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The Immediate Effect of a Brief Energy Psychology Intervention (Emotional Freedom Techniques) on Specific Phobias: A Pilot Study

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Specific phobia is one of the most prevalent anxiety disorders. Emotional Freedom Techniques (EFT) has been shown to improve anxiety symptoms; however, their application to specific phobias has received limited attention. This pilot study examined whether EFT, a brief exposure therapy that combines cognitive and somatic elements, had an immediate effect on the reduction of anxiety and behavior associated with specific phobias. The study utilized a crossover design with participants randomly assigned to either diaphragmatic breathing or EFT as the first treatment. The study was conducted at a regional university in the Southwestern United States. Twenty-two students meeting criteria for a phobic response to a specific stimulus (≥8 on an 11-point subjective units of distress scale). Participants completed a total of five two-minute rounds in each treatment intervention. Study measures included a behavioral approach test (BAT), Subjective Units of Distress Scale (SUDS), and Beck Anxiety Inventory (BAI). Emotional Freedom Techniques significantly reduced phobia-related anxiety (BAI P = .042; SUDS P = .002) and ability to approach the feared stimulus (BAT P = .046) whether presented as an initial treatment or following diaphragmatic breathing. When presented as the initial treatment, the effects of EFT remained through the presentation of the comparison intervention. The efficacy of EFT in treating specific phobias demonstrated in several earlier studies is corroborated by the current investigation. Comparison studies between EFT and the most effective established therapies for treating specific phobias are recommended.
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T
HE
I
MMEDIATE
E
FFECT OF A
B
RIEF
E
NERGY
P
SYCHOLOGY
I
NTERVENTION
(E
MOTIONAL
F
REEDOM
T
ECHNIQUES
)
ON
S
PECIFIC
P
HOBIAS
:AP
ILOT
S
TUDY
Martha M. Salas, MA,
1,2
Audrey J. Brooks, PhD,
3#
and Jack E. Rowe, PhD,
2,4
Background: Specific phobia is one of the most prevalent anx-
iety disorders. Emotional Freedom Techniques (EFT) has been
shown to improve anxiety symptoms; however, their application
to specific phobias has received limited attention.
Objective: This pilot study examined whether EFT, a brief ex-
posure therapy that combines cognitive and somatic elements,
had an immediate effect on the reduction of anxiety and behav-
ior associated with specific phobias.
Design: The study utilized a crossover design with participants
randomly assigned to either diaphragmatic breathing or EFT as
the first treatment.
Setting: The study was conducted at a regional university in the
Southwestern United States.
Participants: Twenty-two students meeting criteria for a phobic
response to a specific stimulus (8 on an 11-point subjective
units of distress scale).
Intervention: Participants completed a total of five two-minute
rounds in each treatment intervention.
Outcome Measures: Study measures included a behavioral ap-
proach test (BAT), Subjective Units of Distress Scale (SUDS),
and Beck Anxiety Inventory (BAI).
Results: Emotional Freedom Techniques significantly reduced
phobia-related anxiety (BAI P.042; SUDS P.002) and
ability to approach the feared stimulus (BAT P.046) whether
presented as an initial treatment or following diaphragmatic
breathing. When presented as the initial treatment, the effects of
EFT remained through the presentation of the comparison in-
tervention.
Conclusions: The efficacy of EFT in treating specific phobias
demonstrated in several earlier studies is corroborated by the
current investigation. Comparison studies between EFT and the
most effective established therapies for treating specific phobias
are recommended.
Key words: specific phobias, energy psychology, Emotional
Freedom Techniques (EFT), anxiety, exposure treatment
(Explore 2011; 7:155-161. © 2011 Elsevier Inc. All rights reserved.)
INTRODUCTION
Specific phobia is the most prevalent anxiety disorder both
within the United States and in other countries.
1-4
A specific
phobia is characterized by a persistent and excessive unreason-
able fear in the presence of, or in the anticipated presence of, a
specific object, or situation. The Diagnostic and Statistical Manual
of Mental Disorders-Fourth Edition (DSM-IV) recognizes four pri-
mary subtypes of specific phobias: animals (eg, snakes), natural
environment (eg, heights), situational (eg, flying), blood-injec-
tion-injury (eg, injections, dentist), and an “other” category for
phobias that do not fit in one of the four subtypes.
5
Despite the widespread prevalence, it is the disorder for which
individuals are least likely to seek treatment
4,6
even though it is
an easily treated disorder. Two recent reviews found exposure-
based treatments, especially in vivo exposure (having the patient
come into direct contact with the feared stimulus), were very
effective.
7,8
However, it is unclear in most of the reviewed stud-
ies how many individuals dropped out or did not enter a study
due to the intense fear of being exposed to the feared stimulus.
8
In a survey of persons meeting clinical criteria for specific pho-
bias, a greater preference and lower refusal rate for virtual reality
over in vivo exposure was found with fear of confronting the
feared stimulus as the most frequent reason given.
9
In addition,
the ability to implement therapist-directed exposure treatments,
especially those involving in vivo demonstrations, in a clinical
setting limits its widespread adoption. Although several alternate
treatment approaches, for example, cognitive approaches or vir-
tual exposure, have been tried in treating specific phobias, they
are not as effective as in vivo exposure. A recent review found
positive results for One-Session Treatment (OST) of specific
phobias.
