Uitgebreid Wetenschappelijk onderzoek EFT, Research EFT, 44 artikelen, 60 downloads a 13.5 MB.

Hersenscans - EEGs - Neurologische Grondslag EFT effect over 4 weken - 12 behandelingen

Hersenscan VOOR de behandeling	Hersenscan na 4 behandelingen
Hersenscan na 8 behandelingen	Hersenscan na 12 behandelingen
Hersenprofiel gemiddeld gezond persoon.(database)	Blauw = normale verhouding (volgens databases)   Turq. = licht disfunctioneel   Roze = gemid. disfunctioneel   Rood = ernstige disfunctie

Klik hier voor een PDF van deze scans die je kan uitprinten

De Neurologische Grondslag van EFT - een onderzoek binnen het meta-onderzoek in Zuid Amerika.
Hersenscan veranderingen gedurende 4 weken behandeling (12 behandelingen) van Gegeneraliseerde Angststoornis (GAS- engels GAD). Beelden beschikbaar gesteld door Dr. Joaquin Andrade, arts. Je kunt contact opnemen via www.bmsa-int.com.

Een serie EEGs van de hersensen van voor tijdens en na de behandeling van een gegeneraliseerde angst stoornis (GAS). Deze mooie beelden maken de veranderingen zichtbaar, en zeggen soms meer dan een heel verhaal. Tijdens dit deelonderzoek waren er 2 groepen, de ene groep klopten (EFT/TFT) terwijl aan angstoproepende beelden of herinneringen werd gedacht, de andere groep kreeg CGT, indien nodig aangevuld door medicatie. Ook wordt daar duidelijk gemaakt dat medicatie eigenlijk alleen maar een onderdrukken is van de symptomen, omdat op de hersenscans te zien is dat de klachten terugkomen als je stopt met medicatie, terwijl de scans van mensen die behandeld zijn met EFT/kloppen een blijvende verbetering lieten zien. Medicatie met CGT blijkt duidelijk minder effectief, en zichtbaar meer recidief (terugkomen van de klacht)

Deze scans zijn onderdeel van de zuidamerikaanse onderzoeken naar EFT. zie Andrade 2004

bron: http://www.innersource.net/ep/articlespublished/neurological-foundations.html 

Key Words: EFT Onderzoek, EFT research.

Zie het gespecialiseerde onderzoeksblad: Energy Psychology Journal.org

laatste wijziging: 13 november 20101

• Church, D. (2010)The Treatment of Combat Trauma in Veterans Using EFT (Emotional Freedom Techniques): A Pilot ProtocolTraumatology, Vol. 16, No. 1, 55-65 (2010)
• Swingle P, et al Neurophysiological Indicators of Successful EFT Treatment of Post-traumatic Stress. Subtle Energies and Energy Medicine vol 15
• Craig, G. (2009) Emotional Freedom Techniques (EFT) For Traumatic Brain Injury, Int Journal of Healing and Caring, May.
• Dinter, I., (2008). Veterans: Finding their way home with EFT. Int Journal of Healing and Caring, Sept
• Figley, 1995/1999 PTSD Active Ingredients Project - Traumatology
• Bray, R 1999 R. TFT and Traumatic Stress Recovery for Refugees - The Thought Field 4(4)
• Johnson, C, 2001. TFT in Kosovo - - The Journal of Clinical Psychology 2001
• Folkes, 2002, TFT and PTSD, TFT and trauma recovery, - Int J Emerg Ment Health. 2002 Spring;4(2):99-103.
• Lubin, 2009: Change is Possible: EFT in San Quentin, Energy Psychology
• Sakai, 2010, Treatment of PTSD in Rwandan Child Genocide Survivors Using Thought Field Therapy, International Journal of Emergency Mental Health, 12(1), 41-50.
• Church, D Single Session Reduction of the Intensity of Traumatic Memories in Abused Adolescents: A Randomized Controlled Trial,
• Salas, 2010, The Immediate Effect of a Brief Energy Psychology Intervention (EFT) on Specific Phobias: A Randomized Controlled Trial
• Stapleton, 2010, A Randomized Clinical Trial of a Meridian-Based Intervention for Food Cravings with Twelve Month Follow-up

• Feinstein, D. (2008). Energy Psychology in Disaster Relief. Traumatology. 14(1), 124-137.
• Miller, 2002, 6 Trauma Imprints Onderzoek naar CISD, TFT and EFT na WTC - Traumatology, 2002
• Ground Zero Almost, Traumatology, 2001

• Wells, S. et al, (2003), Evaluation of a Meridian-Based Intervation, EFT. Journal Clinical Psychology 59
• TFT and acrophobia - An Experimental Study of TFT™ and Acrophobia - Joyce L. Carbonell, Ph.D., TFTdx
• Baker, H, 2005. Replication Phobia.
• Lambrou, Pratt Claustrophobia and Thought Energy Study

• Elder, et al, (2007), Het NIH onderzoek over TAT - J Altern Complement Med 2007 Jan-Feb;13(1):67-78.
• Brattberg, G. (2008). EFT with fibromyalgia: a randomized trial. Integrative Medicine: A Clinician’s Journal, August/September.
• TFT, Sakei - utilization in an HMO in behavioral medicine
• EFT in Nurs Standard, Emotional Acupuncture, Lynch E. - 2007
• TFT - Phobia and Anxiety Treatment by Telephone and Radio - Callhan and Leonoff -1996
• Mollon, 2007, TFT and its derivatives: rapid relief of mental health problems, Mollon 2007, Primary Care and Community Psychiatry
• Brief EFT (Emotional Freedom Techniques) Self-Intervention on Anxiety, Depression, Pain and Cravings in Healthcare Workers
• Lane 2009, Neurochemistry of Counterconditioning: Acupressure Desensitization in Psychotherapy, Energy Psychology
• RCT: Progressive Muscular Relaxation and Emotional Freedom Techniques on Test Anxiety in High School Students , Sezgin, N, energy Psychology
• Baker: Theoretical and Methodological Problems in Research on Emotional Freedom Techniques (EFT) and Other Meridian Based Therapies, Psychology Journal
• Editorial Essay: Energy Psychology 1:1 Nov 2009
• Church, D. (2009). The Effect of EFT (Emotional Freedom Techniques) on Athletic Performance: A Randomized Controlled Blind Trial
• Sutherland, Chronic pain EFT, BSFF en NLP. Lifeworks group
• Sutherland 2001, Acedemic Performance School, EFT, BSFF en NLP Lifeworks group
• Sutherland 2000, Depression EFT, BSFF en NLP Lifeworks group
• Burik, Treatment of Compulsive Eating with Manual Stimulation of Acupuncture Points
• Swingle, 2010, Emotional Freedom Techniques (EFT) as an Effective Adjunctive Treatment in the Neurotherapeutic Treatment of Seizure Disorders

