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EFT for Trauma

Below is a selection of abstracts (summaries) of research articles on EFT for trauma and post-traumatic stress.

For further research on other topics, follow the links below:
- EFT for Pain and Physical Issues
- EFT for Depression
- EFT for Cravings, Weight Issues and Addictions
- EFT for Anxiety, Phobias and Stress
- EFT for Sports Performance
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Karatzias, T., Power, K., Brown, K., McGoldrick, T., Begum, M., Young, Y., Loughran, P., Chouliara, Z., and Adams, S. (2011). A controlled comparison of the effectiveness and efficiency of two psychological therapies for Post-traumatic Stress Disorder: Eye Movement Desensitization and Reprocessing vs. Emotional Freedom Techniques. The Journal of Nervous and Mental Disease, 199(6), 372-378.

The present study reports on the first ever controlled comparison between eye movement desensitization and reprocessing (EMDR) and emotional freedom techniques (EFT) for post-traumatic 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 post-treatment and 3-months follow-up. Overall, the results indicated that both interventions produced significant therapeutic gains at post-treatment 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.



Church, D. (2010). The treatment of combat trauma in veterans using EFT: A pilot protocol. Traumatology, 15(1), 45-55.

With a large number of US military service personnel coming back from Iraq and Afghanistan with posttraumatic 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 (Posttraumatic 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.


Church, D., Hawk, C., Brooks, A. J., Toukolehto, O., Wren, M., Dinter, I., & Stein, P. (2013) Psychological trauma symptom improvement in veterans using EFT (Emotional Freedom Techniques): A randomized controlled trial. Journal of Nervous and Mental Disease. 201, 153-160.

This study examined the effect of Emotional Freedom Techniques (EFT), a brief exposure therapy combining cognitive and somatic elements, on posttraumatic stress disorder (PTSD) and psychological distress symptoms in veterans receiving mental health services. Veterans meeting the clinical criteria for PTSD were randomized to EFT (n = 30) or standard of care wait list (SOC/WL; n = 29). The EFT intervention consisted of 6 hour-long EFT coaching sessions concurrent with standard care. The SOC/WL and EFT groups were compared pre- and posttest (at 1 month for the SOC/WL group, after 6 sessions for EFT group). EFT subjects had significantly reduced psychological distress (p < .0012) and PTSD symptom levels (p < .0001) posttest. In addition, 90% of the EFT group no longer met PTSD clinical criteria, compared with 4% in SOC/WL. Following the wait period, SOC/WL subjects received EFT. In a within-subjects longitudinal analysis, 60% no longer met PTSD clinical criteria after 3 sessions. This increased to 86% after 6 sessions for the 49 subjects who ultimately received EFT, and remained at 86% at 3-months and 80% at 6-months. The results are consistent with other published reports showing EFTs efficacy at treating PTSD and co-morbid symptoms and its long-term effects.


Stein, P. K., & Brooks, A. J. (2011). Efficacy of EFT provided by coaches vs. licensed therapists in veterans with PTSD. Energy Psychology: Theory, Research, and Treatment, 3(1), 11-18.


Background: EFT (Emotional Freedom Techniques) is a validated method for treating post-traumatic stress disorder (PTSD), available to both lay persons and to licensed mental health practitioners (LMP). It is unknown whether results would be significantly different when EFT is administered by licensed practitioners compared to trained lay coaches.

Methods: N=149 veterans with PTSD were approached and 59 were eligible and consented to the study. They were randomized to an active treatment (EFT N=30) and wait list (WL N=29) control group and received treatment from a LMP (N=26) or a coach (N=33). PTSD was assessed using the PCL-M (PTSD Checklist-Military), and psychological symptoms using the SA-45 (Symptom Assessment-45). All study participants met diagnostic criteria for PTSD on the PCL-M. Participants received 6 sessions of EFT over the course of a month. Questionnaires were repeated after 3 and 6 EFT sessions, and at 3 and 6 months. Wait list was assessed at intake and one month before beginning EFT sessions.

Results: Results are based on post-intervention data from the combined EFT and WL groups. Significant declines in the percent meeting PTSD diagnostic criteria were seen after 3 sessions of EFT with 47% of coach and 30% of LMP participants still meeting PTSD diagnostic criteria. Improvements continued to be seen after 6 sessions (17% coach, 10% LMP) and were sustained at 3 months (17% coach, 11% LMP). Although the percent meeting clinical PTSD criteria increased slightly at 6 months (24% coach, 17% LMP), the overwhelming majority of vets with PTSD treated with EFT remained free of clinically-defined PTSD. Although differences between lay coaches and LMPs in PTSD prevalence were not statistically significant, LMP participants did have significantly lower levels of psychological distress on the SA-45.