10
The OST technique employs hierarchical exposure,
1 Corpus Christi Independent School District, Corpus Christi, TX
2 Department of Psychology and Sociology, Texas A&M University-
Kingsville, Kingsville, TX
3 Department of Psychology, University of Arizona, Tucson, AZ
4 Private practice, Coweta, OK
1, 2, 4 This study was conducted as part of the first author’s Masters’
Thesis at the Department of Psychology and Sociology, Texas A&M
University-Kingsville, TX. Ms Salas is now a school counselor with the
Corpus Christi Independent School District, Corpus Christi, TX. Dr
Rowe is now in private practice in Tulsa, OK.
Portions of this data were presented at Energy Psychology Conference-
International 2001, San Diego, CA, and the Sixth Annual Energy Psy-
chology Conference, 2004, Toronto, Canada.
This study was funded in part by the Foundation for Epigenetic Medi-
cine, Fulton, CA, to A.J.B. The authors thank Dawson Church, PhD, for
comments on drafts of this paper.
#Corresponding Author: Addresss:
Department of Psychology, University of Arizona, P.O. Box 210068,
Tucson, AZ 85721
e-mail: brooksaj@email.arizona.edu
155
© 2011 Elsevier Inc. All rights reserved EXPLORE May/June 2011, Vol. 7, No. 3
ISSN 1550-8307/$36.00 doi:10.1016/j.explore.2011.02.005
ORIGINAL RESEARCH
participant modeling, cognitive intervention, and reinforcement
in a single session of up to three hours. However, due to the
intensity of the intervention, a sufficient degree of participant
motivation is required. Therefore, exploration of new treatments
is still needed.
Energy psychology techniques have been proposed as an al-
ternate treatment for anxiety disorders. The most widely used
form of energy psychology is the Emotional Freedom Tech-
niques (EFT).
11,12
EFT was developed by Gary Craig as an ab-
breviation of the methods used in Thought Field Therapy, an
earlier Energy Psychology method that used elaborate diagnostic
and treatment protocols.
13
EFT can be administered by a thera-
pist or taught to individuals for self-application. The technique
employs brief forms of certain components of other therapies
that have demonstrated efficacy, such as cognitive restructuring
and exposure; however, it also includes a somatic component.
The somatic component involves tapping on prescribed acu-
puncture points during the process. As described in Traditional
Chinese Medicine, the acupuncture points used are situated on
or near the endpoints of specific meridians or energy pathways
in the body. It is this use of “energy meridians” that Gary Craig
and other proponents of EFT attribute as one of the primary
mechanisms underlying the method’s effectiveness.
14
Support
for this contention was demonstrated in a recent study that
found the stimulation of acupuncture points by pressure alone,
without using needles, was as efficacious as needling in a ran-
domized controlled trial.
15
Hui and colleagues
16
found acu-
puncture to send fear-dampening signals directly to the
amygdala, the structure in the limbic system that scans the en-
vironment for threats.
Recent studies examining EFT have found evidence for EFT’s
ability to reduce psychological distress symptoms such as test
anxiety, general anxiety, depression, and trauma.
17-24
Wells and
colleagues,
25
for instance, examined the effect of a single EFT
session on specific phobia of small animals. In this study 35
individuals meeting DSM-IV criteria for specific animal phobia
were randomly assigned to either a 30-minute EFT or diaphrag-
matic breathing session. The EFT treatment produced an imme-
diate improvement in behavioral and subjective distress mea-
sures, but not in pulse rate. Twenty-one (60%) of the sample
completed a follow-up assessment six to nine months after the
intervention. Improvements in the behavioral measure were still
present at follow-up, even showing a slight increase from the
posttest. There was also evidence that the improvements in the
subjective distress measures were maintained at follow-up in
that, although they were lower than the posttest values, they did
not return to baseline levels. However, given the declines in
improvement on the subjective distress measures, the superiority
of EFT over diaphragmatic breathing had dissipated somewhat
at the follow-up point. The authors attribute the lack of statisti-
cal significance between the two treatment conditions in part to
the small sample size.
The purpose of the present study was to compare the imme-
diate effectiveness of a single session of EFT with that of a
comparison condition, diaphragmatic breathing, in the reduc-
tion of anxiety of specific phobias. Diaphragmatic breathing was
chosen as the comparison treatment, as it has been used both as
a stand-alone treatment as well as a component of interventions
designed for stress management and to reduce anxiety.
26,27
Breathing therapies are commonly used by healthcare practitio-
ners to reduce tension and arousal, as well as to treat specific
symptoms and disorders.
28
The present study was designed as a
partial replication of the Wells study.
METHOD
Participants
Participants were 22 volunteers recruited from a mass survey of
students in undergraduate Psychology classes at a regional uni-
versity in south Texas. More than half of the sample was female
(N 15, 68%) with an average age of 20.8 years old. Participants
ethnic backgrounds included Hispanic (N 16, 73%), in addi-
tion to Caucasian (N 5, 23%), and other (N 1, 4%). The
inclusion criterion for this study was a phobic response, equal to
or more than 8 on an 11-point subjective units of distress scale
(SUDS) to a specific stimulus (described below). Phobias in-
cluded fear of heights (n 12), snakes (n 5), cockroaches (n
2), darkness (n 2), and syringes (n 1). Participants with a
phobia that could not be tested directly, for example, fear of
flying, were excluded. Although a formal DSM-IV diagnostic
interview for specific phobias was not conducted; the SUDS
cutoff score was chosen to indicate that the participant had a
noticeable phobic response to one of the subtypes of specific
phobias. All participants received a detailed explanation of the
study and provided informed consent to participate. There were
no dropouts or adverse events in the course of the study.