• Recente Abstracts Onderzoek naar EFT
• Andrade en Feinstein 2004 en 2005
• Feinstein 2008 - Review EFT

• Ronald Ruden: How Tapping Works
• Ruden, Model for Disrupting an Encoded Traumatic Memory
• Proposed Mechanism - Michael Lamport Commons
• Feinstein: Rapid Treatment for PTSD: Why Psychological Exposure with Acupoint Tapping May Be Effective

• Downloads

Wetenschappelijk onderzoek naar EFT en Trauma, PTSS

The Treatment of Combat Trauma in Veterans Using EFT (Emotional Freedom Techniques): A Pilot Protocol

Dawson Church, 2010

Epigenetic Medicine Institute, Santa Rosa, CA, USA,dawson@soulmedicine.net

With a large number of U.S. military service personnel coming back from Iraq and Afghanistan with posttraumatic stress disorder (PTSD) and comorbid psychological conditions, a need exists to find protocols and treatments that are effective in brief treatment time frames. 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 30 days prior to treatment and immediately before treatment. Participants were then treated with a brief and novel exposure therapy, EFT (Emotional Freedom Techniques), for 5 days. Statistically significant improvements in the SA-45 and PCL-M scores were found at posttest. 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 posttest but were not consistently maintained at the 30-and 90-day follow-ups. One-year follow-up data were 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 postdeployment intervention.

Key Words: veterans • posttraumatic stress disorder (PTSD) • exposure therapy • depression • anxiety • Emotional Freedom Techniques (EFT)

This version was published on March 1, 2010
 

Traumatology, Vol. 16, No. 1, 55-65 (2010)
DOI: 10.1177/1534765609347549
http://tmt.sagepub.com/cgi/content/abstract/16/1/55

Key words: Onderzoek EFT, Research EFT, Church, 2010, Veterans, PTSD

Swingle Neurophysiological Indicators of Successful

 

Neurophysiological Indicators of Successful EFT Treatment of Post-traumatic Stress.

Paul G. Swingle, Ph.D., Lee Pulos, Ph.D., and Mari K. Swingle, MA

SUBTLE ENERGIES AND ENERGY MEDICINE, VOL15,(1), 75-86 (peer reviewed)

Abstract

Clients previously involved in a motor vehicle accident who reported traumatic stress associated with the accident received two sessions of Emotional Freedom Technique (EFT) treatments. All clients reported improvement immediately following treatment.  Brainwave assessments before and after EFT treatment indicated that clients who sustained the benefit of the EFT treatments had increased 13-15 Hz amplitude over the sensory motor cortex, decreased right frontal cortex arousal and an increased 3-7 Hz / 16-25 Hz ratio in the occiput.  The benefits of psychoneurological research to reveal the processes of subtle energy healing are discussed.

KEYWORDS: Emotional freedom techniques, EFT, traumatic stress, EEG, research, onderzoek

website Paul Swingle and associates, online en ook pdf.

by Patricia Carrington, Ph.D

When the ground breaking Wells et al. study on the use of EFT for small animal phobias was published in 2003 in a leading peer-reviewed journal (The Journal of Clinical Psychology, see reference at end of paper) this was a major happening in the field of energy psychology. As one of the coauthors of the published paper on the Wells' research, I experienced firsthand the years of work that went into preparing the write-up of this research so that it could meet the strict standards of the professional journals. It is therefore extremely gratifying to me to be able to report on some additional research on EFT that has now been published in a peer reviewed journal. This time we see an article reporting research on the physiological effects of this technique as well as the psychological ones.

Doctors Paul G. Swingle and Lee Pulos. together with Mari K. Swingle, studied the effects of two sessions of EFT on nine people involved in motor vehicle accidents who were reporting traumatic stress associated with the accidents. Psychological tests, clinical interviews and neurophysiological measurements were used to determine the effects of EFT on these accident victims before they learned EFT, and these measures were repeated after they had been treated with EFT. The results were published in a peer reviewed journal, “Subtle Energies and Energy Medicine” (reference given at end of article) and I will summarize them here.

When the participants arrived at the office where they were to learn EFT, they were first given a series of psychological tests which included the Beck Anxiety Inventory, the Beck Depression Inventory, 10 items from the State-Trait Anxiety Inventory, and a 10 item questionnaire assessing the need to avoid driving and riding in a motor vehicle. On the same visit they also received an eyes closed assessment of 19 brain locations (a “Brainmap”) that used the QEEG (Quantitative Electroencephalograph) to convert brain waves to quantitative values that reflect the frequency and amplitude of brain wave activity at various brain locations. Normative values associated with these brain wave values have been established previously (Swingle, 2003), and based on them, the researchers were able to determine some of the effects of the EFT treatments on particular kinds of brain activity associated with specific subjective mental and physical states.

After being studied in the laboratory, the participants in the study received two sessions of EFT administered by Dr. Pulos in his office. They were taught the Long (original) Form of EFT, and the sessions were one hour long each. Before receiving their EFT treatment, each participant had been asked to give an Intensity Rating (SUD’s level) indicating their level of distress when they thought about the motor accident in which they had been involved. The SUD’s level consisted of a 10 point scale, with “1” representing no distress upon thinking about the accident, and “10” representing severe distress when thinking about it.

