The Effect of Emotional Freedom Techniques (EFT) on Stress Biochemistry: A Randomized Controlled Trial
Dawson Church, PhD, Foundation for Epigenetic Medicine
Garret Yount, PhD, California Pacific Medical Center (CPMC) Research Institute
Audrey Brooks, PhD, Psychology Department, University of Arizona at Tucson
Journal of Nervous and Mental Disease, (2011), in press.
Cortisol is a physiological marker for stress. Elevated cortisol levels are associated with accelerated aging, many organic diseases, and psychological conditions such as depression and anxiety. This study examined the changes in cortisol levels and psychological symptoms of 83 non-clinical subjects receiving a single hour-long intervention. Subjects were randomly assigned to either an EFT group, a psychotherapy group receiving a supportive interview (SI), or a no treatment (NT) group. Salivary cortisol assays were performed immediately before, and thirty minutes after the intervention. Psychological conditions were assessed using the SA-45. The EFT group showed clinically and statistically significant improvements in anxiety (-58.34%, p < .05), depression (-49.33%, p < .002), the overall severity of symptoms, (-50.5%, p < .001), and symptom breadth across conditions (-41.93%, p < .001). There were no significant changes in cortisol levels between SI (-14.25%, SE 2.61) and NT (-14.44%, SE 2.67); however cortisol in the EFT group dropped significantly (-24.39%, SE 2.62) compared to SI and NT (p < .01). The reduced cortisol levels in the EFT group correlated with decreased severity in psychological symptoms as measured by the SA-45. These results suggest that salivary cortisol tests may be useful not only for assessing stress physiology, but also as an objective indicator of the impact of mental health treatments in reducing psychological symptoms. In the current study, EFT was shown to significantly improve both cortisol-related stress levels and self-reported psychological symptoms after a single treatment session.
Keywords: Cortisol, stress, depression, anxiety, physiology, EFT (Emotional Freedom Techniques).
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A Controlled Comparison of the Effectiveness and Efficiency of Two Psychological Therapies for Posttraumatic Stress Disorder: Eye Movement Desensitization and Reprocessing vs. Emotional Freedom Techniques
Karatzias, Thanos PhD; Power, Kevin PhD; Brown, Keith FRCPsych; McGoldrick, Theresa BA; Begum, Millia MRCPsych; Young, Jenny BA; Loughran, Paul MSc; Chouliara, Zoë PhD; Adams, Sally MSc
Journal of Nervous & Mental Disease: June 2011 - Volume 199 - Issue 6 - pp 372-37
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.
Treatment of PTSD in Rwandan Child Genocide Survivors Using Thought Field Therapy
Caroline Sakai, PhD, Suzanne M. Connolly, LCSW, Paul Oas, PhD.
International Journal of Emergency Mental Health, Winter 2010, 12(1), 41-50.
Thought Field Therapy (TFT), which utilizes the self-tapping of specific acupuncture points while recalling a traumatic event or cue, was applied with 50 orphaned teens who had been suffering with symptoms of PTSD since the Rwandan genocide 12 years earlier. Following a single TFT session, scores on a PTSD checklist completed by caretakers and on a self-rated PTSD checklist had significantly decreased (p < .0001 on both measures). The number of participants exceeding the PTSD cutoffs decreased from 100% to 6% on the caregiver ratings and from 72% to 18% on the self-ratings. The findings were corroborated by informal interviews with the adolescents and the caregivers which indicated dramatic reductions of PTSD symptoms such as flashbacks, nightmares, bedwetting, depression, isolation, difficulty concentrating, jumpiness, and aggression. Following the study, the use of TFT on a self-applied and group utilized basis became part of the culture at the orphanage, and on one-year follow-up, the initial improvements had been maintained as shown on both checklists.