Measures
Subjective Units of Distress Scale.
A list of six potential phobic
situations and objects that could be behaviorally tested was cre-
ated. The situations/objects were elevators, enclosed spaces,
heights, public speaking, small animals/insects, and other anxi-
ety-provoking stimuli that participants self-identified. Partici-
pants responded to each of these stimuli on an 11-point scale
ranging from 0 (no anxiety—would not avoid it) to 10 (extremely
anxious—would avoid it). This widely used scale is commonly
referred to as the SUDS popularized by Joseph Wolpe’s work in
systematic desensitization.
29
As described above, a score equal
to or greater than 8 on one of the six stimuli qualified the
participant for inclusion in the study.
Beck Anxiety Inventory (BAI).
The BAI
30-32
is a widely used,
well-validated measure of anxiety. The 21-item measure assesses
physiological and cognitive symptoms of anxiety on four-point
Likert scale ranging from 0 (not at all) to 3 (severe). Responses are
summed to create a total anxiety score ranging from 0 to 63.
Total scores distinguish between minimal (0-7), mild (8-15),
moderate (16-25), and severe anxiety (26-63). The instructions
were modified to apply to the identified phobic situation, “how
much are you bothered by each symptom when thinking about
being in the feared situation?”
Behavioral Approach Test (BAT).
The BAT is a commonly
used behavioral assessment for specific phobias and a popular
156 EXPLORE May/June 2011, Vol. 7, No. 3 The Effect of EFT on Specific Phobias
objective measure of clinical progress following treatment
such as exposure therapy.
7,33
Participants were assessed on
their ability to approach the feared stimulus without experi-
encing a SUDS level of equal to or more than 5. To assess
approach, the feared stimulus (eg, snake, cockroach) was pre-
sented and the proportion of comfortable distance (eg, feet)
from the stimulus was calculated with 100% representing the
closest distance to the phobic stimulus. In other words, a
higher percentage indicates a less phobic response or ability
to get closer to the feared stimulus. The approach test varied
for each phobic stimulus. In the test for fear of heights par-
ticipants were taken to the university stadium, which contains
38 bleachers. Participants were asked to go up the bleachers
next to the outside guardrail, where they could clearly notice
the height. The approach test for this particular phobia
ranged from 1 bleacher (3%) to 38 bleachers (100%). The
snake phobia approach test was conducted in the university
serpentarium with an observation room containing 20 terrar-
iums with live rattlesnakes. The approach test for snake pho-
bia ranged from being no less than seven feet from the obser-
vation room (14%) to being inside the observation room, two
feet away from the snakes (100%). In testing the darkness
phobia, the approach test was done in an adjacent office with
no light. The approach test ranged from walking toward the
dark room but stopping before standing in front of the closed
door (14%) to being inside the dark room, with the door
completely closed for at least five seconds (100%). The ap-
proach test for the injections phobia ranged from seeing the
researcher (sitting approximately five feet away) hold a syringe
inside the plastic package (14%) to seeing the researcher sim-
ulate an injection (rubbing alcohol on arm and placing the
needle right next to the arm; 100%). The approach test for
phobia of cockroaches was done in an adjacent office where a
live cockroach was kept in a jar. The test ranged from standing
three feet from the jar (20%) to holding the jar and opening
the lid (100%).
Procedure
The present study utilized a crossover design with participants
randomly assigned to either breathing relaxation or EFT as the
first treatment. Half of the participants received the breathing re-
laxation treatment first followed by EFT, and the other half were
assigned to receive EFT first followed by breathing.
The anxiety intervention focused on the specific phobic stim-
ulus identified by the participant. As described above, the study
measures (SUDS, BAI) and intervention were conducted in a
separate area, adjacent to the location of the approach test. Partici-
pants received the intervention individually or in pairs. The study
self-report measures and approach test were conducted at baseline
and following each intervention.
Treatment Intervention
The treatment intervention was provided by the first author who
was a Master’s level graduate student in counseling psychology
under the supervision of a licensed psychologist (third author).
The interventionist was trained in and utilized both treatments
as part of her supervised clinical practice in the university coun-
seling center. Although the intervention was delivered under the
supervision of a licensed psychologist, no specific treatment
fidelity measures were collected. Participants completed a total
of five rounds (described below) in each treatment intervention.
Each treatment round was approximately 2 minutes, resulting in
a 10-minute treatment for each intervention. In both treatment
conditions participants were instructed to focus on the fear while
practicing either EFT or diaphragmatic breathing. In addition,
the intervention took place in proximity to the feared stimulus.
For example, the intervention for fear of heights was conducted
at the bleachers, while the intervention for the fear of snakes was
conducted in an area adjacent the observation room in the ser-
pentarium. After each round of treatment, participants were
asked to assess their anxiety level with a SUDS reading while
thinking about being in the feared situation. The last SUDS
reading after round 5 was considered the posttest.
Diaphragmatic Breathing. Diaphragmatic breathing, involving
the use of the diaphragm, is a standard procedure that has been
used for many years to reduce anxiety. For the present study, a
round of diaphragmatic breathing consisted of three deep
breaths, inhaling for a count of 4, holding for a count of 2, and
exhaling for a count of 4.