The two EFT treatments occurred within 24 days of the initial physiological examination. Following the treatments, take-home treatment protocols were given to each participant for use during the duration of the research. They were asked to practice 5 times a day for the first week, 3 times a day for the second week, and after that to treat themselves accordingly as their SUDs level and anxiety was reduced.

The participants responded very well to their EFT treatments. Before they were treated with EFT, their average SUD’s rating had been 8.3 when thinking about the accident. However, after the second of the two treatments their average SUD’s rating was now 2.5. This reduction in subjectively perceived stress was statistically significant at the p<.01 level, indicating a marked improvement in these accident victims’ distress ratings after receiving EFT treatment.

The participants were then re-assessed on a neurophysiological level between 70 and 160 days following their last EFT treatment for follow-up testing, and at that same time, the questionnaires administered before they had received EFT treatment were re-administered. The percent change from negative to positive responses in the questionnaires from pretest to follow-up was significant at the <.05 level, indicating a positive change in stress level for the group as a whole.

These measurements also revealed an interesting discrepancy between the scores of the participants. At follow-up, the group was roughly split in half with respect to their self-ratings as follows. Five of the participants had scores at this time indicating positive change (at the p<.005 level) from the time they were examined before they learned EFT, while 4 of the 9 participants showed negative or no change in self-rating (p=<.05) at the time of the follow-up assessment. Although all participants had shown a positive change immediately following the final EFT treatment (p <.001), that change did not hold up over time for the latter 4 participants.

The results from the brain mapping analyses at follow-up corroborated the results found in the questionnaires. When the brain wave data was analyzed with respect to brain indicators of depression, cognitive quiescence, and body quiescence, the percent change for the improved participants from their first (pre-EFT) brain measurements to the follow-up measurements 3 - 5 months later was 11.5%, while for the participants reporting no change or negative change the average percent change was –9.4%, a difference between groups that was significant at the p <.02 level.

Also impressive was the fact that for the improved group, the Theta/Beta ratio in the occipital region of the brain, a measure associated with beneficial mental quieting, was increased by 33.3% from pretreatment to follow-up, while for the group of participants not reporting improvement, the change was -32.2%, with a difference between these two groups that was significant at the p <.01 level.

In a similar manner, when studying the Theta/Sensory Motor Rhythm (SMR) ratio, the researchers found a marked difference between the improved and unimproved groups. The SMR is frequently used as an index of bodily quiescence, and increasing the SMR can therefore often be an effective treatment for epilepsy. The percent increase in SMR amplitude from pre-EFT to follow-up for the improved group was found to be 40%, while it was -71% for the participants who were not reporting improvement, a difference between groups that was significant at the p < .05 level.

The fact that the participants seemed to divide almost equally into one group who reported positive change and those who reported none or negative change, suggests that the degree of compliance to the at-home instructions for daily practice with EFT might have been a determining factor in these results. Unfortunately, however, no assessment was made of participant compliance in this study, something which clearly must be an essential part of any future study in this area.

The interesting finding that there was a strong correspondence between subjective reports of improvement on the part of the participants and their respective brain wave patterns suggests that psychoneurological research can provide important data for understanding the processes involved in EFT. We can hope that future investigations will shed even more light on this important finding.

Another question for future studies to address is whether the results obtained here are in fact due to the use of EFT for these trauma victims, or whether some of the improvement seen at follow-up 3 to 5 months later may simply have reflected a spontaneous recovery over time and would have happened regardless of whether or not they had learned EFT. This question can be easily addressed by adding a comparison group of accident victims in a future study, people who do not receive EFT treatment for their condition but are tested and retested at the same intervals. Would these untreated people improve at all with just the passage of time? This is not then a controlled study, however, clinical studies such as this are important in the field of medicine, and the fact that all of the participants showed clear cut improvement when they were retested 2 weeks after learning EFT (as indicated by subjective reports, brain wave readings were not taken at that time), strongly suggests that EFT did indeed have a very beneficial effect on them.

In this paper the authors discuss the fact that the positive results previously reported by Swingle for the use of neurotherapy for the treatment of seizure disorders, may in fact be enhanced by combining neurotherapy with EFT. They believe that EFT may potentiate the latter treatment because the changes in brain wave activity resulting from EFT treatments are in many ways similar to positive neurological changes that can occur with neurotherapy.

In this reviewer’s opinion, the findings of this study have particular value in that they strongly suggest on an experimental level, that EFT can be effective on a physical as well as an emotional level. The participants in the study who reported improvement with EFT were experiencing measurable physiological changes associated with improvement at the same time. I consider this an extremely important finding because it begins to answer a criticism frequently leveled at EFT, namely that the effects of EFT are “just a result of suggestion”. These researchers give us evidence that the improvements seen with EFT in their study were not just imaginary.

In considering the relationship between EFT and seizure disorders, I would agree with the cautions that Dr. Swingle has expressed elsewhere concerning the use of EFT for such disorders, and suggest that anyone who is interested in using EFT for this promising effect contact Dr. Swingle with regard to possibly using a specific harmonic recording that has been shown to control Theta amplitude (which otherwise can be a possible negative factor in the use of EFT for seizures). It seems that with use of this harmonic, the risk of increasing Theta amplitude can be greatly reduced or eliminated entirely. Reduced Theta amplitude is beneficial to increasing seizure threshold (decreasing seizures) in any event, so combining the two procedures (i.e. EFT and the harmonic) would be superior to either individually, thereby further reducing seizure risk. Dr. Swingle lives and works in Canada and can be contacted through his website, http://SwingleandAssociates.com. or by phone at 604-608-0444.

original

Introduction

Energy Psychology and Energy Therapies
Psychologist Roger Callahan, a pioneer in the development of energy psychology, trained with chiropractic physician, George Goodheart the developer of applied kinesiology.  Goodheart developed muscle testing to diagnose the underlying causes of health problems and found the relationships between muscle groupings and the energy meridian pathways associated with acupuncture therapies. Callahan’s experience and training with Goodheart formed the nucleus of the Callahan Techniques that subsequently lead to the development of Thought Field Therapy (TFT).

