Evidence Base Psychology

8/13/2019 Evidence Base Psychology

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[NOT FOR CIRCULATION WITHOUT PERMISSION]

A Systematic Review 1 o t!e Evi"e#ce $ase o% E#e%&yPsyc!o'o&y Met!o"s(

[ %om Psyc!oa#a'ytic E#e%&y Psyc!ot!e%a)y( $y P!i' Mo''o#( To *e )+*'is!e" *y,a%#ac- Lo#"o#( .//0(]

In this review, studies of all varieties of meridian-tapping and somato-sensory stimulation that are used to disrupt dysfunctional cognitive-emotional patterns are outlined. However, there are a number ofdiffering theories and hypotheses about the mechanisms underlying theobserved therapeutic effects and, indeed, different methods mayoperate through slightly different, albeit related, processes. Thesecompeting hypotheses are a matter of ongoing debate and research.

S+mma%y T!o+&!t Fie'" T!e%a)y TFT2 is *ase" o# 3%( Ro&e% Ca''a!a#4s

o*se%vatio# t!at w!e# )a%tic+'a% se5+e#ces o ac+)%ess+%e)oi#ts a%e ta))e" a# associate" a#6iety o% ot!e% )syc!o'o&ica'"ist%ess is e'imi#ate"7 t!e %oots o t!is "iscove%y 'ay wit!i# t!e

ie'" o A))'ie" ,i#esio'o&y( Emotio#a' F%ee"om Tec!#i5+esEFT2- a "e%ivative o TFT- is a wi"e'y +se" met!o" o %a)i"

emotio#a' "ese#sitisatio#- wit! simi'a%ities to EM3R- w!ic! a'soco#tai#s a ta))i#& )%oce"+%e( Ma#y EM3R )%actitio#e%si#co%)o%ate EFT a#" %e'ate" met!o"s i#to t!ei% wo%8( A'' t!ecom)o#e#ts o EFT a%e o+#" i# ot!e% wi"e'y +se" )syc!o'o&ica'met!o"s( T!e mo"es o actio# o EFT a#" TFT- a't!o+&!%e'ate"- may *e somew!at "i e%e#t( I# a""itio# to TFT a#"EFT- t!e%e a%e ma#y ot!e% a))%oac!es wit!i# t!e *%oa" ie'"o e#e%&y )syc!o'o&y(

Li8e ot!e% coitive- *e!avio+%a'- a#" )syc!o"y#amic met!o"s-EFT i#vo'ves c'ose a#" "etai'e" atte#tio# to t!e t!o+&!ts w!ic!&ive %ise to "ys +#ctio#a' emotio#s a#" *e!avio+%( $y co#t%ast-TFT see8s mo%e )%ecise'y t!e e#co"i#& o t!e )syc!o'o&ica')%o*'em i# t!e e#e%&y ie'" o t!e *o"y( T!ese may *eco#si"e%e" com)'eme#ta%y em)!ases(


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TFT- EFT- a#" %e'ate" met!o"s- a%e easi'y 'ea%#e" *y c'ie#tsas sim)'e se' 9!e') too's o a ect %e&+'atio#(

Fo% *est %es+'ts wit! com)'e6 me#ta' !ea't! )%o*'ems- TFT a#"

EFT s!o+'" *e i#co%)o%ate" wit!i# a wi"e% t!e%a)e+tic%amewo%8 +si#& coitive a#" *e!avio+%a' )%i#ci)'es(

TFT a#" its "e%ivatives !ave *ee# +se" o% .: yea%s ; wit!m+c! c'i#ica' 8#ow'e"&e acc+m+'ate" "+%i#& t!is time(

Evi"e#ce o% t!e e icacy a#" c'i#ica' e ective#ess o TFT-EFT- a#" %e'ate" met!o"s i#c'+"es t!e o''owi#& yea% a+"it i# So+t! Ame%ica- i#co%)o%ati#+me%o+s %a#"omise"- co#t%o''e"- "o+*'e *'i#" t%ia's(

U#co#t%o''e" )i'ot st+"ies

Ra#"omise" co#t%o''e" t%ia's !ave "emo#st%ate" t!e e icacy oTFT a#" EFT- mai#tai#e" at o''ow9+) mo#t!s 'ate%(

=a%io+s +#co#t%o''e" c'i#ica' st+"ies %e)o%t &oo" %es+'ts o%TFT- EFT- a#" %e'ate" met!o"s wit! a va%iety o c'i#ica')%o*'ems(


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A 'a%&e sca'e 1> yea% a+"it- i#co%)o%ati#& "o+*'e *'i#" t%ia's- i#So+t! Ame%ica- )%ovi"es st%o#& s+))o%t o% t!e e ective#esso TFT?EFT ty)e o met!o"s- s+&&esti#& t!ei% s+)e%io%ity ove%ot!e% coitive *e!avio+%a' a#" me"icatio# t%eatme#ts(

It is co#c'+"e" t!at t!e%e is a m+c! &%eate% %esea%c!evi"e#ce9*ase o% e#e%&y )syc!o'o&y met!o"s t!a# o% mostot!e% i#te%ve#tio#s wit!i# me#ta' !ea't! se%vices(

W!at a%e TFT a#" EFT@Thought ield Therapy is derived from !pplied "inesiology, and is basedon observations of the encoding of emotional distress in the energy fieldsof the body. #motional reedom Techni$ues, a derivative of T T, is aconstellation of procedures for rapid desensitisation%relief of emotionaldistress. These include e&posure, desensitisation through tapping on thebody, and cognitive restructuring%reframing. There are clear similaritieswith the procedures of #ye 'ovement (esensitisation and )eprocessing*#'()+ 1, but without the ha ards of the latter tapping which is alsoused at times in #'()/ is less eliciting of emotional material than eyemovements 0maha, 2 /. 3oth #'() and # T appear to disrupt therepetitive 4looping5 of cognition, image, and emotion that are present inpsychopathological states thereby allowing a rapid shift towards morepositive states and new perspectives on life situations. 'any #'()therapists incorporate # T into their practice since they combine verywell Hartung 6 7alvin, 2 8 'ollon, 2 9/.

# T is the most widely used of a family of therapeutic approachessometimes called 4energy psychology5 but theoretical positions that donot rely on assumptions about an energy system have also been proposedto account for the observed effects of somato-sensory stimulation. Inclinical practice, # T and related methods are combined with, orembedded within, other psychological therapies. :i;e #'() - it is #ot a

sta#"a'o#e4 t!e%a)y , but is to be used by psychological clinicians withintheir overall field of competence. # T is a simplification of more comple&procedures from which it is derived. This simplification ma;es it easilylearned by clients.

1 #'(), once considered a strange procedure, is now the most highly researchedtreatment for trauma, is well established as an immensely useful method, and featuresin the T?(.


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T!e TFT )%oce"+%e(1. The client is as;ed to thin; about the problem, whilst he or she

taps a se$uence of meridian points. These se$uences may be either

the regularly occurring 4algorithms5, or more individual meridiancodings found through muscle testing.

2. =hec;s may be carried out, using muscle testing, to ascertainresistances within the energy system to releasing theperturbations generating the distress. If found these arecorrected, using an energy tapping procedure.

8. The procedure is followed until the sub@ective distress drops toero. This may also be confirmed by muscle testing.

. If the distress does not rapidly drop, muscle testing may be usedto identify energetic factors that may be interfering thesefactors may include substances and foods that may function as4individual energy to&ins5.

EFT )%oce"+%e?uccinctly put, the method involves the followingA

1. a target image or memory is identified, which evo;es an&iety orother distressing emotion

2. this is dissected into its various components or aspects whichmight be cognitive, affective, sensory, imaginal, or temporal

8. the client is as;ed to thin; of these whilst a desensitisationprocedure is followed, involving tapping on the body the clienttapping on his or her own body/

. the tapping appears to disrupt the previous patterning of cognitive-emotional response, inducing a dissipation of distress

9. the tapping is accompanied by a statement of self-acceptance inrelation to the target problem which reduces a common tendencyto resist the desensitisation/

B. sometimes additional levels of resistance to desensitisation areidentified these ta;e the form of meta-beliefs Cells, 2 / ormeta-motives that lead the person to believe that recovery fromthe emotional problem is dangerous in some way.

D. tapping may, at certain points in the process, be accompanied byeye movements, humming and counting a constellation ofmultisensory activities which further disrupts the previouscognitive-emotional patterning/ a procedure ;nown as the 4E gamut5.

F. the tapping is continued until sub@ective distress is eliminatedE. another aspect of the target problem may then be addressed.


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1 . the wor; is continued until all cognitive and emotional aspects ofthe target problem have been resolved.

11. ?ingle traumas and an&ieties may be targeted. In addition, bywor;ing systematically through a range of ;ey instances of a

networ; of thematically related memories, the emotional chargecan be ta;en out of a significant areas of personality impairment

for e&ample, a range of e&periences underpinning low self-esteem/.

The practitioner closely monitors the client5s progress from moment tomoment, by careful observation and by as;ing the client to provideratings of the ?ub@ective Gnits of (isturbance *?G(s+. This feedbac; isused to guide the process.