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Psychological Trauma in Veterans using EFT (Emotional Freedom Techniques): A Randomized Controlled Trial
Dawson Church, PhD, Crystal Hawk, MEd, Audrey Books, PhD, Oliver Toukolehto, Maria Wren, LCSW, Ingrid Dinter, Phyllis Stein, PhD. These data were presented at the Society of Behavioral Medicine, Seattle, Washington, April 7-10, 2010. In peer review.
This study examined the effect of Emotional Freedom Techniques (EFT), a brief exposure therapy combining cognitive and somatic elements, on post-traumatic stress disorder (PTSD) and psychological distress symptoms in military veterans receiving mental health services. Veterans meeting the clinical criteria for PTSD were randomized to EFT (n = 30) or wait-list (n = 29; WL). The EFT intervention consisted of six hour-long EFT coaching sessions concurrent with standard care. PTSD was assessed using the PTSD Checklist-Military (PCL-M). Psychological distress was measured using the Symptom Assessment 45 (SA-45), which has 2 global scales and 9 subscales for conditions such as anxiety and depression. The WL and EFT groups were compared pre- and posttest (at 1 month for the WL group, after 6 sessions for EFT group). EFT participants had significantly less psychological distress on the global and on all but one of subscales on the SA-45 (p<0.0002) and the PTSD total score (p<0.0001) at posttest. 90% of the EFT group no longer met PTSD clinical criteria vs. 4% in the WL. Following the wait-period, WL participants received the EFT intervention. In a within-subjects longitudinal analysis, 60% no longer met PTSD clinical criteria after 3 sessions. This increased to 86% after 6 sessions, and remained at 86% on 3-month follow-up. Statistically significant decreases in psychological distress and PTSD total scores were present after 6 sessions (p<0.0001), and remained stable at follow-up. The results are consistent with other published reports showing EFTs efficacy at treating PTSD and co-morbid symptoms, and its long-term effects.
Keywords: veterans, PTSD, exposure therapy, trauma, EFT (Emotional Freedom Techniques)
The Treatment of Combat Trauma in Veterans Using EFT: A Pilot Protocol
Dawson Church, PhD
Traumatology, (2010), 15(1), 45-55.
With a large number of US military service personnel coming back from Iraq and Afghanistan with post-traumatic stress disorder (PTSD) and co-morbid psychological conditions, a need exists to find protocols and treatments that are effective in brief treatment timeframes. In this study, a sample of 11 veterans and family members were assessed for PTSD and other conditions. Evaluations were made using the SA-45 (Symptom Assessment 45) and the PCL-M (Post-traumatic Stress Disorder Checklist - Military) using a time-series, within-subjects, repeated measures design. A baseline measurement was obtained thirty days prior to treatment, and immediately before treatment. Subjects were then treated with a brief and novel exposure therapy, EFT (Emotional Freedom Techniques), for five days. Statistically significant improvements in the SA-45 and PCL-M scores were found at post-test. These gains were maintained at both the 30 and 90-day follow-ups on the general symptom index, positive symptom total and the anxiety, somatization, phobic anxiety, and interpersonal sensitivity subscales of the SA-45, and on PTSD. The remaining SA-45 scales improved post-test, but were not consistently maintained at the 30 and 90-day follow-ups. One-year follow-up data was obtained for 7 of the participants and the same improvements were observed. In summary, after EFT treatment, the group no longer scored positive for PTSD, the severity and breadth of their psychological distress decreased significantly, and most of their gains held over time. This suggests that EFT can be an effective post-deployment intervention.
Rapid Treatment of PTSD: Why Psychological Exposure with Acupoint Tapping May Be Effective
David Feinstein, PhD
Psychotherapy: Theory, Research, Practice, Training, (2010), 47(3), 385-402.