Conclusion: 6 sessions of EFT whether administered by a coach or an LMP is efficacious in treating PTSD symptoms among veterans. However, results suggest that LMPs may be more effective in reducing psychological distress. Future studies with larger samples are needed to answer this question.


Church, D., Piña, O., Reategui, C., & Brooks, A. J. (2012). Single session reduction of the intensity of traumatic memories in abused adolescents: A randomized controlled trial. Traumatology, 18(3), 73-79.

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). Post-test 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.


Hartung, J., & Stein, P. K. (2012). Telephone delivery of EFT remediates PTSD symptoms in veterans. Energy Psychology: Theory, Research, and Treatment, 4(1), 33-40.

Telephone-mediated psychotherapy is a resource for persons who have difficulty accessing office visits because of geography, economic restrictions, or fear of stigma. In the present report, phone-delivered Emotional Freedom Techniques (EFT) was compared with EFT provided in a therapy office while subjects in both conditions also received concurrent standard care. Forty-nine veterans with clinical PTSD symptoms were treated with 6 one-hr sessions, either in an EFT coach’s office (n = 25) or by phone (n = 24). In each condition, some subjects were treated immediately, whereas others received delayed treatment after a 1-month waiting period. No change in PTSD symptom levels was reported by either the phone or office delayed-treatment group following the wait period, whereas both groups improved significantly after EFT treatment. Differences in benefit were found between phone and office delivery methods. Significant improvement in PTSD symptoms was found after 6 phone sessions but after only 3 office sessions. A 6-month post-treatment assessment indicated 91% of subjects treated in the office and 67% of those treated by phone no longer met PTSD diagnostic criteria (p < .05). Results suggest that although less efficacious than in-person office visits, EFT delivered via telephone is effective in remediating PTSD and comorbid symptoms in about two thirds of cases.


Gurret, J-M., Caufour, C., Palmer-Hoffman, J., & Church, D. (2012). Post-Earthquake Rehabilitation of Clinical PTSD in Haitian Seminarians. Energy Psychology: Theory, Research, and Treatment, 4(2), 33-40.

Seventy-seven male Haitian seminarians following the 2010 earthquake were assessed for posttraumatic stress disorder (PTSD) using the PTSD Checklist (PCL). Forty-eight (62%) exhibited scores in the clinical range (>49). The mean score of the entire sample was 54. Participants received 2 days of instruction in Emotional Freedom Techniques (EFT). Following the EFT training, 0% of participants scored in the clinical range on the PCL. A paired t-test analysis of the pre–post PCL scores indicated a statistically significant decrease (p < .001), to a mean of 27 at the post-test. Post-test PCL scores decreased an average of 72%, ranging between a 21% reduction to a 100% reduction in symptom severity. These results are consistent with other published reports of EFT’s efficacy in treating PTSD symptoms in traumatized populations, such as war veterans and genocide survivors.


Church, D., Geronilla, L., & Dinter, I. (2009). Psychological symptom change in veterans after six sessions of Emotional Freedom Techniques (EFT): An observational study. International Journal of Healing and Caring, 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 behaviour, 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.


Green, M. M. (2002). Six trauma imprints treated with combination Intervention: critical incident stress debriefing and Thought Field Therapy (TFT) or Emotional Freedom Techniques (EFT). Traumatology, 8(1), 18-22.

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. The article details 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.


Stone, B., Leyden, B. and Fellows, B. (2010). Energy Psychology Treatment for Orphan Heads of Households in Rwanda: An Observational Study. Energy Psychology: Theory, Research, & Treatment, 2(2), 31-38.

A team of four energy therapy practitioners visited Rwanda in September of 2009 to conduct trauma remediation programs with two groups of orphan genocide survivors with complex posttraumatic stress disorder (PTSD) symptoms. Results from interventions with the first group were reported earlier (Stone, Leyden, & Fellows, 2009). This paper reports results from the second group composed of Orphan Head of Households. A multi-modal intervention using three energy psychology methods (TAT, TFT, and EFT) was used, with techniques employed based on participant needs. Interventions were performed on two consecutive workshop days followed by two days of field visits with students. Data were collected using the Child Report of Posttraumatic Stress (CROPS) to measure pre- and post-intervention results, using a time-series, repeated measures design. N = 28 orphans with clinical PTSD scores completed a pre-test. Of these, 10 (34%) completed post-test assessments after one week, three months, and six months, and all analysis was done on this group. They demonstrated an average reduction in symptoms of 37.3% (p < .005). Four of the ten students (40%) dropped below the clinical cut-off point for PTSD at the six month follow-up. These results are consistent with other published reports of the efficacy of energy psychology in remediating PTSD symptoms.


Schulz, K. (2009). Integrating Energy Psychology into Treatment for Adult Survivors of Childhood Sexual Abuse. Energy Psychology: Theory, Research, & Treatment, 1(1), 15-22.