TFT a#" EFT "o #ot %et%a+matiseThese methods may be used by s;illed psychological therapists who areable to trac; the client5s progress through the layers of an&ieties,dysfunctional cognitions, and traumatic memories. They may also bereadily employed by the client as a simple stress-relief and affect-regulation tool. The methods do not re$uire the client to relive emotionaltrauma nor re$uire him or her to tal; in detail about the e&perience.This is a considerable advantage in wor;ing with traumatised patients whomay become overwhelmed by simply tal;ing of the traumatic e&perience.!dverse reactions appear e&tremely rare.

TFT a#" EFT may *e com*i#e" wit! ot!e% met!o"sT T and # T may readily be combined with other psychological methods,including other cognitive-behavioural strategies. In clinical practice theactual tapping procedure is li;ely to be embedded within much moreactivity of a conventional verbal cognitive or psychoanalytic or other/nature. Through the ordinary discourse of psychotherapy, thepractitioner will identify the affective, cognitive, and psychodynamicareas to target with T T or # T. or e&ample, most of a psychotherapysession may consist of verbal en$uiry and e&ploration, with T T%# Tta;ing up the last few minutes after the crucial issues have been clarifiedand understood. 0n the other hand, it is possible to wor; more free-associatively with 4tapping and tal;ing5 since the process appears to allowa more free emergence of psychological material.


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TFT a#" EFT !e') to %e"+ce states o *ei#& emotio#a''y ove%w!e'me"Those clinicians who combine T T%# T with #'() tend to use eyemovements if there is a need to elicit cognitive-emotional material andto use tapping methods if the client is li;ely to become emotionally

overwhelmed Hartung 6 7alvin, 2 8 'ollon, 2 9 0maha, 2 /. The$ualities of being soothing and non-eliciting of emotional intensity ma;eT T%# T ideal as a self-help tool for affect regulation, as outlined inpopular boo;s such as :ynch and :ynch 2 1/.

$e#e its o TFT a#" EFT The benefits of T T and # T, as commonly reported by its practitioners,are thatA

1. It is often highly effective.2. It is often e&tremely rapid in its effects.8. >atients report immediate benefit in terms of relief from

emotional distress. It does not re$uire the patient to relive trauma with depth and

intensity.9. In general, it does not cause distress to the client.B. =lients often li;e to use the method on their own and report

benefit in doing so.D. It can be used both as a simple stress relief method and as part of

comple& psychological therapy.F. It can be combined with other psychological therapies.

T!e "i e%e#t 'eve's o evi"e#ce! range of different ;inds of evidence may be relevant in evaluating atherapeutic approach. !t the most basic level, case studies and anecdotalreports are crucial. ?ystematic observation, involving gathering data fromroutine clinical practice is another form of evidence. This may sometimesbe thought of as 4practice-based evidence5 often an important balanceto the evidence provided by trials in more refined and restrictiveresearch settings 3ar;ham 6 'ellor-=lar;, 2 /. Tests of efficacy,involving good research design, help to demonstrate that the therapyactually does something beyond a placebo effect. :arge scale randomisedcontrolled trials may compare the effectiveness of different therapeuticmodalities on clinical problems. 'ost treatments within mental healthservices are not based on the latter form of evidence.

Case st+"ies a#" a#ec"ota' %e)o%ts


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There is a great deal of evidence of this nature. Cor;shops, specialinterest groups, and conferences, within the G" and the G?!, are onesource of clinical reports and discussion of cases. The hundreds of briefcase e&amples, with discussion, on the www.emofree.com website have

already been mentioned. Criting within the auspices of the !ssociationfor =omprehensive #nergy >sychology !=#>/, (r. (avid einsteincommentsA

#stimates based on informal interviews by the author with asampling of the *association5s+ members are that more than9 4stri;ingly effective5 cases more rapid and more favourableoutcomes than the therapist would have predicted had standardtreatments for the conditions been employed/ are documented inthe membership5s clinical recordsJ. * einstein 2 9+

In a later paper, he adds that in general energy psychology methods arebac;ed by more than thirty thousand documented casesJ. * einstein

2 D+. !s well as the clinical accounts in the present boo;, there are alsoa number of other te&ts with case e&amples and discussion e.g. =onnolly,2 (iepold, 3ritt 6 3ender, 2 7allo, 1EEE 2 2 Hartung 6 7alvin,2 8 'ollon, 2 9 Kuinn 2 /. ! detailed personal account is providedby ?chaefer 2 2/.

E6am)'es o cases %om t!e www(emo %ee(com we*site

'any of the cases reported on 7ary =raig5s www.emofree.com websiteare interesting and persuasive. or e&ample, 'air :lewellyn gives anaccount of a single session treatment of depression in a young man in hisearly twenties. Initially his voice was flat and his face e&pressionless. Hewas very unhappy because he had split up from his girlfriend and was alsoworried about his @ob. Chen as;ed about his family and childhood, hisemotions began to emerge and he agreed to tap whilst they continuedtal;ing. He tal;ed of his feeling of powerlessness as a child and about hisparents continually arguing. He mentioned a time when his mother hadleft and how frightened he felt. It seemed he had felt he was to blame,that he was unlovable. !s he continued tapping, the sadness cleared andhe began tal;ing with new insight and clarity. ?he $uotes him as followsA

It wasn5t my fault about (ad and 'um arguing, as I was only a little ;id,too young to be responsible.


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that the girl I love has left me and my @ob is coming to an end, but that isactually how I feel I won5t need to feel those sad feelings ever againJThis remar;able shift in mood and cognition, with real mutative insight,came about simply through tal;ing and tapping in a single session. 7ary

=raig commentsA This cognitive shift is one of the most fascinatingfeatures of the tapping procedures. :iteral belief changes happen behindthe scenes and clients see the whole scenario through a different set ofglasses beliefs/. It often ta;es years sometimes decades/ of tal;therapy or other conventional procedures to arrive at this enviablehealing place. Cith # T it is often simultaneous. This feature is soimportant that I often use it as evidence that # T has been successful.In a way it is the ultimate evidence.JhttpA%%www.emofree.com%(epression%te&tboo;.htm

=arol ?olomon presents a case of a corporate e&ecutive who becameafraid to fly in the months following E%11, saying that he had watched toomuch news coverage. He had a history of panic attac;s prior to this. Hisworst fear was of e&periencing another panic attac;. (r. ?olomonidentified a large number of aspects of her client5s an&iety, each of whichwas addressed using a specific tapping statement. ?he incorporated4choices5 phrasing into some of these. Thus, for the general anticipatoryan&iety, she invited him to tap using a number of statements such asA

#ven though I get an&ious @ust thin;ing about the plane flight #venthough I am afraid of having another panic attac; J then interweavingthese also with positive choices statements such asA #ven though I amworried about the flight, I choose to ;now I can calm myselfJ and #venthough I am not certain how things will go, I choose to let it be fun andeasy.J or specific fears, she suggested phrasing such asA #ven though Iam afraid I won5t be able to breathe J and #ven though I am terrifiedto get on the plane J, then with choices statements such asA #venthough I am afraid of suffocating, I choose to ;now there is plenty of airand I can breathe freelyJ and #ven though une&pected things canhappen, I choose to stay rela&ed and confident.J. or physical symptoms,the phrases includedA #ven though my chest and gut feel tight%my palmsare sweaty%I feel li;e I can5t breatheJ. There was considerable generalimprovement through wor;ing on these aspects, but some element of theproblem remained. Therefore (r. ?olomon as;ed if there might have beenevents in childhood during which he might have had similar feelings. Hespo;e of times when his older brother would pin him down under the bedcovers, and he would be in a state of complete panic, feeling that he couldnot breathe or move and that he was what he called 4enveloped5. # T


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then continued with phrases includingA #ven though I felt panic;ed andhad to get out #ven though I felt enveloped #ven though I couldn5tbreatheJ etc. but then shifting to the possibility of letting go of theanger at his brotherA #ven though I was terrified and afraid I would

never get out, I am open to the possibility of forgiving my brother.J Cor;on these issues covered several months, reducing his an&iety to ero.

our and a half years later, the client reported that he regularly flies,with no an&iety at all.httpA%%www.emofree.com%>anic-an&iety%E11-an&iety.htm

These two cases were selected at random, with little searching, from thearchives on the www.emofree.com website. There is an inherentplausibility to the accounts because the underlying structure of theproblem is unravelled in the course of the treatment. There arethousands of such e&amples, succinctly described. The sheer weight ofnumbers of clinical anecdotes is a powerful indication of the efficacy andvalue of the method.

Systematic c'i#ica' "emo#st%atio# met!o"o'o&y(The 1EE 4!ctive Ingredient >ro@ect5 lorida ?tate Gniversity.*reported in =arbonell and igley, 1EEE+.