Combining brief psychological exposure with the manual stimulation of acupuncture points (acupoints) in the treatment of post-traumatic stress disorder (PTSD) and other emotional conditions is an intervention strategy that integrates established clinical principles with methods derived from healing traditions of Eastern cultures. Two randomized controlled trials and six outcome studies using standardized pre- and post-treatment measures with military veterans, disaster survivors, and other traumatized individuals corroborate anecdotal reports and systematic clinical observation in suggesting that (a) tapping on selected acupoints (b) during imaginal exposure (c) quickly and permanently reduces maladaptive fear responses to traumatic memories and related cues. The approach has been controversial. This is in part because the mechanisms by which stimulating acupoints can contribute to the treatment of serious or longstanding psychological disorders have not been established. Speculating on such mechanisms, the current paper suggests that adding acupoint stimulation to psychological exposure is unusually effective in its speed and power because deactivating signals are sent directly to the amygdala, resulting in reciprocal inhibition and the rapid attenuation of maladaptive fear. This formulation and the preliminary evidence supporting it could, if confirmed, lead to more powerful exposure protocols for treating PTSD.
Elimination of Post Traumatic Stress Disorder (PTSD) and Other Psychiatric Symptoms in a Disabled Vietnam Veteran with Traumatic Brain Injuries (TBI) in Just Six Sessions Using Healing from the Body Level Up Methodology, an Energy Psychology Approach
Judith A. Swack, PhD
International Journal of Healing and Caring, September 2009, 9(3).
Increasing numbers of returning veterans and veterans of previous conflicts are being diagnosed with depression, anxiety, post traumatic stress disorder (PTSD), and other psychological problems caused by military service. It is important to develop brief and effective treatment methods to facilitate reentry into civilian life. Energy psychology techniques have been found effective for rapidly treating trauma. This case study describes the results of treatment of a Vietnam Veteran for PTSD and other psychiatric symptoms with Healing from the Body Level Up (HBLUTM) methodology, an approach from the field of Energy Psychology. The patient, a Navy Seal, sustained a bullet wound to the skull in Vietnam, and later sustained separate, severe injuries to the brain requiring four rounds of surgery 1990 - 1994. The Veteran’s administration diagnosed him 100% disabled. His symptoms were assessed using the SA-45, a well-validated instrument for measuring anxiety, depression, obsessive-compulsive behavior, phobic anxiety, hostility, interpersonal sensitivity, paranoia, psychosis, and somatization; and the PCL-M, the military assessment for PTSD. Testing was done just prior to treatment and 2 months post-treatment. After three double sessions over a period of three months, he demonstrated complete recovery from PTSD and a return to normalcy in all nine areas of formal psychological test evaluation.
Key Words: Post Traumatic Stress Disorder, PTSD, Vietnam Veteran, Traumatic Brain Injury, TBI, Healing from the Body Level Up, HBLU, Energy Psychology
Single session reduction of the intensity of traumatic memories in abused adolescents: A randomized controlled trial
Church, D., Piña, O., Reategui, C., & Brooks, A. J.Paper presented at the Eleventh Annual Toronto Energy Psychology Conference, October 15 - 19, 2009.
Submitted for publication at Psychological Trauma.
The population for this study was drawn from an institution to which juveniles are sent by court order if they are found by a judge to be physically or psychologically abused at home. Sixteen males, aged 12 – 17, were randomized into two groups. They were assessed using subjective distress (SUD), and the Impact of Events scale (IES), which measures two components of PTSD: intrusive memories and avoidance symptoms. The experimental group was treated with a single session of EFT (Emotional Freedom Techniques), a brief and novel exposure therapy that has been found efficacious in reducing PTSD and co-occurring psychological symptoms in adults, but has not been subject to empirical assessment in juveniles. The wait list control group received no treatment. Thirty days later subjects were reassessed. No improvement occurred in the wait list (IES total mean pre=32 SD ±4.82, post=31 SD ±3.84). Posttest scores for all experimental group subjects improved to the point where all were non-clinical on the total score (IES total mean pre=36 SD ±4.74, post=3 SD ±2.60, p<0.001), as well as the intrusive and avoidant symptom subscales, and SUD. These results are consistent with those found in adults, and indicates the utility of single-session EFT as a fast and effective intervention for reducing psychological trauma in juveniles.