This study evaluated the experiences of 12 therapists who integrated energy psychology (EP) into their treatments for adult survivors of childhood sexual abuse. Participants completed an online survey and the qualitative data was analyzed using the Constant Comparative method. Seven categories containing 16 themes emerged as a result of this analysis. The categories included: (1) Learning about EP; (2) diagnosis and treatment of adult CSA using EP; (3) treatment effectiveness of EP; (4) relating to clients from an EP perspective; (5) resistance to EP; (6) the evolution of EP; and (7) therapists’ experiences and attitudes about EP. These themes are compared and contrasted with existing literature. Clinical implications are discussed, as well as suggestions for future research. The results provide guidelines for therapists considering incorporating these techniques into their practices.


Lubin, H. & Schneider, T. (2009). Change Is Possible: EFT (Emotional Freedom Techniques) with Life-Sentence and Veteran Prisoners at San Quentin State Prison. Energy Psychology: Theory, Research, & Treatment, 1(1), 83-88.

Counseling with prisoners presents unique challenges and opportunities. For the past seven years, a project called “Change Is Possible” has offered EFT (Emotional Freedom Techniques) counseling to life sentence and war veteran inmates through the education department of San Quentin State Prison in California. Prisoners receive a series of five sessions from an EFT practitioner, with a three session supplement one month later. Emotionally-triggering events, and the degree of intensity associated with them, are self-identified before and after EFT. Underlying core beliefs and values are also identified. In this report, the EFT protocol and considerations specific to this population are discussed. Prisoner statements are included, to reveal self-reported changes in their impulse control, intensity of reaction to triggers, somatic symptomatology, sense of personal responsibility, and positive engagement in the prison community. Future research is outlined, including working within the requirements specific to a prison population in a manner that permits the collection of empirical data.


Church, D., Yount, G., & Brooks, A. J. (2012). The effect of Emotional Freedom Techniques (EFT) on stress biochemistry: A randomized controlled trial. Journal of Nervous and Mental Disease, 200(10), 891-6.

This study examined the changes in cortisol levels and psychological distress 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 distress symptoms were assessed using the SA-45. The EFT group showed statistically significant improvements in anxiety (-58.34%, p<0.05), depression (-49.33%, p<0.002), the overall severity of symptoms, (-50.5%, p<0.001), and symptom breadth (-41.93%, p<0.001). The EFT group experienced a significant decrease in cortisol (-24.39%, SE 2.62) compared to the decrease observed in the SI (-14.25%, SE 2.61) and NT (-14.44%, SE 2.67) groups (p<0.03). The decrease in cortisol levels in the EFT group mirrored the observed improvement in psychological distress.


Feinstein, D. (2010). Rapid Treatment of PTSD: Why Psychological Exposure with Acupoint Tapping May Be Effective. Psychotherapy: Theory, Research, Practice, Training, 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.


Lane, J. (2009). The Neurochemistry of Counterconditioning: Acupressure Desensitization in Psychotherapy. Energy Psychology: Theory, Research, & Treatment, 1(1), 31-44.

A growing body of literature indicates that imaginal exposure, paired with acupressure, reduces midbrain hyperarousal and counter-conditions anxiety and traumatic memories. Exposure therapies that elicit the midbrain's anxiety reflex and then replace it with a relaxation response are said to “reciprocally inhibit” anxiety. More recent research indicates that manual stimulation of acupuncture points produces opioids, serotonin, and gamma-aminobutyric acid (GABA), and regulates cortisol. These neurochemical changes reduce pain, slow the heart rate, decrease anxiety, shut off the FFF response, regulate the autonomic nervous system, and create a sense of calm. This relaxation response reciprocally inhibits anxiety and creates a rapid desensitization to traumatic stimuli. This paper explores the neurochemistry of the types of acupressure counterconditioning used in energy psychology and provides explanations for the mechanisms of actions of these therapies, based upon currently accepted paradigms of brain function, behavioral psychology, and biochemistry.


Feinstein, D. (2008). Energy Psychology in Disaster Relief. Traumatology. 14(1), 124-137.

Energy psychology utilizes 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—for inducing psychological change. While 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 U.S. At least three international humanitarian relief organizations have adapted energy psychology as a treatment in their post-disaster missions. Four tiers of energy psychology interventions include 1) 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 paper reviews the approach, considers its viability, and offers a framework for applying energy psychology in treating disaster survivors.
Full text of the article is available here.
 
Further resources

          

For further research on other topics, follow the links below:
- EFT for Pain and Physical Issues
- EFT for Depression
- EFT for Cravings, Weight Issues and Addictions
- EFT for Anxiety, Phobias and Stress
- EFT for Sports Performance