T!is st+"y "emo#st%ate" t!e e icacy o T!o+&!t Fie'" T!e%a)y-%om w!ic! EFT was "e%ive"(

Trauma researcher (r =harles igley and colleagues were concerned inthe early 1EE s at the apparent absence of effective and efficientpsychological therapies for treating trauma treatments that were muchin need for the many veterans of the Lietnam war. or e&ample, a 1EE2meta-analysis of all published studies ?olomon et al./ found that notreatment approach reported even a partial success rate greater than2 M after 8 hours of treatment and ?eligman 1EE / noted that only4marginal5 relief is possible for those diagnosed with >T?(A

*there are+ almost no cures. 0f all the disorders we havereviewed, >T?( is the least alleviated by therapy of any sort. Ibelieve that the development of new treatments to relieve >T?( isof the highest priority.J ?eligman 1EE , p 1 /.

'oreover, patients would find that spea;ing of their trauma was difficultand would cause as much suffering as the original trauma, often without
http://www.emofree.com/http://www.emofree.com/


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any relief from doing so. !gainst this blea; bac;ground, igley andcolleagues established a programme to e&amine and evaluate innovativemethods of treating traumatic stress. They chose to use a 4systematicclinical demonstration methodology5 =arbonell 6 igley 1EEB :iberman 6

>hipps 1EFD/ essentially small scale measures of efficacy.

In order to select 4innovative and promising methods of treatingsymptoms of post-traumatic stress5, a survey was sent to 1 . membersof an Internet consortium of therapists, as;ing them to nominatetreatments that were e&tremely efficient and could be observed underlaboratory conditions. In addition, the authors contacted hundreds ofclinicians to solicit treatment nominations. !n advisory board oftraumatologists then e&amined nominated treatments to select some forfurther investigation. our promising approaches were identified, each ofwhich were in clinical use but at the time had a paucity of researche&amining their effectiveness. These wereA Traumatic Incident )eduction

a ;ind of focused )ogerian counselling/ Lisual "inesthetic (issociationan strategy/ #'() and Thought ield Therapy the precursor of

# T/. =arbonell and igley 1EEE/ add 0ther approaches were noted,such as various e&posure-based, behavioural and cognitive treatments.JThe innovators of each of these four approaches were invited to send atreatment team to the research laboratory for D-F days and to treatclients under conditions of the research design. Two symposia were heldfor each of the treatment approaches, with discussion by clinicians andresearchers, both of the method its history, theory, procedure,indicators of success, re$uirements for training etc/ and the outcomes ofthe therapy.

#ach patient was identified as having a trauma history and symptoms oftraumatic stress. They were all given the 3rief ?ymptom Inventory,before and B months after treatment a 98 item self-report inventorywith ratings of distress on a 9 point scale, which is ;nown to be sensitiveto change. The Impact of #vents ?cale and the ?ub@ective Gnits of(isturbance ratings were also used. >articipants were also as;ed to ;eepa diary of ratings on a daily basis for the ne&t B months.

The length of each session was determined by the therapist, but theresearch design limited the therapy to one wee;. The length of eachsession varied from hours for the Traumatic Incident )ecall, to 2minutes for Thought ield Therapy. The average duration of treatment


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per client, in minutes was 29 for TI), 118 for L"%(, 1D2 for #'(), andB8 for T T.

Res+'ts

!ll four treatments produced a drop in scores. or reasons of variationamongst the levels of severity of symptoms of the patients in the fourgroups, as well as the relatively small numbers of sub@ects, the studycould not be ta;en as a comparative measure of effectiveness. However,the authors note in relation to the ?G( scoresA


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0ur investigations showed that this method wor;ed dramaticallyand permanently to eliminate psychologically based distress in asubstantial number of people. Ce have shared our findings withcolleagues and continue to be confident that such therapy does

succeed in counterconditioning, similar to cognitive-behaviouralmethodsJ. *viii+.

Two %a#"omise" co#t%o''e" "emo#st%atio#s o e icacy(

T!e st+"y o EFT *y We''s a#" co''ea&+es .//B2(The first randomised and controlled study of # T, is that by Cells et al.

2 8/. >articipants with phobias of small animals - such as spiders,rodents, or coc;roaches were randomly assigned to two groups. 0negroup received a 8 minute treatment with # T *n 1F+. The otherreceived training in a procedure called diaphragmatic breathing *n 1D+,which has been shown to produce physiological changes consistent withdeep-rela&ation :ehrer et al. 1EEE/. Thus, the control group treatmentdid contain active ingredients li;ely to induce rela&ation and thereforeli;ely to facilitate desensitisation. 'oreover, the deep-breathingcondition was designed to parallel as closely as possible the # T condition.Chilst the # T group tapped on the meridian points, repeating thereminder phrase e.g. this fear of spidersJ/ at each point, the deep-breathing group was as;ed to repeat this phrase between each breath.#ach emotional aspect of the problem was addressed with 4rounds5 ofdeep-breathing, paralleling the rounds of meridian tapping with # T.:evels of fear were assessed by ta;ing ?G(s at different stages of a3ehavioural !pproach Tas; 3!T/. The 3!T involved F points atprogressively distances nearer to the feared animal. ! further measurewas how far the participant could tolerate approaching the animal on the3!T. ollow-up measures were ta;en B months or more later. The resultswere that the # T treatment produced significantly greater improvementthan did the deep-breathing condition, as measured behaviourally and onself-report measures. The improvement was found to be largely sustainedat follow-up.

The significance of this study is that it contained a control condition forcomparison, and it was randomised thus meeting the highest researchstandards. The choice of a control condition that mimic;ed the procedureof # T in all details e&cept for *a+ the use of a self-acceptance

statement, and *b+ tapping on the meridian points, suggests that theeffective factors did have something to do with the ingredients specific


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to # T. ?ince deep-breathing does induce rela&ation, the superiority ofthe # T condition must be due to more than induction of an ordinaryrela&ation response.

11 additional participants were also assigned to an # T group treatment.?imilar improvements to the individual treatment condition were found.

$a8e% Sie&e' .//:( A )a%tia' %e)'icatio# a#" e6te#sio# o t!e We''set a'( st+"y( Ca# a >: mi#+te sessio# o EFT 'ea" to a %e"+ctio# oi#te#se ea% o %ats- s)i"e%s a#" wate% *+&s@4(

This study is contrasted with that of Cells et al 2 8. In addition to the# T condition, 3a;er and ?iegel inserted a no-treatment controlcondition. or the other comparison condition they used a supportiveinterview similar to )ogerian nondirective counselling. Thus there werethree groups.

The results supported the Cells study. >articipants improvedsignificantly in their pre-post test ability to wal; closer to a fearedanimal after # T, whilst the other two conditions showed noimprovement. The # T group showed significant decreases on the ?G(smeasure of fear, and on the ear Kuestionnaire, as well as on a new$uestionnaire designed for the study. >articipants in the other twoconditions *no treatment, and the supportive interview+ showed nodecrease in fear on these sub@ective measures.

'easures of heart rate showed a large but e$ual change for eachcondition thus indicating that rela&ation alone is not the activeingredient.

! chec; for the influence of suggestion was included. The participantswere told which of the three conditions they would be assigned to andwere as;ed to rate the degree to which they e&pected this describedcondition to help reduce their fear. The # T and ?upportive Interviewparticipants did not differ significantly in their mean e&pectation scores but despite these e$ual e&pectations, they did differ mar;edly inoutcome, with # T showing superior results. >articipants in the notreatment group sitting and reading for 9 minutes/ did not thin; thiscondition would reduce their an&iety. (espite the e&pectation ofimprovement in the ?upportive Interview condition, these participants didno better than the no treatment group 2.


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! follow-up was conducted of participants 1. months after the originaltesting. 0n most measures the significant effects of one sessions of # Theld up and remained superior to that of the two comparison conditions.

(r. >atricia =arrington reports on a series of studies planned or inprogress, building upon these studies, by one of the co-authors, (r.Harvey 3a;er, and colleagues www.eftupdate.com%)esearchon# T.html /A*1+ a controlled study in a clinical setting, comparing # T with two controlgroups this will involve three groups, an # T treatment group, apsychoeducational intervention group, and a no treatment group receivingonly medication *2+ a comparison of # T and a sham variant no trueacupoints being tapped/ e&amining the effect on maths an&iety *8+ astudy of the effect of # T versus two control conditions on bas;et balls;ill * + a study of the effect of # T on alcohol addiction in a smallvillage in India *9+ a comparison of # T using the standard tapping pointswith a version using tapping on other body locations a study of the effectof # T on fears of public spea;ing, using a virtual reality programme totest this.

Ot!e% co#t%o''e" st+"ies

EFT com)a%e" wit! P%o&%essive M+sc'e Re'a6atio# [SeD&i# ODca#.//>](82 students in Tur;ey were treated for test an&iety in relation to theuniversity entrance e&am. #ach half of the group was given a lecture onthe modality to be used, either # T or muscle rela&ation, and were giveninstructions on how to apply these. The groups were as;ed to carry outthe modalities three times a wee; for two months, particularly whenfeeling an&ious about the e&am. Chilst both groups showed a decrease inan&iety, measured on the Test !n&iety Inventory, the decrease with # Twas significantly greater than that in the progressive muscle rela&ationgroup p N . 9/.