34
EFT. The EFT technique has both cognitive and somatic ele-
ments. The cognitive component pairs thinking about being in the
feared situation with a self-acceptance statement, while the somatic
component of EFT involves tapping specific points on the body
with the tips of the index and middle fingers. These points corre-
spond to the endpoints of traditional acupuncture meridians. The
present study employed a brief version of EFT
11
utilizing 8 of the 12
body points. The first point on the body, referred to as the “setup,”
consists of tapping on the side of the hand next to the little finger,
while repeating an affirmation statement three times, for example
“Even though I have this fear of heights, I deeply and completely
accept myself.” After the setup is complete, a “reminder phrase,”
such as “this fear of heights,” is repeated while tapping seven times
at each of the remaining seven body points. These body points
include the beginning of either eyebrow, the outside corner of the
eye, about one inch under either eye, under the nose in the center of
the upper lip, between the lower lip and the chin, just below the end
of the collarbone next to the sternum, and about four inches down
from the center of either armpit. A round of EFT consisted of the
self-acceptance statement and tapping the eight body points.
RESULTS
Statistical Analysis
A General Linear Model repeated-measures analysis of covari-
ance was conducted on each of the dependent variables, SUDS,
Table 1. Baseline t-Test Results by Treatment Order Means and
Standard Deviations
Variable
Breathing-EFT
Mean SE
EFT-Breathing
Mean SE t(20) Sig
SUDS 9.45 0.82 8.91 0.94 1.45 0.16
BAI 38.82 13.20 31.64 7.62 1.56 0.13
Approach 39.91 27.86 35.55 14.29 0.46 0.65
157
The Effect of EFT on Specific Phobias EXPLORE May/June 2011, Vol. 7, No. 3
BAI, and BAT, controlling for the baseline value. The between-
subjects variable was the order of therapy presentation (breath-
ing first/EFT second versus EFT first/breathing second) and the
within-subjects variable was time of measurement (after the first
treatment, and after the second treatment). Post hoc Tukey tests
were conducted on significant findings.
Results
The t-tests were conducted on the baseline SUDS, BAI, and BAT
variables comparing the two treatment order groups and no
significant differences were found (see Table 1). In the models
examining intervention effects over time, the time by treatment
order interactions were significant for each dependent variable.
In the post hoc Tukey analyses the SUDS, BAI, and BAT breath-
ing first posttest was significantly higher than the EFT presented
first posttest, the EFT presented second posttest, and breathing
presented second posttest (Table 2). When presented first,
breathing therapy is significantly less effective in reducing sub-
jective distress, anxiety, and ability to approach the feared stim-
ulus than EFT. In addition, when EFT is presented following the
breathing intervention a statistically significant reduction in sub-
jective distress, anxiety, and ability to approach the feared stim-
ulus occurs above any effect the breathing may have had. No
additional reduction in subjective distress, anxiety, and ability to
approach the feared stimulus occurs when breathing is presented
following EFT (Figures 1,2and 3).
Effect sizes were calculated for the first posttest between
groups for the three dependent variables. Cohen’s dwere ob-
tained for SUDS, BAI, and BAT (1.11, 0.941, and 0.893, respec-
tively). According to Cohen values of dgreater than 0.80 are
considered a large effect
35
indicating a large treatment effect for
EFT.
DISCUSSION
The present study demonstrated the ability of EFT to reduce
anxiety related to a specific phobia in comparison to diaphrag-
matic breathing. EFT significantly reduced phobia-related anxi-
ety and behavior whether presented as an initial treatment or
following the comparison treatment, diaphragmatic breathing.
When presented as the initial treatment, the effects of EFT re-
mained through the presentation of a second comparison inter-
vention. The use of a comparison condition that is often an
element of many exposure, desensitization, and relaxation treat-
ments, suggests that EFT is not merely a placebo, and therefore,
worthy of additional research for the treatment of specific pho-
Figure 1. Subjective Units of Distress Scale treatment pretest and posttests adjusted means by treatment order.
Table 2. First and Second Treatment Adjusted Posttest Means and Standard Errors by Treatment Order
Variable Treatment Order
First Treatment Posttest
Mean SE
Second Treatment Posttest
Mean SE F(1,19) Sig
SUDS Breathing-EFT 5.719 0.77
a
2.890 0.74
b
12.30 0.002
SUDS EFT-Breathing 2.872 0.77
b
2.792 0.74
b
BAI Breathing-EFT 27.872 3.82
a
15.278 3.75
b
4.75 0.042
BAI EFT-Breathing 15.946 3.82
b
11.995 3.75
b
Approach Breathing-EFT 51.153 5.88
a
79.255 6.40
b
4.58 0.046
Approach EFT-Breathing 68.574 5.88
c
79.472 6.40
b
Posthoc Tukey test a b, P.001; a c, P.03.
158 EXPLORE May/June 2011, Vol. 7, No. 3 The Effect of EFT on Specific Phobias
bias. Furthermore, statistically significant effects were found
with a small sample indicating a robust treatment effect.
The results of this study should be interpreted in light of the
following limitations. This study is limited by the lack of a
follow-up. The first author provided the treatments and col-
lected the data. However, although it was hypothesized that EFT
would yield superior results; both treatments were used by the
first author in clinical practice with positive results.
The present study confirmed the immediate effect of EFT
found in the Wells study. In addition, the present study exam-
ined multiple subtypes of specific phobias, not just small animal
phobias as in the Wells study.