The theory of TFT is based on Rupert Sheldrake’s hypothesis of formative causation which suggests the presence of individual fields beyond time and space that can influence physical forms.  This has been a recurring theme expressed by Plato (ideal forms), Aristotle (external forms), Hans Driesch (entelechy), Burr (Life Fields) and what Sheldrake refers to as morphogenic or M-Fields1.

As new learning or behavior creates a new M-Field through morphic resonance, the causative field is changed, however slightly.  TFT assumes that in the case of a phobia or traumatic stress, a perturbation or energy static in the thought field (or M Field) creates a break or disruption in the circuitry of the electrical circulation system - the Qi circulating in the fourteen energy meridians of the body.  In other words, any negative emotional condition such as fear, anxiety, guilt, depression, or shame cause disruptions in the body’s energy system which gives rise to anxiety, fear responses and higher stress levels.

There are approximately 1100 acupuncture points or windows on the body where the electrical resistance on the skin is significantly lower compared to the non-acupuncture points.  According to Traditional Chinese Medicine (TCM) this allows the life giving energy or Qi to either exit or enter these windows.

Development of TFT Treatment Strategy
Within the 1100 acupoints of the body there are twelve alarm points which are located in the twelve respective meridians.  These are diagnostic points with six located along the midline of the body and six alarm points situated bilaterally on the body.  There are also twelve primary treatment points corresponding to each meridian located on the face, upper body and fingers.

Callahan developed the TFT treatments by asking the body whether the treatment point on a meridian could be utilized to reduce the fear or anxiety of the client’s specific issue.  He used applied kinesiology2 or energy testing to give vocal chords to the subconscious as the diagnostic tool.  Callahan then developed a series of algorithms or specific acupoints that when tapped in the proper sequence would reduce the Subjective Units of Distress (SUD) from an eight or nine (high) to a one (low) in minutes. The diagnostic procedures developed by Callahan are described in greater detail by Durlacher in his book Freedom From Fear3.  There are at least twenty different algorithms for psychological problems ranging from simple and complex phobias, posttraumatic stress, panic attacks, anger, physical pain, depression and more recently, heart rate variability.  Thus, for Callahan, each emotional or physical problem has its own specific algorithm and the sequence of the points is crucial to his treatment order.

Emotional Freedom Technique (EFT)
Gary Craig was one of Dr. Callahan’s first trainees.  He utilized the TFT algorithms successfully with hundreds of people.  However, there were many conditions such as bruxism, nightmares, TMJ, dyslexia and insomnia for which there were no specific algorithms.  Craig therefore reasoned that if one tapped all twelve treatment points in sequence one could expand the number of conditions that could be treated without developing or diagnosing new algorithms.  Thus, Craig developed one comprehensive algorithm and called this simplified procedure Emotional Freedom Techniques (EFT)4.

There are several advantages to EFT.  It provides one easily memorizable sequence that is useful for all problems5.  It also increases the number of psychological issues that can be treated for which there were no algorithms.  The EFT sequence is very easy to memorize and it integrates all the major concepts of TFT into one very simple system for clients to utilize and follow through as needed in the future.

One of the authors (LP) was trained by Callahan and has treated close to 2500 private clients with TFT achieving an 85% to 90% success rate (reduction of SUD to a one).  Subsequently, he began using EFT treating an equal number of clients with comparable diagnoses and achieved a comparable success rate as TFT.  It was decided to use EFT for the present study as it was much easier to teach and utilize and the success rate was comparable.


Research in Energy Psychology
While there have been thousands of individual case studies, testimonials and anecdotal evidence reported6,7 there is very little in the peer review literature to support the energy psychotherapies.  Wade8, in a doctoral dissertation achieved positive results using TFT to increase self-concept with phobic subjects. Figley and Carbonell9, in their Active Ingredients Project, compared TFT to EMDR, Trauma Incident Reduction (TIR) and Visual/Kinesthetic Dissociation (V/KD) and confirmed that TFT worked dramatically with long-term success to eliminate PTSD in fourteen subjects.  Lambrou and Pratt10 utilized TFT in a pilot study with four claustrophobic subjects and four controls.  Based on psychological, physiological and behavioral measures before and after exposure to a small room, a significant reduction in state anxiety was achieved.  Wells11, utilized EFT and a Diaphragmatic Breathing (DB) technique with thirty-five subjects with specific phobias of small animals.  Participants were randomly assigned to either EFT (N=18) or DB (N=17) and were treated in a single thirty minute session.  EFT produced a significantly greater improvement than DB on self-report and behavioral measures.  At 6-9 months follow-up EFT participants (N=12) continued to show significant improvement over pre-test on all measures and the DB subjects on two of the five measures.  

The first study to show direct neurophysiological evidence of the efficacy of EFT was reported by Swingle12.  Clients’ brainwave activity was measured before and after a brief EFT repetition.  Swingle found that the Sensory Motor Rhythm (SMR), which is brainwave activity in the 13-15 Hz range over the sensory motor cortex (location Cz; 10-20 international EEG site location system) which is approximately in the center of the head over the tips of the ears, increased in amplitude after EFT.  This finding of increased SMR amplitude resulting from EFT was extraordinary important since SMR amplitude enhancement is the focus of neurotherapeutic treatment for epilepsy.  The average increase in the SMR amplitude (in microvolts) was 26.9 percent (SD=14.1, df=12, p<.01).  Swingle also reported a number of case studies in which EFT was very effective in reducing the number of neurotherapy sessions required to increase seizure threshold in epileptic clients.  Most encouraging was the finding that if a client had a prodromal, an awareness of an impending seizure, some clients could abort the seizure with self-administration of an EFT routine.
 