%o+) t%eatme#t wit! EFT( [Rowe- .//:]1 2 individuals were treated with # T, modified for a group, and showedhighly significant improvement p . 9/ on a test of psychological stress.These improvements held up at B month follow-up. ! within-sub@ectsdesign used the sub@ects as their own controls. The (erogatis ?ymptom

=hec;list-E ?=:-E -) ?! 9 short form/ was given one month prior tothe wor;shop, immediately prior, immediately after, one month after, and
http://www.eftupdate.com/ResearchonEFT.htmlhttp://www.eftupdate.com/ResearchonEFT.html


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OT!T was a feasible intervention, warranting further study as a potentialweight maintenance intervention.O

The research is published as 'ist et al. 2 9 and also available atA

httpA%%@ournals.medicinescomplete.com%@ournals%fact%current%fact1 9a18aB .htm

3octo%a' "isse%tatio#s "emo#st%ati#& e icacy(*(F individuals with public spea;ing an&iety were randomly assigned to a

treatment group or a waiting list control group. They were then re$uiredto give a speech in front of a small audience, followed by theadministration of measures of an&iety *the =levenger and Halvorson?pea;er !n&iety ?cale, and the ?peilberger Trait and ?tate !n&iety?cale+ as well as self-report *?G( ratings+. articipants in the study showed decreased shyness,confusion, physiological activity, and post-speech an&iety, as well asincreased poise and interest in giving a future speech. These gains wereretained at month follow-up.

3a%*y .//1 9 #ee"'e )!o*ias(2 patients who had been unable to receive necessary medical treatmentbecause of intense needle phobia showed significant immediateimprovement after one hour of T T and at one month follow-up. 'easuresused were the Colpe and :ang ear ?urvey ?chedule and ?G( ratings.?ignificance was at the . 1 level

Wa"e 1 / 9 )!o*ias a#" se' 9co#ce)t
http://journals.medicinescomplete.com/journals/fact/current/fact1005a13a60.htmhttp://journals.medicinescomplete.com/journals/fact/current/fact1005a13a60.htmhttp://journals.medicinescomplete.com/journals/fact/current/fact1005a13a60.htmhttp://journals.medicinescomplete.com/journals/fact/current/fact1005a13a60.htm


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This study investigated the effects of T T on an&iety and self-conceptwith 2F sub@ects with a phobia. The T T reduced the phobiassubstantially, as indicated by ?G( ratings, and significant improvementwas found on standardised measures of self-acceptance, self-esteem, and

self-congruency the Tennessee ?elf =oncept ?cale and the ?elf =oncept#valuation of :ocation orm/. ! waiting list control group of 29 patientsdid not show any improvement.

Sa'as .//1 ; s)eci ic )!o*ias22 sub@ects were used as their own controls for a study of treatment ofspecific phobias, half receiving # T first, followed by (iaphragmatic3reathing, the other half receiving (iaphragmatic 3reathing followed by# T. The 3ec; !n&iety Inventory, a modified 3ehavioural !voidance Test,and ?G( ratings were administered prior to treatment and after eachtreatment. # T produced a significant decrease of an&iety on all threemeasures regardless of whether it was the first or second treatment. 3ycontrast, the (iaphragmatic 3reathing produced a significant drop in the?G( ratings but not the other two measures, and only when it was thefirst treatment.

Sc!+'D .//0( T!e%a)ists4 views o# i#te&%ati#& e#e%&y )syc!o'o&y i#wo%8 wit! s+%vivo%s o c!i'"!oo" se6+a' a*+se12 psychologists in private practice were surveyed regarding their use ofenergy psychology with adult survivors of childhood se&ual abuse. 9 ofthese used energy psychology as their primary modality, whilst the otherD combined it with tal; therapy, =3T, and%or #'(). !ll 12 therapistsconsidered energy psychology methods to be the most effectivetreatment for the an&iety, panic, and phobias suffered by survivors ofabuse, and also reported improved relationships, mood and self-esteem inthese patients as a result of using energy psychology methods. 1 of theinterviewees attributed decreases in the dissociative symptoms of theirclients to energy psychology, with better self-care and less self-harmingbehaviours also being reported. 0ne therapist summarised the commone&perience as followsA 'y life and wor; have been enriched beyondmeasure I have been able to help people in ways I never imaginedpossible. The speed and depth of change can be astonishing.J *?chul2 Db+.

St+"ies i#c'+"i#& *%ai# sca# "ata

Swi#&'e- P+'os Swi#&'e .//>


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Roa" T%a ic Acci"e#ts T%a+ma

This studied the effect of # T on E road traffic accident victimssuffering from >T?(. # T was taught to the sub@ects in two sessions and

they were given tapping home-wor;. Three months after this interventionthe accident victims showed significant positive changes, both in brainscan measures and in self-reported symptoms of stress. 'easures usedwere the 3ec; (epression Inventory, the 3ec; !n&iety Inventory, tenanger items from the ?pielberger ?tate-Trait !n&iety Inventory, and a$uestionnaire to assess avoidance of driving or riding in vehicles. Thesewere administered 1 -2 days before treatment and again within D to1B days following # T treatment. In addition an eyes-closed $##7assessment of 1E brain locations was carried out. The ?G( ratingsdropped significantly for all nine sub@ects initial ?G( averaged F.8following treatment they averaged 2.9 p N . 1/ and a global reduction ofsymptoms was found at follow-ups, not all the gains held for of the Esub@ects at follow-up. 3rain wave data showed differences between thefive whose improvement held and the four whose did not. The lattershowed increased arousal of the right frontal lobe, considered to be anindicator of depressed mood p N . 2/. 0n the other hand, the five whosustained improvements showed increased theta%beta ratio changes,following treatment, in the occipital region an indicator of centralnervous system $uiescence/ and increased theta%sensory motor rhythmamplitude over the sensory motor corte& a measure of somatic$uiescence/. ! further interesting factor was that the four whoseimprovements were not sustained did not comply with the tapping home-wor;.

Swi#&'e ./// [co# e%e#ce )%ese#tatio#]Re"+ctio#s i# t!e %e5+e#cy o seiD+%es

# T was used as a treatment for children with epilepsy. They were given# T by their parents whenever they thought a sei ure might occur.?wingle found significant reductions in fre$uency of sei ures amongthese young children, as well as e&tensive improvement in their ##7readings after two wee;s of daily in-home # T.

Lam*%a+- P%att- C!eva'ie% .//B( T%eatme#t o c'a+st%o)!o*ia 9wit! *%ai# sca# "ata


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our sub@ects suffering with claustrophobia were treated with T T in athirty minute session and pre- and post-treatment ##7 readings wereta;en, along with physiological measures and ?G( ratings. These werecompared with those of four non-phobic control sub@ects who were given

a thirty minute rela&ation treatment. !ll sub@ects were as;ed to enterand remain in a small metal lined enclosure for as long as they couldtolerate, up to 9 minutes. This was repeated after the T T or rela&ationtreatment. The results were that although the claustrophobic sub@ects5theta activity ##7 scores were higher than those of the control sub@ects

p N . 1/, along with physiological and sub@ective measures, after the T Ttreatment these decreased to the same level as the non-phobic sub@ects.)educed an&iety remained at 2 wee; follow-up.

3ie)o'" o'"stei# .///( TFT e ect o# 5EE meas+%es mai#tai#e"at 1G mo#t!s

!n individual5s $##7 measures were ta;en before and after a T Tsession, and again at 1F month follow-up. Chen the sub@ect thought ofthe targeted personal trauma prior to the T T statistically abnormalbrain-wave patterns were observed, but not when thin;ing of a neutralevent. ollowing the T T, the brain waves were normal when thin;ing ofthe same trauma. This improvement held at 1F month follow-up.

A#"%a"e a#" Fei#stei# ; "i&itise" EE sca#s i# e#e%a'ise" A#6iety3iso%"e% [www(i##e%so+%ce(#et]

!n individual with 7eneralised !n&iety (isorder 7!(/ was studied with##7 scans prior to T T treatment and again after , F, and 12 sessions.>atients with 7!( are ;nown to have distinctive brain wave ratiosignatures :ubar 2 /. Cith the T T treatment the symptoms of 7!(subsided and the ##7 patterns normalised. These images are posted onthe www.innersource.net website. Chen a group of scans of patients with7!( who received T T were compared with a group who were treatedonly with medication, the T T group showed a normalisation whilst themedication group did not, even though both groups e&perienced alessening of an&iety. These studies formed part of the large ?outh!merican audit.

Systematic c'i#ica' o*se%vatio#s wit! o+tcome "ata

Sa8ai et a'( .//1
http://www.innersource.net/http://www.innersource.net/


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Ta))i#& met!o"s i# me"ica' a#" )syc!iat%ic se%vices

?even T T trained therapists applied T T to D1 patients at the "aiser3ehavioral 'edicine ?ervices with referrals from primary care/ and

3ehavioral Health ?ervices a specialist psychiatry%mental healthservice/. The purpose was to establish, for this health maintenanceorganisation, the potential of T T in relation to a variety of clinicalconditions. ! wide range of symptoms and disorders were treated including, for e&ample, acute stress, an&iety, 0=(, phobia, depression,anger, food cravings, chronic pain, panic disorder, and >T?(. ?tatisticallysignificant within-session reductions in self-reported stress wereobtained with 81 problems%symptoms in 19E applications with D1patients. >re and post-test ?G( ratings were significant at . 1 level ofprobability for these, e&cept for alcohol cravings, ma@or depressivedisorder, and tremors, which were at the . 1 level of probability. ?i& casestudies were included in the report. Three of these case descriptionsincluded data on changes in heart rate variability, often used as anob@ective measure of physiological change with T T.