25
Although the Wells study em-
ployed a 30-minute intervention, the present study demon-
strated a reduction in phobia-related anxiety and behavior fol-
lowing a 10-minute intervention. Given the lack of a follow-up
in the present study, it is not possible to determine durability of
the effects with a 10-minute intervention. Further research is
needed to determine the optimal intervention period. Although
the present study only examined the immediate effect of EFT on
phobia-related anxiety, the Wells study on which this study was
based, found some evidence for the long-term benefit of EFT in
treating specific phobias. A study conducted as a partial replica-
tion of the Wells study found EFT to be superior to a supportive
interview treatment and no treatment in treating small animal
phobias.
36
Similar to Wells results, evidence supporting the
long-term effect of EFT was found. Effect sizes obtained in these
two studies, as well as the present study, indicate a large effect for
EFT on specific phobias. Furthermore, the effect sizes obtained
Figure 2. Beck Anxiety Inventory treatment posttests—adjusted means by treatment order.
Figure 3. Approach treatment posttests—adjusted means by treatment order.
159
The Effect of EFT on Specific Phobias EXPLORE May/June 2011, Vol. 7, No. 3
in these studies is consistent with those obtained in a recent
meta-analysis of OST of specific phobias.
10
Accordingly, these
studies provide support for EFT as a well-established treatment
in that the studies used a between group design comparing EFT
to a psychological treatment;
37
however, the comparison treat-
ments in these studies were not specifically designed to treat
specific phobias and had relatively small sample sizes. Therefore,
a comparison of EFT with other current treatments of specific
phobias is needed to establish EFT as an efficacious treatment
for specific phobias.
Certain elements of EFT are comparable to other specific
phobia interventions, which may explain the positive results
observed in this study. Namely, imaginal exposure, cognitive
restructuring, and relaxation associated with tapping are all pres-
ent in EFT. However, unlike other techniques, EFT is hypothe-
sized to intervene on the body’s energy system through the
mechanism of tapping specific energy meridian endpoints. The-
ories based on the body’s energy system hypothesize that energy
blockages or imbalances, often due to trauma or psychological
conditioning as in phobias, cause emotions to persist and block
the flow of energy.
38,39
Removing the blockage and rectifying
the flow of energy is believed to alleviate symptoms, such
as those experienced in a phobic situation. Preliminary support
for this hypothesis was found in a pilot study of EFT for claus-
trophobia. Changes in electrical conductance between acupunc-
ture points were observed following a single EFT treatment.
22
Although further studies are needed to determine whether EFT
is as, or more, efficacious as the existing specific phobia treat-
ments, the contribution of tapping to the common treatment
elements warrants further study. Both the present study and the
Wells study utilized diaphragmatic breathing as the comparison
condition as a control for EFT’s ability to reduce anxiety; how-
ever, a control for the cognitive component of EFT was not used
in the diaphragmatic breathing intervention in either study.
Therefore, future dismantling studies of EFT should examine
the contribution of both the cognitive component and tapping.
In addition, verifying the unique contribution of tapping will
provide further support for the principles of not just EFT, but
energy psychology in general.
Clinical Implications. A strength of the present study is that
positive results were observed after a very brief 10-minute EFT
intervention. The single-session intervention (OST) employed
to treat specific phobias can take up to three hours. Furthermore,
EFT is particularly amenable to self-administration as well as
instruction in group settings further enhancing its use in either
the direct treatment of specific phobias or to augment an exist-
ing treatment. For example, significant improvements in psy-
chological distress were found following both brief (four-hour
workshop including two hours of self-application,
40
two weekly
two-hour sessions
17
) and intensive (three-day) instruction in
EFT.
23
Improvements were maintained at both 90-day
40
and
six-month follow-ups.
23
In contrast to other anxiety disorders,
specific phobias are particularly responsive to self-administered
or minimal therapist contact interventions,
41
thus enhancing
EFT’s value as an intervention for this type of disorder. The short
intervention time frame required and ability to administer the
treatment in a group format suggests that EFT may be a cost-
effective treatment for specific phobias.
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The Effect of EFT on Specific Phobias EXPLORE May/June 2011, Vol. 7, No. 3
... Although the primary focus of the treatment was not directed toward depression or anxiety, improvements in these conditions were observed. The stress reduction characteristics of EFT can be beneficial for complex disorders that include anxiety as a component, such as food-related anxiety [50] and specific phobias [51]. Our findings suggested that EFT can relieve anxiety, demonstrating a large effect size and low heterogeneity. ...
Article
Full-text available
Energy psychology, particularly emotional freedom techniques (EFT), has gained attention as a non-pharmacological treatment for posttraumatic stress disorder (PTSD). We conducted a meta-analysis to assess the efficacy of EFT in alleviating PTSD symptoms. This meta-analysis follows PRISMA guidelines. We conducted a literature search on PubMed, Embase, Cochrane, Web of Science, Airiti Library, and ClinicalTrials.gov for relevant studies published before December 31, 2024. The meta-analysis included 13 studies involving 621 patients. Our findings showed that EFT significantly improved PTSD symptoms compared to the baseline (standardized mean difference [SMD]: − 0.901; 95% confidence intervals [CI]: − 1.130– − 0.671; Hedge's g: −0.865) and was more effective than the control group (SMD: − 2.106; 95% CI: − 2.759– − 1.452; Hedge's g: −2.062). Furthermore, anxiety (SMD: − 0.591; 95% CI: − 0.726– − 0.456; Hedge's g: −0.567) and depression (SMD: − 0.516; 95% CI: − 0.654– − 0.377; Hedge's g: −0.495) scores decreased significantly compared to the baseline. Notably, these treatment effects were sustained for up to three months for PTSD severity (SMD: − 0.757; 95% CI: − 0.967– − 0.547; Hedge's g: −0.723), anxiety (SMD: − 0.522; 95% CI: − 0.683– − 0.361; Hedge's g: −0.498), and depression (SMD: − 0.420; 95% CI: − 0.542– − 0.298; Hedge's g: −0.402). The subgroup analysis of veterans revealed that EFT effectively reduced PTSD symptoms (SMD: − 1.159; 95% CI: − 1.441– − 0.877; Hedge's g: −1.102), anxiety (SMD: − 0.715; 95% CI: − 0.943– − 0.487; Hedge's g: -0.676), and depression (SMD: − 0.627; 95% CI: − 0.803– − 0.451; Hedge's g: −0.597). EFT effectively treated PTSD and reduced comorbid symptoms, including anxiety and depression. Moreover, its therapeutic effect could be applied in veteran populations and sustained for up to three months.