Methods

Overview of the experimental design.
The purpose of the present study was to determine the neurophysiological effects of EFT with a group of participants who reported traumatic stress as a result of a recent motor vehicle accident.  Subjects who reported having been involved in a motor vehicle accident within the previous twelve months were brain mapped using a Quantitative Electroencephalograph (QEEG).  At the time of the initial QEEG the participants also completed questionnaires to access anxiety, depression, and avoidance of driving/riding in a motor vehicle.  After EFT treatment, participants were again brain mapped and completed a second set of questionnaires to assess the same factors as measured on the first questionnaires.

Subjects
Participants, 8 males and 2 females were recruited from a newspaper advertisement calling for volunteers.  Criteria for inclusion were that the volunteer had to be over 18 years of age, had been involved in a motor vehicle accident within the previous twelve months and reported moderate to severe traumatic stress as a result of the accident.

Procedure  
Respondents to the call for subjects, who survived the criteria for inclusion, reported for initial assessment to the office of the first author at which time they completed the  Beck Depression Inventory13, the Beck Anxiety Inventory14, 10 anger items from the State-Trait Anxiety Inventory15  and a 10 item questionnaire assessing avoidance of driving and riding in a motor vehicle.  At the same visit, an eyes closed QEEG assessment of 19 brain locations was obtained.  The EEG was the Lexicor N24, with an Electrocap 19 site harness, and all sites were brought below 5K ohms impedance.  Following the initial assessment the participants received two sessions of EFT administered by the second author at his office.  Prior to commencing the EFT treatments, participants were required to provide an estimate of their Subjective Units of Distress (SUD’s) associated with the traumatic event.  The SUD’s16 was based on a 1-10 scale with one representing no subjective distress and 10 representing severe distress.  Two treatments of EFT, administered by the second author, occurred within 24 days of the initial QEEG (M=16.0, SD=4.0).  The second QEEG was administered between 70 and 160 days post treatment (M=108.1, SD=43.0).


EFT Treatment Procedure
Once having met the criteria to qualify for the study, each subject was seen individually for one hour by the second author (LP).  An overview of energy psychology, meridian therapy and a detailed description and diagrams of the location of the twelve acupressure points was provided to each participant.  Energy testing or applied kinesiology was also explained as a means of identifying possible subconscious beliefs as to whether or not the person could succeed in overcoming their PTSD symptomatology. A pre-treatment SUD rating was obtained at this time.

Each subject was guided through the EFT algorithm by tapping each of the twelve points for approximately seven to ten seconds while focusing on their stress and fear about driving an automobile in traffic.  The acupressure points utilized in sequence were Bladder 2, Gallbladder 1, Stomach 1, Governing Vessel 27, Conception Vessel 24, Kidney 27, Spleen 21, Lung 11, Large Intestine 1, Pericardium 9, Heart 9, and Small Intestine 3.

Two more practice treatment sequences followed by asking the subject to raise their SUD as high as a possible while thinking about their motor vehicle accident and then reduce the stress by tapping the EFT acupressure algorithm.  Take home treatment protocols with diagrams, directions and theory were provided and each subject was asked to practice five times a day for the first week, three times a day for the second week, and then treat themselves accordingly as their SUD and anxiety was reduced.

The identical procedure was employed in the follow-up sessions twelve to fourteen weeks later and a final SUD rating was obtained as a comparison measure.


Results

Of the 10 volunteers who began treatment one client was dropped from analysis because of artifact contaminated QEEG on the second assessment.  This volunteer responded well to treatment with a final SUD’s of 1.0.  The second QEEG was administered between 70 and 160 days (M=122.3,SD=27.6) after the final EFT treatment.  The EFT treatments were administered from 10-24 days after the initial QEEG (M=16, SD=4.0).  At the time of the first EFT treatment the average pretreatment SUD’s rating was 8.3 (SD=1.1).  After the final EFT treatment the average SUD’s rating was 2.5 (SD=2.3).  This difference in SUD’s ratings was statistically significant (t=7.25, p<.01) indicating marked improvement in subjective distress after EFT treatment.

At the time of the second QEEG the questionnaires administered at the first QEEG assessment were readministered.  A global index of change was obtained by calculating the percentage change of the sum of responses to all the self-report questionnaires.  The range of summated ratings was from 0 to 284 with higher numbers reflecting more negative self-rated states.  The percent change in the global index for the entire group of 9 clients was –29.0% (SD=44.8, t=1.95, p<.05, 1-tailed).  This indicates a positive change for the group as a whole.

The global index revealed an interesting bimodal distribution of scores between clients with substantially improved self-ratings and those with no improvement or worsening of their self-rated condition.  Five of the clients global index scores indicated substantial positive change (M=-68.0, SD=24.0, t=6.36, p<.005, 1 tailed).  However, four of the nine clients had negative or no change in self-rating at the time of the second brain mapping session (M=10.3, SD=7.7, t=2.71. p<.05, 1-tailed).

This bimodal distribution indicates that EFT treatment was efficacious for a group of clients but may actually have had negative effects for some clients.  It should be noted that these global index changes reflect self-rated changes between 70 and 160 days after the final EFT treatment.  Further, the SUD’s rating obtained immediately following the final EFT treatment revealed a positive change for every client.  The change averaged 5.85 points on a ten-point scale (SD=1.94, t=9.59, p< .001, 2-tailed).

The second brainmap was administered between 70 and 160 days following the last EFT treatment.  This difference in time to second global self rating was unrelated to degree of improvement in the global index (r=.04, ns).  On the other hand, it is interesting to note that the number of days between the first brainmap and the final EFT treatment was negatively related to self-rated improvement (r=-.55, p<.07).  The time to complete the EFT treatments then appears to be important in obtaining positive outcomes, perhaps indicating that EFT is more efficacious with shorter intertreatment intervals.  