The methodology of this study is criticised by :ohr 2 1/, but some ofhis arguments seem a little odd, based apparently on his perception ofT T and its rationale as implausible. :ohr5s complete dismissal of thestudy seems a little harsh, especially in view of the authors5 own commentin the abstractA These are preliminary data that call for controlledstudies to e&amine validity, reliability, and maintenance of effects overtime.J *p 1219+.

Com)a%iso# o TFT "ata wit! a st+"y o C$T ; e ects o# !ea%t %ateva%ia*i'ity i# seve%e'y "e)%esse" )atie#ts

(r. =allahan is enthusiastic about the use of Heart )ate Lariability H)L/as an ob@ective, reliable, and placebo-free measure of the effectivenessof T T. He became interested in this after being contacted by a cardiacspecialist, who had been using T T for stress relief amongst his patients,noticed a remar;able improvement in H)T, which is usually ratherdifficult to influence. !bnormally low H)L is a strong predictor ofmortality


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However, (r. =allahan has repeatedly found that often T T can produceimprovements in ?(


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taboos on displays of emotional suffering, the ?G(s scale could not beused, nor the word 4trauma5. The translation of the phrase 4bad moments5was used and the complete absence of distressing emotion and somaticdisturbance was ta;en as the measure thus the patient might say,

thorough translationA Pes, at this moment it is completely gone if theway I feel at this moment becomes all moments I will be completelysatisfiedJ. or 1 8 of the 1 9 patients, and for 2 D of 2 E traumaticmemories, the treatment was successful. The authors commentA

In addition to the self-report of complete relief, theirspontaneous e&pressions provided confirming clues. >eople gavethat loo; of astonishment, hugged, put their hands to theirtemples, and loo;ed up to the heavens in gratitude !lso it wastypical for them to feel great energy, then disappear long enoughto return with a bag full of peaches or nuts.J

ollow-up data ranged from 1 month to E months. !ll treatment successesendured without relapse.

This report was criticised by )osner 2 1/, on the grounds that *a+ onlysuperficial information about the sample was provided, *b+ diagnosticinformation was absent, *c+ the self-report measure of distress wasrather crude, *d+ the description of T T was rather short. However, thereviewer does note that doing research in a postwar society is more thandifficultJ and that it is only to be e&pected that methodologicalstandards should be of lesser importance than in a review of laboratoryresearch performed in safety in a rich country.J *p 12 1-12 2+. 3ycontrast, Hartung and 7alvin 2 8/ commentA ?cientists can criticisethis study5s lac; of randomisation of sub@ects, use of nonstandardisedmeasures, failure to account for competing hypotheses, and the li;e.>racticing psychotherapists, on the other hand, will more li;ely feele&hilarated when reading about this wor;. ! report of EFM recoveryfrom trauma, even if informal, is li;ely to encourage a clinician who isdedicated to alleviating the suffering of trauma victims.J *p B +

0ne of the main therapists in the "osovo wor; was =arl Qohnson, a clinicalpsychologist with a bac;ground as a >T?( specialist with the Leteran5s!dministration. He made four further visits to "osovo following thepublication of the original account, mainly in order to train local healthcare practitioners in Thought ield Therapy. He was able to obtain follow-up information, from two physicians, on D9M of the people he had treatedduring his first five visits. In almost every case, the improvementsfollowing the initial T T treatments had been maintained for each


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treated traumatic memory, the sub@ective distress had been eliminated.The physicians did as; Qohnson to see two patients for furthertreatment of some additional memories that had not initially beenaddressed. In a letter of appreciation, the chief medical officer of

"osovo, (r. ?;;el en ?yla a psychiatrist/, wrote about these resultsA

J'any well-funded relief organisations have treated the posttraumatic stress here in "osovo. ?ome of our people had limitedimprovement but "osovo had no ma@or change or real hope until we referred our most difficult trauma patients to *(r. Qohnson andhis team++. The success of T T was 1 M for every patient, andthey are still smiling until this day.J

Qohnson5s records of his wor; in "osovo show that a total of 1FE patientswere treated for a total 9 D traumatic memories. 0f these, 1FD peopleand 9 9 traumatic memories were treated successfully with completecessation of distress in relation to those particular memories. His reportsof his use of T T in other disaster areas are as followsA ?outh !fricaA EDclients were all treated successfully for a total of 819 traumaticmemories )wandaA 22 clients were all treated successfully for a total ofD8 traumatic memories =ongoA of 2E clients, 2F were treatedsuccessfully for a total of DD out of DF traumatic memories. Qohnsonhimself ac;nowledges that treating traumatic memories is only one aspectof healing >T?( einstein 2 B/.

In an article in The Thought ield =allahan 2 1/, (r. =allahan respondsto a common reaction of disbelief e&perienced by those unfamiliar withT T on hearing of the impressive results reported by Qohnson. 0necommentator had $uestioned whether the traumatised people could trulybe smiling, as stated in the letter from (r. ?yla. (r. =allahan had as;ed(r. Qohnson to e&plain more and to clarify the reported findings.

(r. Qohnson e&plained that (r. ?yla5s letter had been to do with anadditional group of patients, following those referred to in the @ournalarticle. He had been as;ed bac; to "osovo following the earlier wor;,partly in order to train local doctors in the method. (uring two trips in2 1, he treated a total of 9 patients, with a total of 19 traumas. Theresults were recorded by (r. ?yla, and the success rate was 1 M. (r.Qohnson further e&plained his approach as followsA

'any of these traumas involved the death of loved ones. I learnedearly, bac; in the "osovar refugee camp in 0slo, that it is not


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possible to treat such a trauma in the same way as others. If youset a goal of reducing the suffering or the problem, etc. the personresists because they fear losing the last aspect of theirrelationship, even though that is suffering. ?o now I present it in a

different way. Chen the person tries to recall the good times withthe lost one, it hurts too much so they must push all of thememory away. This is a bloc; which prevents the presence of thelost loved one the sweet memories, the wisdom, the closeness inthe heart that would be possible even now. I as; if the patientwould want me to remove this bloc; so that they might have theloved one bac;, to this e&tent. !lways the answer is yes.

Chen all perturbations have been removed and the problem issoothed, I chec; for the various reversals and then, prior to thefinal testing, I have the patient say something li;e inally I havemy father with me again.J !fter treating other types of wartrauma I finish by treating the war as a whole, and at the end thepatient says inally I have freedom from that warRRJ Invariably,after ma;ing these statements the trauma has been soothed/ thepatient shows a wonderful smile and usually hugs me. They aresmiling about the lost one without pushing the memory away. Theyare not responding to the trauma memory with a smile. 3ut if I seea patient on the street and as; if the treatments are still holdingstrong, they will say po *yes+ meir *it is good+ faleminderit*than; you+J and give me a very nice smile.J *=allahan 2 1 $uotation from online @ournal+.

Ra"io )!o#e9i# )%o&%ammes ; t%eatme#t o t!e &e#e%a')+*'ic

Two studies =allahan, 1EFD 2 1 :eonoff, 1EEB/ have reported theresults of radio phone-in programmes, where callers were treated overthe phone for various problems, such as phobias, an&ieties, addictions,guilt and marital problems. =allahan treated BF callers over the phone,reporting a success rate of EDM, with an average improvement of D9.EM

indicated by immediate ?G( ratings/, and an average treatment time of.8 minutes :eonoff also treated BF people, reporting 1 M success

rate, with an average improvement of D9.2M, and an average treatment

time of B. minutes. Chilst many $uestions can be raised regarding thereliability and accuracy of the data, these studies may still have some


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merit. !s Hartung and 7alvin 2 8/ comment, the clinicians deserve somecredit for having the courage to e&pose their method so publiclyA !fterall, it might have turned out the other wayA ninety per cent of the callerscould have announced to thousands of listeners that they did not feel any

better and that T T is a hoa&.J *p B1+.