... 19 Several studies have shown that the EFT has positive effects on variables such as phobias, anxiety, depression, and posttraumatic stress disorder. [20][21][22][23] In the field of women's health, the results of EFT studies on fear of childbirth, psychological development, cortisol levels in pregnant women with prenatal loss, postpartum depression, and dysmenorrhea [24][25][26][27] are extremely positive. In this context, the present study will contribute to the literature due to the lack of studies examining the effect of EFT application for premenstrual syndrome. ...
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Objective The study was conducted to determine the effect of emotional freedom techniques (EFT) on the severity of premenstrual syndrome (PMS). Methods The study was conducted as a randomized controlled trial, with a premenstrual syndrome sample comprising 78 single female students of reproductive age presenting with PMS complaints (40 in the experimental group and 38 in the control group). Students in the experimental group were interviewed individually in the week before their menstrual cycle and received two EFT sessions with a 3‐day interval. Results The participants in the experimental group had higher post‐test subjective units of experience (SUE) mean scores (experimental group mean 7.8 ± 1.7; control group mean 0.5 ± 5.7) and lower post‐test PMS total (experimental group mean 76.8 ± 30.1; control group mean 127.4 ± 34.6) and subscale mean scores than the students in the control group, and the difference between the groups was statistically significant (P < 0.05). In repeated measures analysis, time‐dependent change showed statistical significance between the groups (P < 0.05). Conclusion The EFT was found to be an effective non‐pharmacologic intervention for coping with PMS.
... To improve a person's quality of life, help them overcome their worries, and improve their overall well-being, phobias need to be addressed (Eaton et al., 2018). An unreasonable or exaggerated worry that is out of proportion to the true threat or danger is known as unfounded fear (Salas et al., 2011). People with phobias may react to this unjustified fear with extreme anxiety or panic attacks. ...
Article
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A phobia is a kind of anxiety condition characterized by a strong, irrational dread of a particular object or situation. Avoidance behavior, in which people will stop at nothing to avoid being around distressing stimuli, is frequently the outcome of this dread. Usually, the level of dread is not commensurate with the danger or danger itself. Common phobias include aviophobia (fear of flying), arachnophobia (fear of spiders), and acrophobia (fear of heights). Phobias are caused by a combination of genetic, psychological, and environmental factors. Cognitive behavioral therapy (CBT), exposure therapy, and occasionally medication are used in treatment to manage symptoms and enhance quality of life.
... Dalam kondisi kritis, seperti dalam komplikasi kehamilan preeklamsia, perawat dapat melakukan beberapa intervensi terapi komplementer untuk menurunkan kecemasan, antara lain memberi informasi pentingnya istirahat tidur, melakukan health education, membina kepercayaan dengan pasien, memberi waktu menemani pasien, mengajarkan terapi kognitif, latihan pernapasan dalam, terapi psikologi energy, terapi spiritualitas, memberikan humor, pijat, aroma terapi, terapi sentuhan, dan juga bisa dengan terapi musik dan guided imagery (Ahmaniyah & Indriyani, 2020;Burk, 2010;Church et al., 2012;Morton & Fontaine, 2009;Salas et al., 2011). ...
