (Hedge's g = -0.66: 95% CI: -0.99 to -0.33) and significantly high heterogeneity (I(2) = 80.78) across studies was found using a random effects model indicating that EFT, even after removing outliers (decreases in I(2) = 72.32 and Hedge's g = -0.51:95% CI:-0.78 to -0.23), appears to produce an effect. The analysis involved 12 studies comparing EFT with waitlist controls, 5 with adjuncts and only 1 comparison with an alternate treatment. Meta-regression and subgroup analyses were conducted to examine the effect of moderators on effect size of symptom change following EFT.
Due to methodological shortcomings, it was not possible to determine if the effect is due to acupoint stimulation or simply due to treatment elements common with other therapies.
Copyright © 2015 Elsevier Ltd. All rights reserved.
phanage with clinical PTSD scores completed a pretest. Of these, 34 (71%) completed a posttest assessment. They demonstrated an average reduction in symptoms of 18.8% (p < .001). Seven students (21%) dropped below the clinical cutoff point for PTSD, with average score reductions of 53.7% (p < .001). Follow-ups are planned, to determine if participant gains hold over time. Directions for future research arising out of data gathered in this pilot study are discussed.
Energy psychology is a clinical and self-help modality that combines verbal and physical procedures for effecting therapeutic change. While utilizing established clinical methods such as exposure and cognitive restructuring, the approach also incorporates concepts and techniques from non-Western healing systems. Its most frequently utilized protocols combine the stimulation of acupuncture points (by tapping on, holding, or massaging them) with the mental activation of a targeted psychological issue. Energy psychology has been controversial, in part due to its reliance on explanatory mechanisms that are outside of conventional clinical frameworks and in part because of claims by its early proponents—without adequate research support—of extraordinary speed and power in attaining positive clinical outcomes. This paper revisits some of the field's early claims, as well as current practices, and assesses them in the context of existing evidence. A literature search identified 51 peer-reviewed papers that report or investigate clinical outcomes following the tapping of acupuncture points to address psychological issues. The 18 randomized controlled trials in this sample were critically evaluated for design quality, leading to the conclusion that they consistently demonstrated strong effect sizes and other positive statistical results that far exceed chance after relatively few treatment sessions. Criteria for evidence-based treatments proposed by Division 12 of the American Psychological Association were also applied and found to be met for a number of anxiety-based conditions, including PTSD. Neurological mechanisms that may be involved in these surprisingly strong findings are also considered. (PsycINFO Database Record (c) 2014 APA, all rights reserved)
This study compared the effectiveness of process-experiential psychotherapy with one of its components, client-centered psychotherapy, in the treatment of (34) adults suffering from major depression. The client-centered treatment emphasized the establishment and maintenance of the Rogerian relationship conditions and empathic responding. The experiential treatment consisted of the client-centered conditions, plus the use of specific process-directive gestalt and experiential interventions at client markers indicating particular cognitive-affective problems. Treatments showed no difference in reducing depressive symptomatology at termination and six month follow-up. The experiential treatment, however, had superior effects at mid-treatment on depression and at termination on the total level of symptoms, self-esteem, and reduction of interpersonal problems. The addition, to the relational conditions, of specific active interventions at appropriate points in the treatment of depression appeared to hasten and enhance improvement.