=allahan himself notesAChy radio showsS In treating sceptical strangers one may

minimise positive e&pectations associated with one coming for helpand paying for it. !lso it avoids the secrecy element associatedwith psychotherapy claims in the past. raud has been ;nown tooccur in science and a public demonstration helps avoid some ofthese problems. .. !udio tapes of all treatments were made and areavailable for review.J *1EE9 paper, revised 1EEF+

A+"io a#" vi"eo %eco%"i#&s o e#e%&y )syc!o'o&y t%eatme#ts

!s (r. =allahan notes in his discussion of radio show data, the recordingand ma;ing public of treatments using T T and other methods is, in manyrespects, ultimately a more persuasive demonstration of effectivenessthat the presentation of dry reports or abstract numbers. There are nowmany such recordings available.

or e&ample, the # T website www.emofree.com/ offers over 2 # Tsessions on various (L(s produced as educational materials. Theseinclude wor; with B inpatients at the Leteran5s !dministration Hospital in:os !ngeles, suffering from severe >T?(. 0ne e&ert shows a patient witha severe height phobia, lin;ed to memories of 9 parachute @umps in a war

one. In addition he suffers with flashbac;s of traumatic memories andinsomnia, despite psychotherapy over a period of 1D years. !fter fiveminutes of tapping, he reports a complete absence of fear when thin;ingof heights, even though initially he e&perienced e&treme discomfort. Thetherapist invites him to wal; out onto the fire escape on the third floorhe e&periences no an&iety but much astonishment/. Three of his mostintense traumatic memories of the war were then addressed. He is taughthow to tap on his own to deal with further memories. Two days later he isinterviewed again and he reports having slept through the night for thefirst time for many years. He is able to recall without an&iety the

traumatic memories that had been treated.
http://www.emofree.com/http://www.emofree.com/


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(avid einstein has posted a video on the internet showing rapidtreatment of a severe height phobia. >rior to treatment a woman is seensha;ing with fear when on a th floor balcony, but following half an hourof energy psychology wor; she is able to lean over the railing without

discomfort. ! two and a half year follow-up, also videoed, indicates thather fear has not returned. This can be found athttp://video.google.com/videoplay?docid=5507061960927141022&q=height+phobia+video&hl=e

*or go to www.video.google.com , then type 4height phobia5 into the searchfield.+

St+"ies e6)'o%i#& w!et!e% it matte%s w!e%e t!e c'ie#t ta)s(A# a%ea o co#ti#+i#& "e*ate a#" st+"y

Ca%*o#e'' 1 0T%eatme#t o ac%o)!o*ia((

0ne study by =arbonell and colleagues conducted a randomised double-blind study, comparing T T with a placebo treatment in which thesub@ects who suffered from fear of heights tapped points not used intrue T T, although including some components of T T such as the 4Egamut5 tapping se$uence with eye movements etc. The sub@ects in the

true T T condition showed significantly greater improvement than theplacebo group using both ?G( ratings and scores on the =ohen!crophobia Kuestionnaire/.

Waite Ho'"e% .//B[a'so "isc+sse" a*ove- as a %a#"omise" co#t%o''e" st+"y]

These researchers assigned participants to one of treatmentconditionsA 1. normal # T 2. tapping on the arm, using the normal # T

verbalisations 8. tapping on a doll, using the usual # T verbalisations .ma;ing a toy out of paper. Two minutes of each treatment wereconducted. >re and post-test ?G(s were ta;en. The first threeconditions showed a drop in fear of 1FM. The th , control, conditionshowed no drop in fear. Caite and Holder concluded that the benefits of# T do not depend on tapping the specific points used in # T.

3a;er and =arrington *2 9+ have discussed this paper. They point outthat in all three tapping conditions the decrease in fear occurred very$uic;lyA Ce ;now of no scientific studies of procedures characteristic of
http://www.video.google.com/http://www.video.google.com/


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more traditional therapies which show an 1FM decrease in fear in so shorta timeJ.

This finding by Caite and Holder is also consistent with the hypothesis

that it is the tapping on mechanoreceptors, which are present all over thebody, that is important rather than the stimulation of energy meridians*e.g. 'ollon 2 9b )uden 2 9+.

La%&e sca'e o+tcome st+"y wit! %a#"omise" co#t%o's

T!e So+t! Ame%ica# St+"ies< A 'a%&e sca'e a+"it a#" )%e'imi#a%y t%ia'o EFT met!o"s ove% 1> yea%s 9 T!e st+"y *y oa5+i# A#"%a"e M3a#" co''ea&+es %om U%a&+ay(


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twelve months. The most prominent diagnosis was 4an&iety disorders5 which included panic disorder, post-traumatic stress disorder, specificphobias, social phobias, obsessive-compulsive disorders, and generalisedan&iety disorder. >re and post treatment scores on standardised

measures such as the 3ec; !n&iety ?cale, The ?pielberger ?tate-Trait!n&iety Inde&, and the Pale-3rown 0bsessive =ompulsive ?cale, were alsoused to supplement the assessors5 ratings. In many cases pre and post-treatment functional brain scan images were also used as an ob@ectivemeasure of change.

The interviewers had a record of the diagnosis and inta;e evaluation, butnot of the treatment method. 3oth patients and raters were instructednot to discuss the therapy procedures that had been used. The raterswere as;ed to assess whether the patient was now asymptomatic, showedpartial remission, or had no clinical response to treatment. >sychologicaltesting and brain mapping were carried out by other staff who wereneither the patient5s therapist nor rater.

0f the 8B clinicians, 28 were physicians 9 of whom were psychiatrists/, Fwere clinical psychologists, 8 were mental health counsellors, and 2 werenurses. !ll had e&tensive e&perience in treating an&iety disorders, withvarying levels of training and e&perience in Thought ield Therapy andderivative methods.

The ratings of the interviewers, supported by the psychometric data,indicated that the T T%# T type of methods were more effective thanthe e&isting treatments for a range of conditions. However, a number ofmore detailed sub studies were conducted employing a randomised designwith the e&isting treatments, of 4=3T with medication5 as a control, andusing double blind assessment.

:/// )atie#ts wit! a#6iety "iso%"e%sThe largest of the sub studies followed 9 patients with an&ietydisorders over a five and a half year period. Half of these receivedT T%# T type of treatment without medication, whilst the other halfreceived =3T with medication. (iagnoses included panic disorder, socialphobias, specific phobias, 0=(, generalised an&iety disorder, >T?(, acutestress disorder, somatoform disorders, eating disorders, !(H(, andaddictive disorders.

)esults of the sub-study of 9 patientsA


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>ositive clinical responses ranging from complete relief to partialrelief to short relief with relapses/ were found in B8M of thosetreated with =3T and medication and in E M of those treated withT T%# T p N . 2/.

=omplete relief from symptoms was found in 91M of those treatedwith =3T and medication, and DBM of those treated with T T%# T

p N . 2/. !t one year follow-up, the patients in the tapping group were less

prone to relapse than those in the =3T and medication group.

Com)a%iso# o #+m*e%s o sessio#s %e5+i%e"There was a difference in the number of sessions re$uired to achievepositive outcomes. EB patients with specific phobias were treated with=3T and medication, whilst E with the same diagnosis were treated usingT T%# T combined with the method of visual-;inaestheticdissociation watching an internal movie of the phobic situation/. Cithappro&imately E9M of the patients, functional brain imaging was used inaddition to the clinical ratings and pr and post-treatment test scores.The results wereA

>ositive results were obtained with BEM of patients treated with=3T and medication within E-2 sessions, with a mean of 19sessions.

>ositive results were obtained with DFM of the patients treatedwith T T%# T and visual-;inaesthetic dissociation within 1-Dsessions, with a mean of 8 sessions.

The brain mapping correlated with the raters5 conclusions and withthe psychological test data. Those patients showing the greatestimprovement showed the largest reduction in beta fre$uencies.These beta fre$uency reductions not only persisted at 12 monthfollow-up, but in fact became more pronounced.

Com)a%iso# *etwee# me"icatio# a'o#e a#" TFT?EFT(8 patients with generalised an&iety disorder were prescribed dia epam,whilst 8 patients with the same diagnosis were given T T%# T.

D M of the medication group e&perienced positive results. DF.9M of the T T%# T group e&perienced positive results. !bout half the medication patients e&perienced side effects or a

recurrence of an&iety on stopping the medication. This did nothappen with the tapping group.

Com)a%iso# o st%ict ve%s+s va%ie" se5+e#ce o ta))i#&


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The importance of se$uence in tapping was investigated. B phobicpatients were treated with a standard 9-point algorithm another groupof B patients were treated with the order of tapping varied.

>ositive responses were e&perienced by DB.BM of the standard

algorithm group and by D1.BM of the varied order tapping group.This was not statistically significant.

The treatment team formed the impression that for manydisorders a wide variation in the tapping protocol can be employed,whilst for certain conditions more precise protocols are re$uiredfor optimum clinical response.

Ta))i#& com)a%e" wit! ac+)+#ct+%e #ee"'es patients with panic disorder were given tapping treatments focused on

pre-selected acupuncture points. 8F patients with the same diagnosisreceived acupuncture stimulation using needles on the same points.

>ositive responses were e&perienced by DF.9M of the tapping groupbut only 9 M of the needle group.

E ective#ess o% "i e%e#t c'i#ica' &%o+)s)atings of effectiveness for different clinical groups were given in fourcategoriesA 1. 'uch better results than with other methods 2. 3etterresults than with other methods 8. ?imilar to the results with othermethods . :esser results than e&pected with other methods 9. roblems relating to childhood abuse and neglect.0ther emotional problemsA fear grief guilt anger shame

@ealousy re@ection painful memories loneliness frustration love

pain procrastination.


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$ette% %es+'ts t!a# wit! ot!e% met!o"s(0bsessive compulsive disorders.7eneralised an&iety disorders.!n&iety disorders due to general medical conditions.?ocial phobias.:earning disorders communication disorders feeding and eatingdisorders of childhood.?omatoform disorders.

actitious disorders.?e&ual dysfunction.?leep disorders.)elational problems.