Psychological Symptom Change in Veterans After Six Sessions of Emotional Freedom Techniques (EFT); An Observational Study
Dawson Church, PhD, Linda Geronilla, PhD, & Ingrid Dinter
International Journal of Healing and Caring, January 2009, 9(1).
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<.001), anxiety decreased 46% (p<.001), depression 49% (p<.001), and PTSD 50% (p<.016). These gains were maintained at the 90-day follow-up.
Neurophysiological Indicators of EFT Treatment Of Post-Traumatic Stress
Journal of Subtle Energies & Energy Medicine, (2005),15, 75-86.
Swingle, P., Pulos, L., & Swingle, M. K.
Description of Study
This research study, conducted by Dr. Paul Swingle and his colleagues (Swingle, Pulos & Swingle, 2005), studied the effects of EFT on auto accident victims suffering from post traumatic stress disorder - an extremely disabling conditioning that involves unreasonable fears and often panic attacks, physiological symptoms of stress, nightmares, flashbacks, and other disabling symptoms. These researchers found that three months after they had learned EFT (in two sessions) those auto accident victims who reported continued significant symptom relief also showed significant positive changes in their brain waves. It was assumed that the clients showing the continued positive benefits were those who continued with home practice of self-administered EFT.
Clients previously involved in a motor vehicle accident who reported traumatic stress associated with the accident received two sessions of Emotional Freedom Techniques (EFT) treatments. All clients reported improvement immediately following treatment. Brainwave assessments before and after EFT treatment indicated that clients who sustained the benefit of the EFT treatments had increased 13-15 Hz amplitude over the sensory motor cortex, decreased right frontal cortex arousal and an increased 3-7 Hz / 16-25 Hz ratio in the occiput. The benefits of psychoneurological research to reveal the processes of subtle energy healing are discussed.
Keywords: Emotional freedom techniques (EFT), traumatic stress, EEG.
Six Trauma Imprints Treated with Combination Intervention: Critical Incident Stress Debriefing and Thought Field Therapy (TFT) or Emotional Freedom Techniques (EFT)
Traumatology, (2002), 8(1), 18.
Green, M. M.
Green Cross Project volunteers in New York City describe a unique intervention which combines elements of Critical Incident Stress Debriefing (CISD) with Thought Field Therapy and Emotional Freedom Techniques. Six trauma imprints were identified and treated in a number of the clients. The combination treatments seemed to have a beneficial effect in alleviating the acute aspects of multiple traumas. Here are the stories of two Spanish speaking couples who were treated in unison by bilingual therapists two to three weeks after the attack on the World Trade Center.
A Systematic Clinical Demonstration of Promising PTSD Treatment Approaches
Carbonell, Joyce L., and Figley, Charles, Florida State University.
Traumatology, 5:1, 1999.
Traumatic Incident Reduction, Visual-Kinesthetic Disassociation, Eye Movement Desensitization and Reprocessing, and Thought Field Therapy were investigated through a systematic clinical demonstration (SCD) methodology. This methodology guides the examination, but does not test the effectiveness of clinical approaches. Each approach was demonstrated by nationally recognized practitioners following a similar protocol, though their methods of treatment varied. A total of 39 research participants were treated and results showed that all four approaches had some immediate impact on clients and appear to also have some lasting impact. The paper also discusses the theoretical, clinical, and methodological implications of the study.?The purpose of the present study was to explore and examine four brief treatments purported to be efficient, effective treatments for PTSD. Unfortunately, because of problems with client screening and data collection, the study fell short of reaching it goals. Moreover, the nature of the study precludes comparison of the approaches, and such a comparison was never planned. The variety of presenting problems and the varying levels of severity of those problems within each treatment group precluded us from drawing conclusions about the utility of any treatment for any particular type of trauma. Nevertheless, all four of these treatments deserve further study in more controlled conditions and some of these approaches have already been the object of such research.
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