Article
Pendahuluan: Preeklamsia merupakan hipertensi pada kehamilan yang ditandai dengan peningkatan tekanan darah lebih dari atau sama dengan 140/90 mmHg setelah umur kehamilan 20 minggu, disertai dengan proteinuria lebih dari 300 miligram per 24 jam. Preeklamsia dapat menimbulkan kecemasan pada ibu akan dampak yang dapat ditimbulkan dari preeklamsia, sebaliknya kecemasan juga dapat meningkatkan tekanan darah pada ibu. Tujuan penelitian ini adalah memberikan gambaran efektifitas terapi musik dan guided imagery dalam menurunkan tingkat kecemasan ibu hamil dengan preeklamsia. Metode penelitian adalah deskriptif kualitatif dengan pendekatan studi kasus. Peneliti melaksanakan asuhan keperawatan kepada ibu hamil dengan preeklamsia dan meingimplementasikan terapi musik dan guided imagery untuk mengurangi kecemasan ibu. Penetapan sampel menggunakan teknik purposive sampling dengan kriteria inklusi ibu hamil dengan preeklamsia berat disertai proteinuria serta menjalani program hingga selesai, sehingga didapatkan sampel sebanyak empat ibu hamil. Hasil: setelah diberikan intervensi terapi musik dan guided imagery selama tiga kali, terjadi penurunan tingkat kecemasan pada keempat ibu hamil yang mengalami preeklamsia. Tingkat kecemasan responden pertama menurun dari skor 27 (kecemasan sedang) menjadi 14 (kecemasan ringan). Responden kedua menurun dari skor 25 (kecemasan sedang) menjadi 14 (kecemasan ringan). Responden ketiga menurun dari skor 26 (kecemasan sedang) menjadi 13 (kecemasan ringan). Responden keempat menurun dari skor 26 (kecemasan sedang) menjadi 14 (kecemasan ringan). Hasil penelitian studi kasus memberikan gambaran bahwa penerapan terapi musik dan guided imagery dapat menurunkan tingkat kecemasan ibu hamil dengan preeklamsia setelah diberikan intervensi sebanyak tiga kali. Kata Kunci : Guided Imagery, Ibu hamil, Kecemasan, Preeklamsia, Terapi Musik
... One of the non-medicinal methods that can be effective is called Emotional Freedom Techniques (EFT). This technique, consisting of tapping and cognitive therapy, can be used either by a trainer or by people themselves (15). In different studies, this technique has been used to treat various psychological disorders, such as anxiety, depression, phobias, and post-traumatic stress disorder (PTSD), and different physical disorders like headaches, pain, brain injury, fibromyalgia, psoriasis, and seizures (16,17). ...
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Background: Various physical and mental problems and diseases may develop with aging. Poor sleep quality is the third most common major problem in older adults, affecting all aspects of life. Emotional Freedom Techniques (EFT) can be used to treat the disease in older adults. Objectives: This interventional study attempted to investigate the effect of EFT on sleep quality, sleepiness, and quality of life of older adults. Methods: This was a quasi-experimental study. The selection of the participants was based on the convenience sampling method. Twenty-one people participated in the study and were divided into two groups of interventions. The study was conducted in the adult day-care center. In one group, 11 people and in the other group, 10 people were included. First, an educational session regarding sleep hygiene was held. Then, the EFT was administered for 4 weeks, 2 sessions per week, and each session lasted for 30 - 45 minutes in the intervention group by the student (first author); sleep hygiene training was also provided for the second group. Study measures included the PSQI (Pittsburgh Sleep Quality Index), the Epworth Sleepiness Scale (ESS), and the quality-of-life scale. Follow-ups were performed after the intervention and one month later. The statistical tests used were repeated measures and chi-Square tests. A P-value < 0.05 was considered as statistically significant. Results: The trend of changes in sleep quality (P = 0.001, P = 0.001, respectively) and sleepiness (P = 0.023, P = 0.001, respectively) was incremental and significant before and after the intervention and one month later in each of the groups, but results show that there was no significant interaction effect for any subscale, including subjective sleep quality (P = 0.786), sleepiness (P = 0.568), and quality of life (P = 0.289). Conclusions: According to the results, the EFT was effective on sleep quality, sleepiness, and quality of life of older adults in the adult day-care center, and sleep hygiene was influential.
... Em 1995, o engenheiro norte-americano Gary Craig criou as EFT como uma simplificação das técnicas usadas na Thought Field Therapy (Terapia do Campo do Pensamento), uma abordagem anterior à Energy Psychology (Psicologia da Energia) que utiliza protocolos complexos de diagnóstico e tratamento (Salas, Brooks, & Rowe, 2011). Baseada nos princípios da acupunctura chinesa e no conceito de sistema energético do corpo, as EFT são uma forma de acupressão psicológica que envolve tocar em pontos específicos do corpo físico com as pontas dos dedos enquanto se foca num problema emocional ou biológico específico (Church, 2017). ...
Book
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Embarque numa viagem profundamente transformadora com O Poder da Vida no Útero. Explore 21 protocolos de EFT para a potencial resolução de traumas pré-natais e a sua ligação aos seus atuais desafios existenciais. Este guia abrangente, apoiado por cerca de 300 estudos científicos, permite-lhe transformar positivamente as suas cognições e emoções, e motiva-o a abraçar a vida com uma saúde ótima, amor mais genuíno, empatia e bem-estar. Os protocolos podem ser utilizados por qualquer pessoa como uma ferramenta de autoajuda, bem como por profissionais de saúde que desejem integrar as EFT na sua prática clínica. Empodere-se com as 776 sequências frásicas transformacionais incluídas nos 21 protocolos EFT.
... In 1995, North American engineer Gary Craig created EFT as a simplification of the techniques used in Thought Field Therapy, an earlier approach to Energy Psychology that uses complex diagnostic and treatment protocols (Salas, Brooks, & Rowe, 2011). Based on the principles of Chinese acupuncture and the concept of the body's energy system, EFT is a form of psychological acupressure that involves tapping on specific points on the physical body with the fingertips while focusing on a specific emotional or biological problem (Church, 2017). ...