The neurological data also reveal some intriguing relationships with self-reported improvements.  The brainwave data were analyzed in terms of indicators of depression, cognitive quiescence and body quiescence.  A neurological correlate of dysphohic mood states is frontal lobe asymmetry in which the right frontal lobe (F4) is more aroused then the left frontal lobe (F3).  Cortical activation can be indexed with Alpha (8-12 Hz) amplitude17 or with Beta (16-25Hz) amplitude and the Theta (3-7 Hz)/Beta (16-25 Hz) ratio18.  For the purposes of the present study the Theta/Beta ratio was used as the neurological indicator.  A ratio of F3 to F4 Theta/Beta ratio was calculated for the first and second brain assessments.  The percent change from the first to the second brain assessments for the improved clients was 11.5% (SD=9.9) and for the clients reporting no change or negative change the average percent change in the frontal Theta/Beta ratio was –9.4% (SD=10.4).  This difference in change was significant (t=3.07, p<.02).  This indicates that improved clients had greater left frontal lobe arousal whereas those clients reporting no or negative change had greater right frontal lobe arousal at the second brain assessment relative to the first assessment.

An indicator of central nervous system quiescence is the Theta/Beta ratio in the occipital region of the brain.  Increased Theta amplitude is associated with mental quieting19 and the therapeutic increasing of Theta amplitude is an extraordinarily effective treatment for certain types of alcoholics and for stress related conditions20.  For the present study the Theta/Beta ratio as measured in the occipital region of the brain (01) served as the indicator of mental quiescence.  The measure of change was the difference in the Theta/Beta ratio between the first and the second brain assessments.  Increases in the Theta/Beta ratio indicate increased mental quieting.  For the improved group the change was 33.3% (SD=34.8) and for the group of clients not reporting improvement the change was –33.2% (SD=11.8, t=4.00, p< .01).  

The index of somatic quiescence used in the present study was the Theta/Sensory Motor Rhythm (SMR) ratio.  The SMR is 13-15 Hz amplitude measured over the sensory motor cortex (C3, Cz, C4).  Increasing the SMR amplitude is an effective treatment for epilepsy21 and the Theta/SMR ratio has been found to be a significant indicator of various forms of seizure like behaviors22.  The percent increase in SMR amplitude between the first and the last brain assessment was 40% (SD=85.5) for the improved group and –71.8% (SD=37.7) for the clients not reporting improvement (t=2.62, p< .05).


Discussion

Originally this study was designed to simply determine if EFT gave rise to any changes in the clients EEG.  The research to date has been primarily focused on outcome measures such as SUD’s ratings.  Such studies do indicate the therapeutic efficacy of EFT but do not help us to understand the processes by which positive change occurs.  The study by the first author (PGS)12 indicated that at least one immediate beneficial effect of EFT was an increase in the SMR amplitude.  This could be associated with the positive effect that EFT has on reduction of phobic reactions.  This focus on physiological and neurological indicators has been suggested as a worthwhile avenue of research in the areas of spiritual and distance healing23,24.  Shealy24, for example, found significant brainwave changes in response to healing energy sent over distances from 100 feet to 160 miles.  Determining brainwave changes in response to EFT treatment likewise may help researchers to understand the psychoneurophysiological processes underlying EFT and other forms of energy psychology and medicine.  

Fortunately for the purposes of the present study the group of clients treated with EFT divided almost equally into a group of clients who reported positive change and those who reported no or negative change.  Interestingly, all reported positive change immediately after EFT treatment but four of the nine clients reported no or negative changes at the time of the last brain assessment.  Those who improved had significantly greater Theta/Beta ratio changes in the occipital region of the brain, increased SMR amplitude over the sensory motor cortex and increased arousal of the left frontal lobe (relative to the right) as compared with the unimproved group of clients.
    
The immediate hypothesis that comes to mind to explain these effects is that improved clients are compliant with treatment recommendations whereas the unimproved clients are not compliant.  The marginally significant correlation between the days to complete the EFT treatment and reported improvement might suggest less commitment to treatment by less improved clients.  It could also indicate that less time between treatments facilitates EFT treatment by sustaining subjective feelings of improvement or providing more immediate reinforcement for compliant clients (i.e., less time to get out of the routine of daily self administered treatments).  As we did not obtain self-report data on compliance nor assess the accuracy of self administered treatments during office visits (presumably an indicator of systematic practice) the relationship of compliance to sustained positive changes in brainwave activity cannot be determined.  We do know, however, that the sustained self-reported benefit of EFT, at least with our very limited sample, was directly related to positive changes in brainwave activity.  This further indicated, along with Levin23, Shealy24 and others that psychoneurophysiological research can provide important data for understanding the processes involved in subtle energy healing.

The present study and the previous study on the use of EFT with neurotherapy for treatment of seizure disorders reported by Swingle12 indicates that the combination of the two treatment technologies can be very effective for rapidly and permanently treating many disorders.  Neurotherapeutic treatment of disorders such as epilepsy, depression, anxiety, pain, and the like would seem to be potentiated by EFT.  The data indicate that the changes in brainwave activity resulting from EFT treatments are consistent with neurological changes that occur with neurotherapy.  Although small sample size limits generalization it is plausible that EFT could enhance and/or maintain brainwave changes associated with neurotherapy.  That neurotherapy and EFT may be a synergic combined treatment is suggested by the findings of the present study that enduring self-rated improvements occurred only with clients whose brainwave changes were stable over the measurement period.   

Correspondence: Paul G. Swingle, Ph.D.  630-1190 Melville Street, Vancouver, BC V6E 3W1 Canada.
 