Simi'a% to t!e %es+'ts e6)ecte" wit! ot!e% met!o"s('ild to moderate reactive depression.:earning s;ills disorders.'otor s;ills disorders.Tourette5s syndrome.?ubstance abuse-related problems, including an&iety.#ating disorders.*It was found that for these conditions, it is best to combine a

number of approaches.+

Lesse% %es+'ts t!a# e6)ecte" wit! ot!e% met!o"s('a@or endogenous depression.>ersonality disorders and dissociative disorders.*tapping methods are considered a useful ad@unct to othermethods+.

No im)%oveme#t o% co#t%ai#"icate"(>sychotic disorders.3ipolar disorders.(elirium.(ementia.=hronic fatigue.*although it is recognised that there are many anecdotal reports ofpeople with these diagnoses being helped by tapping methods witha number of life problems.+


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*


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immediately followed by the dental treatment. The mean ?G( rating priorto # T was F and after # T was 8. !ll patients e&perienced reduction inan&iety. The reduction in an&iety is impressive since the second ?G(rating was ta;en @ust before the dental treatment.

httpA%%www.emofree.com%)esearch%graham-temple-dental-study.htm

S)o%ts )e% o%ma#ce im)%oveme#t wit! EFT ?am ?mith conducted a simple study of s;ills in ;ic;ing a ball, before andafter # T, at a fundraising event on a sports field. 8D volunteers showedan overall improvement of F .DM in rugby penalty ;ic;s following # T.!fter the first ;ic;, the volunteers were as;ed to state two factors thatthey believed may have impeded their success. These comments, whichwere then used as # T statements, included such ideas asA 4I5m not strongenough5 4too many people were watching5 4I5m no good at this ;ind ofthing5. Chilst some of the improvement could be due to a simple practiceeffect, it seems unli;ely that the magnitude of the pre and post-# Tdifference could be due entirely to this.httpA%%www.emofree.com%)esearch%rugby-;ic;ing-contest.htm

Eyesi&!t im)%oveme#t wit! EFT =arol :oo; conducted an F wee; pilot study of improvement in variouseyesight problems, using # T instructions given by post. participantsinitially signed up for the study, having been recruited throughnewsletters and conferences. 0nly 12 of these completed the full Fwee; course. #ach wee;, the participants were sent instructions for # Ttapping in relation to various emotional issues that could have a bearing onvisual problems. D9M of participants reported improvement in variouseyesight problems. ?>?? statistical software, with t tests and !


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!lthough there is debate in relation to the $uestions of the importanceof tapping on traditionally recognised acupressure points as opposed torandom tapping on the body/, and whether a theory of energy is re$uiredto account for the therapeutic effects of tapping, the evidence for the

e&istence of meridians, and for the potency of acupuncture, is worthnoting. #ven if theories of energy are put aside, acupoints are noted to beclose to nerve bundles or nerve endings, and thus appear to be regions ofincreased sensitivity ?tu&, 3erman, 6 >omeran 2 8/ that deliverenhanced signals to the brain when stimulated.

Evi"e#ce o% t!e e6iste#ce o t!e me%i"ia# systemrench researcher, >ierre de Lerne@oul, in@ected radioactive isotopes into

the acupuncture points and trac;ed their movement using a gamma raycamera. The in@ected isotopes followed e&actly the same pathway as themeridians as traditionally conceived. !s a control, in@ections were alsomade into nearby non-meridian locations, and also into blood and lymphaticvessels these did not diffuse in the same manner as the in@ections atmeridian sites. These studies were carried out on 29 healthy sub@ectsand F patients with renal pathology. !nother interesting finding wasthat in@ections into the bilateral ;idney meridian diffused faster on thehealth side and slower on the diseased side. *(arras, Q-=., de Lerne@oul,>., 6 !lbarhde 1EE2+.

!cupressure points show lowered electrical resistance than other areas3ec;er, 1EE 3ergsmann 6 Coolley-Hart, 1ED8 =ho, 1EEF =ho 6 =hung,

1EE :iboff, 1EED ?yldona 6 )ein, 1EEE/. =hanges in brain function areassociated with stimulation of specific acupressure points =ho, 1EEF(arras, 1EE8 Hui, 2 0mura, 1EFE, 1EE /.

Evi"e#ce o% t!e e ect o ac+)+#ct+%e?ac+)%ess+%eThe Corld Health 0rganisation lists over 9 conditions that may behelped by acupuncture. 'any of these are mental health problems,including an&iety, depression, addictions, insomnia, and hypertension. The3ritish !cupuncture =ouncil reviewed seven controlled clinical trials ofacupuncture for an&iety or depression, as well as four studies that didnot include control groups and concludedA The findings from thesestudies suggest that acupuncture could play a significant role in thetreatment of depression and an&ietyJ *3ritish !cupuncture =ouncil, 2 2,p 11/.


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'ost studies of the effects of acupuncture have addressed its analgesicproperties. This effect is mar;ed and is also found in relation toanimals, thus casting doubt on e&planations in terms of placebo effects.?timulation of sham acupoints does not produce the same analgesic

effect. There is evidence that acupuncture analgesia is related toendorphin release ?tu&, 3erman, 6 >omeran 2 8/.

Evi"e#ce o% t!e e ective#ess o T!e%a)e+tic To+c!Therapeutic Touch is a simple form of energy-based physical touch,derived from !pplied "inesiology, that has been used e&tensively innursing conte&ts, including psychiatric nursing. It has been foundeffective in reducing physical pain and an&iety 7agne, 1EE Heidt, 1EF1Hughes, 1EED >ec;, 1EED/.

Eva'+atio# o t!e %esea%c! *asis o% e#e%&y )syc!o'o&y met!o"sThere has been a significant amount of research into both the efficacy

achieving an effect in a laboratory conte&t/ and the clinicaleffectiveness being helpful with clinical populations/ of T T, # T, andrelated methods. =onsiderable clinical ;nowledge has been accumulatedsince the first e&ploration of T T in 1EDE =allahan, 1EF1/. This clinical;nowledge is shared amongst colleagues internationally in boo;s,conferences, and websites. The effectiveness with a wide variety ofclinical problems has been reported in a huge number of case studies andsystematic clinical observations, as well as field studies in disaster areas.Heart )ate Lariability is a most interesting new outcome measure thathas been e&plored with T T preliminary results suggesting that whilstother psychological therapies, such as conventional =3T, do not improveH)L, T T produces a mar;ed improvement. !lthough the very large andlong term ?outh !merican study lac;s some of the rigour of formalresearch being designed for internal audit rather than publication/, itsfindings from double blind studies are very strongly suggestive, not onlyof the value of T T type of methods, but their superiority to cognitiveand behavioural methods that lac; some of the components of T T or# T.

This research evidence-base is considerably more than is the case formost interventions in psychiatry and psychotherapy. !lthough drugs areobviously sub@ect to careful trials of efficacy and safety, many otheractivities within a mental health service, such as most group activities,art therapies, occupational therapies, supportive activities etc., havelittle or no research evidence-base. !s )oth, onagy and >arry 1EEB/


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comment, there are over different named therapies, which can beseen as variations on the basic themes within a smaller number of familiesof theories and techni$ues. The vast ma@ority of these 4brand name5therapies are totally unevaluated.J *p +.

The efficacy of # T has not only been demonstrated to e&ist, but to beconsiderable. ! mar;ed reduction in an&iety, under laboratory conditions,was found to result from a short session of # T and to be sustained at12 month follow-up . This effect did not occur in the two controlconditions and was not due to suggestion. 'ost psychological therapieshave not had such efficacy demonstrated. or e&ample, there are nostudies demonstrating the efficacy of a psychoanalytic interpretation, ora cognitive therapy 4?ocratic $uestion5, in terms of its immediate effecton the client5s level of an&iety. 3y contrast, the use of the ?G( scaleenables the # T clinician to monitor the client5s level of distress frommoment to moment, and to ;now more or less immediately whether thetapping intervention is wor;ing or not.

?ome directions that would be valuable for future research in relation toenergy psychology therapies would beA further e&ploration of H)L as anoutcome measure, with comparisons between different therapies furtherdismantling studies to determine which components of the T T 6 # Tprocedure are crucial to efficacy e.g. whether particular tapping pointsare important, whether the verbal statements of self-acceptance areimportant, whether the presence of the therapist ma;es a differencecompared to the condition of the client performing T T%# T alone, etc./second, randomised controlled studies comparing T T and # T with othertherapies for clinical populations.

Re e%e#ces

!ndrade, Q., 6 einstein, (. 2 8. >reliminary report of the first largescale study of energy psychology.www.emofree.com%research%andradepaper.htm!lso published as 4#nergy psychologyA Theory, indications, evidence5. In (.

einstein. 2 . #nergy >sychology Interactive. )apid Interventions for:asting =hange. Innersource. !shland. 0). 1EE-21

3a;er, !.H., 6 =arrington, >. 2 9. ! comment on Caite and Holder5sresearch supposedly invalidating # T.www.energypsycho.org%research-criti$ue-eft.php
http://www.emofree.com/research/andradepaper.htmhttp://www.energypsycho.org/research-critique-eft.phphttp://www.emofree.com/research/andradepaper.htmhttp://www.energypsycho.org/research-critique-eft.php


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3a;er, !.H. 6 ?iegel, :.?. 2 9. =an a 9 minute session of # T lead to areduction of intense fear of rats, spiders and water bugsS ! replicationand e&tension of the Cells et al. 2 8/ laboratory study. 'anuscript in

preparation.