Book
Full-text available
Embark on a profoundly transformative journey with The Womb Connection. Explore 21 EFT protocols for the potential resolution of prenatal trauma and its connection to your current existential challenges. This comprehensive guide, backed by nearly 300 scientific studies, empowers you to positively transform your cognitions and emotions, and motivates you to embrace life with optimal health, more genuine love, empathy and well-being. The protocols can be used by anyone as a self-help tool, as well as by health professionals who wish to integrate EFT into their clinical practice. Empower yourself with the 775 transformational phrase sequences included in the 21 EFT protocols. Official page: https://ici.org.pt/editora/eft1/
Article
Objective: This randomized controlled trial investigated the effect of emotional freedom techniques (EFT) on the severity of nausea-vomiting and anxiety in early pregnancy. Design: The sample consisted of 131 pregnant women in the experimental and control groups between 6 and 16 weeks of pregnancy attending an antenatal clinic. Participants were randomly assigned to receive training on EFT or a control group. Data were collected using a personal information form, subjective experiences, the Pregnancy-Related Anxiety Questionnaire, and the Pregnancy-Unique Quantification of Emesis. Both groups attended two visits, a week apart. The participants in the EFT group received a session of EFT at each visit and completed two EFT sessions as home assignments, 2 and 4 days after the first visit. The participants in the control group attended two visits a week apart and completed assessments but did not receive EFT. Results: There were 55 women in each group who completed the study, and the groups were similar in terms of baseline measures, including socioeconomic status, smoking status, previous pregnancy, severity of nausea-vomiting, and total pregnancy-related anxiety. EFT significantly reduced anxiety levels from the baseline to the second session (fear of delivery, worries about bearing a handicapped child, concern about one's own appearance) and total pregnancy-related anxiety (total pretest 29.85 ± 9.87, post-test 20.67 ± 8.38; p < 0.001), while the control group showed no reduction in pregnancy-related anxiety (total pretest 26.1 ± 7.79, post-test 25.98 ± 8.49; p = 0.933). Although nausea-vomiting was reduced in both groups over the two-session period, at the end of treatment, the EFT group had significantly lower nausea intensity (EFT group 4.4 ± 1.81, control group 5.36 ± 2.48; p = 0.02). Conclusions: EFT is a nonpharmacologic intervention that can be effective in reducing nausea, vomiting, and anxiety in early pregnancy. Clinical Trials Registration Number: NCT05337852.
Chapter
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Enerji psikoterapileri içerisinde kullanılan alternatif yöntemlerden biri de Duygusal Özgürlük Tekniğidir (Emotional Freedom Technique, EFT). Bu teknik, fiziksel rahatsızlık (acı, ağrı, dimenore vb.) ve duygusal problemler de alternatif bir tedavi yöntemi olarak kullanılmaktadır. Psikolojik akupresür veya dokunma olarak da adlandırılmaktadır. Bu tekniği kullanan bireyler, vücuda bölgesel dokunuşların enerji sisteminde bir denge yaratabileceğine, böylece fiziksel ve ruhsal sorunların tedavi edebileceğine inanmaktadır. Söz konusu derlemede, EFT yöntemi, kullanım yöntemi ve etkisi hakkında bilgi vermek amacıyla yazılmıştır.
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Energy psychology uses cognitive operations such as imaginal exposure to traumatic memories or visualization of optimal performance scenarios—combined with physical interventions derived from acupuncture, yoga, and related systems—to induce psychological change. Although a controversial approach, this combination purportedly brings about, with unusual speed and precision, therapeutic shifts in affective, cognitive, and behavioral patterns that underlie a range of psychological concerns. Energy psychology has been applied in the wake of natural and human-made disasters in the Congo, Guatemala, Indonesia, Kenya, Kosovo, Kuwait, Mexico, Moldavia, Nairobi, Rwanda, South Africa, Tanzania, Thailand, and the United States. At least three international humanitarian relief organizations have adapted energy psychology as a treatment in their postdisaster missions. Four tiers of energy psychology interventions include (1) providing immediate relief/stabilization, (2) extinguishing conditioned responses, (3) overcoming complex psychological problems, and (4) promoting optimal functioning. The first tier is most pertinent in psychological first aid immediately following a disaster, with the subsequent tiers progressively being introduced over time with complex stress reactions and chronic disorders. This article reviews the approach, considers its viability, and offers a framework for applying energy psychology in treating disaster survivors.
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Protocols to treat veterans with brief courses of therapy are required, in light of the large numbers returning from Iraq and Afghanistan with depression, anxiety, PTSD and other psychological problems. This observational study examined the effects of six sessions of EFT on seven veterans, using a within-subjects, time-series, repeated measures design. Participants were assessed using a well-validated instrument, the SA-45, which has general scales measuring the depth and severity of psychological symptoms. It also contains subscales for anxiety, depression, obsessive-compulsive behavior, phobic anxiety, hostility, interpersonal sensitivity, paranoia, psychosis, and somatization. Participants were assessed before and after treatment, and again after 90 days. Interventions were done by two different practitioners using a standardized form of EFT to address traumatic combat memories. Symptom severity decreased significantly by 40% (p
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This comprehensive volume provides up-to-date information on the 3 main types of phobic disorder: panic disorder and agoraphobia, social phobia, and specific phobia. The book integrates current research findings with practical recommendations for diagnosis and treatment. For each disorder, clinicians will find guidelines for assessment, including diagnostic interviews, behavioral assessments, symptom diaries, and standardized self-report measures that are highly useful for differential diagnosis and treatment planning. The authors present flexible and detailed treatment protocols for each disorder that include session frequency and duration, sequencing of cognitive and behavioral strategies, bibliotherapy, homework, and monitoring forms for tracking patient progress. Basic principles of exposure-based treatment and social skills training and the most effective cognitive techniques are described, illuminated by sample therapist–patient dialogue and troubleshooting tips. A chapter on the most commonly used medications, side effects, issues related to dosage, and strategies for discontinuing medication is included. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
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