References

1.Sheldrake, R. (1988).  The presence of the past.  New York: Time Books.
2.Walther, D.S. (1998) Applied Kinesiology: Synopsis.  Pueblo, CO:  Systems DC.
3.Durlacher, J.V. (1994) Freedom from fear forever.  Tempe,                                                                                                                                                                                                                                                                                                                                                                                                                             AZ: Van Ness.
4.Craig, G. & Fowlie, A. (1995). Emotional freedom techniques: The manual. Sea Ranch, CA: Author.
5.Craig, G. (1997-1999). EFT (e-mail) discussion group: eftinfor@emofree.com.
6.Callahan, R.J. (Winter, 1987). Successful psychotherapy by radio and telephone. International college of applied kinesiology.
7.Leonoff, G. (1998). Phobia and anxiety treatment by telephone and radio: replication of Callahan=s 1986 study. http://tftrx.com/tft4std.html.
8.Wade, J.F. (1990). The effects of the Callahan phobia treatment techniques on self concept. San Diego, CA: The Professional School of Psychological Studies.
9.Figley, C.R. and Carbonell, J. (1995). The active ingredient project: preliminary findings. At the 2nd Annual Conference of the FSU Active Ingredient Project, FSU Conference Center, Tallahassee, FL. May 5-8.
10.Lambrou, P., and Pratt, G. (2000) Instant emotional healing, New York, Broadway Books.
11.Wells, S., Polglase, K., Andrews, H.B., Carrington, P., and Baker, H. A. (2003). Efficiency of a meridian based desensitization technique (EFT) versus diaphragmatic breathing in the treatment of specific phobias. A pilot study.  Journal of Clinical Psychology, 59, 943-966.
12.Swingle, P.G. (2001) Emotional Freedom Technique (EFT) and theta suppressing harmonic markedly accelerates SMR treatment of seizure disorders.  Paper presented at the meeting of the Association for applied Psychophysiology and Biofeedback Raliegh, NC.
13.Beck A.T., Ward, C.H., Mendelsohn M., Moch, J., and Erbaugh J. (1961)  An inventory for measuring depression.  Archives of General Psychiatry, 4, 561-571
14.Beck, A.T., Epstein, N., Brown, G., and Steer, R.A. (1988) An inventory for measuring clinical anxiety:  The Beck Anxiety Inventory Journal of Consulting and Clinical Psychology, 56, 893-877.
15.Speilberger, C.D., Gorsuch , R.L., and Lushene, R.E (1970) Manual for the Stale-Trait Inventory.  Palo Alto, CA: Consulting Psychologists Press.
16.Wolpe, J (1990) The practice of behavior therapy (4th ed.).  New York:  Pergamon Press
17.Henriques, J.B and Davidson, R.J. (1991) Left frontal hypoactivation in depression. Journal of Abnormal Psychology, 100, 535-545.
18.Swingle, P.G. (2001).  Parameters associated with rapid neurotherapeutic treatment of common ADD (CADD).  Journal of Neurotherapy, 5, 73-84.
19.Green, E., and Green, A. (1997) Beyond Biofeedback.  New York.  Dell.
20.Peniston, E.G., and Kulkosky, P.J. (1999), in J.R. Evans (Ed.) Introduction to Quantitative
21.Sterman, M.B. (2000).  Basic concepts and clinical findings in the treatment of seizure disorders with EEG operant conditioning.  Clinical Electroencephalography, 31, 45-55.
22.Swingle, P.G., (1998) Neurofeedback treatment of pseudoseizure disorder, Biological Psychiatry, 44,1196-1199
23.Levin, J. (2001) Etiology recapitulates ontology:  Reflections on restoring the spiritual dimension to models of the determinants of health.  Subtle Energies and Energy Medicine, 12, 17-37.
24.Shealy, C.N., Smith, T., Liss, S. and Borgmeyer, U. (2000) EEG alteration during absent “healing”.  Subtle Energies and Energy Medicine, 11, 241-248.
 

Key words: EFT onderzoek, Research EFT, Swingle,  Neurological indicators, PTSS
 

download origineel van Swingle, (zonder beschrijving van Carrington)

Emotional Freedom Techniques (EFT) For Traumatic Brain Injury

Craig, G., Bach, D., Groesbeck, G., & Benor, D. J., {2009}. Emotional Freedom Techniques (EFT) For Traumatic Brain Injury. International Journal of Healing and Caring, May. 9(2), 1-12. pdf

Abstract

This article describes the resolution in one session of several residual symptoms following severe Traumatic Brain Injury (TBI) six years earlier in a 51 year-old woman. The intervention was Emotional Freedom Techniques (EFT), developed by Gary Craig, the first author of this article. Mind Mirror electroencephalogram (EEG) monitoring during EFT sessions revealed increasing patterns of relaxation and centeredness as the treatment progressed. Implications for further research and for assessment and treatment of wartime TBI, PTSD and depression are discussed.

Key words: Emotional Freedom Techniques, EFT, Energy Psychology, Traumatic Brain Injury, TBI, Post Traumatic Stress Disorder, PTSD, Depression, Mind Mirror Electroencephalogram, EEG, Vertigo

Key words: EFT onderzoek, EFT research.

Veterans: Finding their way home with EFT--an observational study

Dinter, I., (2008). Veterans: Finding their way home with EFT. International Journal of Healing and Caring, September, 8:3.

Abstract

Helping Veterans heal from the trauma of war has been a journey into a spiritual place that I might not have been able to reach otherwise. I am filled with gratitude for every soldier who has allowed me to get an insight into his or her world. These are my most amazing mentors who are  giving me their loving trust and support to continue this journey. As a life coach, specializing in Emotional Freedom Techniques (EFT), I have been blessed and  honored to help many Veterans heal from their trauma of war. I have worked with US Marines who, even after 40 years, still can’t find forgiveness for what happened in Vietnam. I have  helped Veterans from most recent wars who have relived their nightmares of horror, overwhelm  and danger every night. EFT4Vets, the training program for practitioners I have developed, understands PTSD  symptoms as symptoms of the soul. It offers an integrated program for practitioners that will enable the EFT coach to assist the Veterans on the physical, mental, emotional, relational and  soul levels. This program honors the transformational effect that using EFT for helping Veterans to release PTSD symptoms can have on the practitioner as well as the Veteran. Building rapport  and trust between the practitioner and the client before the work together begins is an integral  part of the training, and so is the thorough teaching of specific applications and techniques of EFT for Veterans through presentation, demonstration and practice.