3ar;er, '., 6 'ellor-=lar;, Q. 2 . )igour and relevanceA the role ofpractice-based evidence in the psychological therapies. In sychological Therapies.)esearch and !pplications. :ondon. )outledge.

3ec;er, ).0., )eichmanis, '., 'arino, !.!., 6 ?padaro, Q.!. 1EDB.#lectrophysiological correlates of acupuncture points and meridians.>sychoenergetic systems. 1. 1 9-112.

3ergsmann, 0. 6 Cooley-Hart, !. 1ED8. (ifferences in electrical s;inconductivity between acupuncture points and ad@acent areas. !mericanQournal of !cupuncture. 1. 2D-82.

3eutler, 3.)., 6 Harwood, T.'. 2 1. !ntiscientific attitudes. Chathappens when scientists are unscientificS Qournal of =linical >sychology.9D. 8-91.

3ray, ). 2 B. Thought ield TherapyA Cor;ing through traumatic stresswithout the overwhelming response. Qournal of !ggression, 'altreatment6 Trauma. 12. *apers of theInstitute of !pplied "inesiology.

=allahan, ). 1EE9. ! thought field therapy T T/ algorithm for traumaA !reproducible e&periment in psychotherapy. >aper presented at the annualmeeting of the !merican >sychological !ssociation,


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=allahan, ). 2 1b. "osovo revisted. The Thought ield. D. *8+ (ec.*www.tftr&.com+

=allahan, ). 2 1c. 0b@ective evidence of the superiority of T T in

eliminating depression. The Thought ield. B. * + Qan. *www.tftr&.com+

=arbonell, Q. 1EED. !n e&perimental study of T T and acrophobia. TheThought ield. 2 *8+ 1-B

=arbonell, Q.:. 6 igley, =. 1EEE. ! systematic clinical demonstration ofpromising >T?( approaches. Traumatology. 9A1. !rticle .httpA%%www.fsu.edu%Utrauma%promising.html

=ho, ?., 6 chung, ?. 1EE . The basal electrical s;in resistance ofacupuncture points in normal sub@ects. Ponsei 'edical Qournal. 89. B -

D

=ho, V.H. 1EEF. sychotherapy. ?edona, !V. 7eorge Tyrell >ress.

(arby, (. 2 1. The efficacy of thought field therapy as a treatmentmodality for individuals diagnosed with blood-in@ection-in@ury phobia.Gnpublished doctoral dissertation. 'inneapolis. '., 6 !lbarhde, >. 1EE2. ! study on themigration of radioactive tracers after in@ection at acupoints. !mericanQournal of !cupuncture. 2 *8+

(evilly, 7.Q. 2 9. >ower therapies and possible threats to the science ofpsychology and psychiatry. !ustralian and sychiatry. 8E. *B+ 8D- 99.

(avies, H.T.0., 6 =rombie, I.". 2 9. Chat is a systematic review. Chatis S Lol. 1 *9+.www.evidence-based-medicine.co.u; .
http://www.fsu.edu/~trauma/promising.htmlhttp://www.evidence-based-medicine.co.uk/http://www.fsu.edu/~trauma/promising.htmlhttp://www.evidence-based-medicine.co.uk/


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(iamond, Q. 1EDF. 3ehavioural "inesiology and the !utonomic ress.

(iepold, Q.H., 3ritt, L., 6 3ender, ?.?. 2 . #volving Thought ield

Therapy. The =linician5s Handboo; of (iagnosis, Treatment, and Theory.sychology and #'().=ombining orces to 0ptimi e Treatment. lacebo interventions for allclinical conditions. =ochrane :ibrary. Issue 2.httpA%%www.cochrane.org%cochrane%revabstr%ab 8ED .htm

Hui, ""?., :iu, Q., 'a;ris,


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Qohnson, =., ?hala, '., ?eddi@a@, W., 0dell, )., 6 (abishevci, ". 2 1.Thought field therapy - soothing the bad moments of "osovo. Qournal of=linical >sychology. 9D. 128D-12

:ambrou, >.T., >ratt, 7.Q., 6 =hevalier, 7. 2 8. >hysiological andpsychological effects of a mind%body therapy on claustrophobia. ?ubtle#nergies and #nergy 'edicine. 1 *8+ 28E-291

:eonoff, 7. 1EBB. ?uccessful treatment of phobias and an&iety bytelephone and radioA ! preliminary report on a replication of =allahan5s1EFD study. The Thought ield, 2 *1+ 8- .

:iberman, ).>., 6 >hipps, =.=. 1EFD. Innovative treatment andrehabilitation techni$ues for the chronically mentally ill. In C. 'enninger6 7. Hannah #ds./ The =hronic 'ental >atient. Cashington, (=. !merican>sychiatric >ress.

:iboff, !.). 1EED. 3ioelectrical fields and acupuncture. Qournal of!lternative and =omplementary 'edicine. 8. 9DD-9FD

:ilienfeld, ?.0., :ynn, ?.Q., 6 :ohr, Q.'. *#ds.+ 2 8. ?cience and>seudoscience in =linical >sychology. ress.

:ohr, Q.'. 2 1. ?a;ai et al. is not an ade$uate demonstration of T Teffectiveness. Qournal of =linical >sychology. 9D 1 /A 122E-128B

:ynch, L., 6 :ynch, >. 2 1. #motional Healing in 'inutes. :ondon.Thorsons.

'!? 'anagement !dvisory ?ervice to the sychology ?ervices.

'ist, ?., #lder, '., !ic;in, '., 6 )itenbaugh. 2 9. ! randomised trial ofTapas !cupressure for weight-loss maintenance. Foc+s o# A'te%#ativea#" Com)'eme#ta%y T!e%a)ies(1/(BG9B *a $uarterly review @ournalpresenting evidence-based approaches to health care+. !bstracts of 12th!nnual ?ymposium on =omplementary Health =are. 1E-21st ?eptember.2 9. #&eter, G".

'ollon, >. 2 9. #'() and the #nergy Therapies. >sychoanalytic>erspectives. :ondon. "arnac.


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'ollon, >. 2 9b. ! cognitive reformulation of # T. Gnpublished paper.

sychology. 9D. 1 / 12 1-12

)oth, !., onagy, >., 6 >arry, 7. 1EEB. >sychotherapy research, funding,and evidence-based practice. In !. )oth 6 >. onagy, Chat Cor;s forChomS ! =ritical )eview of >sychotherapy 4)esearch. ress.

)owe, Q.#. 2 9. The effects of # T on long-term psychologicalsymptoms. =ounseling and =linical >sychology. 2 *8+ 1 -111

)uden, ).!. 2 9. aperny, (., 'athews, '., Tamida, 7., 3oyd, 7., ?imons, !.,Pamamoto, =., 'au, =., 6


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?alas, '.'. 2 1. The effect of an energy psychology intervention # T/versus diaphragmatic breathing on specific phobias. Gnpublished thesis."ingsville, Te&as. Te&as ! 6 ' Gniversity.

?choninger, 3. 2 1. #fficacy of thought field therapy T T/ as atreatment modality for persons with public spea;ing an&iety. Gnpublisheddoctoral dissertation. =incinnati, 0H. Gnion Institute.

?chul , ".'. 2 D. Integrating energy psychology into treatment foradult survivors of childhood se&ual abuseA !n e&ploratory clinical studyfrom the therapist5s perspective. Gnpublished doctoral dissertation.=alifornia ?chool of >rofessional >sychology, ?an (iego.

?eligman, '.#.>. 1EE9. Chat you can change and what you can5t.


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?wingle, >.7. 6 >ulos, :. 2 . aper presented atthe second international energy psychology conference, :as Legas, ., >ulos, :., 6 ?wingle, '. 2 . #ffects of a meridian-basedtherapy, # T, on symptoms of >T?( in auto accident victims. >aperpresented at the annual meeting of the !ssociation for =omprehensive#nergy >sychology, :as Legas, ., 6 3a;er, !.H. 2 8.#valuation of a meridian based intervention, emotional freedomtechni$ues # T/, for reducing specific phobias of small animals. Qournalof =linical >sychology. 9E. E 8-EBB


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1 ! systematic review aims to find all relevant studies, published and unpublished, assess each study,synthesise the findings from individual studies in an unbiased way, and present a balanced and impartialsummary of the evidence.J *(avies, H.T. 0. 6 =rombie, I.". 2 9+2 It is often proposed that the effect of seemingly unusual methods might be due to suggestion or aplacebo effect. In addition to the control for this included in the 3a;er and ?iegel study, =allahan ma;esthe following apt pointA

It is generally believed that treatments re$uire confidence or optimism in order to wor;?eligman, 1EE p298/. However, no belief or confidence is needed in the T T treatment in fact,it typically wor;s in the face of e&treme militant scepticism. The procedure itself does not inspireconfidence. #ven when it wor;s some people don5t believe itR see !pe& problem/.J *1EE9+

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Evidence Base Psychology