Key words: Research EFT, Onderzoek EFT, Dinther, Veterans, 2008.

zie pdf

bron: Stressproject.org

PTSD/trauma

Charles Figley, een zeer bekende Psychotraumatoloog,  die verantwoordelijk is geweest om serieuze erkenning te krijgen voor het vak Psychotraumatologie door onderzoek en publcaties. Hij is de man die post traumatische stressstoornis (PTSS) als diagnose erkend heeft gekregen in de DSM. Later is hij de man geweest die compassiemoeheid bekend heeft gemaakt. In het begin van de jaren 90 heeft hij via het Traumatology forum, een internet emaillijst, iedereen uitgenodigd om vernieuwende nieuwe interventietechnieken of therapievorment te oppperen voor een onderzoek naar deze nieuwe vormen. Destijds was het zoeken naar en vinden van effectieve en efficiente middelen voor de behandeling van PTSS een langzaam proces, maar er gingen wel geruchten dat er snelle en effectieve behandelingen mogelijk waren.

Vier therapievormen werden geselecteerd op basis van nominaties en het voldoen aan en aantal eisen. De criteria waaraan o.a. moest worden voldaan waren 300 beroepsbeoefenaars die getrained en gecertificeerd waren in de technieken, bereidheid om op FSU onderzoek te doen.

Doelstelling onderzoek:
Er werden 6  doelstellingen genoteerd: 1) Identificeer de meest veelbelovende therapievormen 2) Onderzoek deze door middel van systematische Klinische demonstratie 3) samenwerken met andere partijen die informatie willen over effectieve behandelvormen, 4) zoek de actieve ingrediënten van deze interventietechnieken, 5) ontwikkel een model dat laat zien hoe traumatische stress een trauma word, en ook weer kan oplossen. 6) ontwikkel richtlijnen voor behandeling van trauma.
 

Het onderzoek dat de naam Active Ingredients Project kreeg, is heel belangrijk geweest om Thought Field Therapy (TFT), de voorloper van EFT, in de belangstelling van een grote groep psychologen en therapeuten te kijgen. Dit onderzoek heeft namelijk laten zien dat TFT vergeleken met EDMR bijna 3 keer zo snel, en vergeleken met de Visueel Kinestetische Dissociatie methode uit de NLP ongeveer 2 keer zo snel was.  Hoewel de het tijdsbestek waarin de evaluatie en de aantallen proefpersonen aanzienlijk varieerden tussen de verschillende interventies, de volgende indrukwekkende resultaten: De N grootte, het (gemiddeld) aantal minuten benodigd en de SUDscore tijdens evaluatie:  

 tabel uit Fred Gallo's website.

Key words: EFT onderzoek, EFT research, Figley, PTSD, Traumatology

Thought Field Therapy and Traumatic Stress Recovery for Refugees & Immigrants

By Robert L Bray, PhD, LCSW, CTS, TFTdx
and Crystal Folkes, MS.

. The Thought Field, 4 (4), 1-2.

A pilot project in San Diego has demonstrated the effectiveness of TFT in helping immigrants and refugees to resolve post traumatic stress symptoms. The San Diego Elementary School Counseling Partnership (through a grant from the U.S. Department of Education) sponsored a traumatic stress clinic for children and families in the mid City area of San Diego for two months. Although short in duration, it proved to be of great value.

This project, serving an inner city school area provided services primarily to immigrant and refugees. Andrew Jackson Elementary School, home base for the study, serves several immigrant communities. Seventy percent of the 1,165 students at the school have limited English proficiency. Ninety seven percent of the students receive free breakfast and lunch at the school. This population was chosen for several reasons. First, there was a great need for services in general and more specifically to resolve trauma experienced in their homeland and in their transition to the U.S.. Second, because of their unfamiliarity with mainstream approaches to treatment and their distrust of "strangers" these groups were unlikely to seek traditional counseling services. Third, difficulties with the English language and access to translation, and high mobility rates among immigrants and refugees require quick treatment approaches.

Services were provided by counseling interns trained in algorithms and one diagnostic trained supervisor. The three of the counselors were multilingual multi-cultural: Ethiopian, Mexican American, and Somali. Clients were served in English, Spanish, Amharic (Ethiopia), Tigrinia (Eritrea), and Somali, French, Swahili, and Arabic.

One to three Thought Field Therapy sessions were provided free of charge to individuals and families. Services were provided at the school or at home. In most cases TFT was done in the presence of other family or community members. Algorithms were used to treat a wide range of thought fields based in memories ranging from single incidents of psychological threats to multiple acts of the worst possible violence and torture. TFT diagnostic work was done with two individuals. Information, educational, referral, and other assistance were provided as appropriate to the families.

During the first meeting clients were asked to complete a pre test evaluating post traumatic stress symptoms. The PTSD checklist for civilians (PCL-C) and the PTSD Checklist for Children (PCL-Child) were used. The checklist consists of 17 items rated one to five as to how frequently they have experienced the symptoms within the last month. This self report survey form has a diagnostic deficiency rating of 90 percent at a cutoff of 40 points or above for predicting the presence of PTSD in several studies. The PCL-C and PLC-Child were translated in Amharic, Tigrinia, Somali, and Spanish. In some cases because of language or literacy difficulties the counselors read the forms aloud to the client without any additional explanation and clients were instructed to mark his/her response. Clients completed the same form as a post test 30 days or more after treatment.

A total of 64 individuals were served. Of the 64 served, 34 completed both a pretest (X=51.3, SD=14.1) and a post test (X=31.23, SD=13.5) evaluating post traumatic stress symptoms. There was nearly a 40% decreased of frequency of symptoms reported overall. These results were constant across age, primary language, gender, ethnicity, and service provider.

The value of TFT becomes even more evident when analyzing the 29 individuals who had scores on the PCL pre test above the 40 point cutoff for a PTSD diagnosis. Eighteen of the 29 individuals (62%) had post test scores below the threshold for a PTSD diagnosis. Another five of the 11 individuals with pre test scores above the threshold reported symptoms reduced by at least 20%. In the end 79% reported significant improvements in the frequency of their traumatic stress symptoms.

Those clinicians familiar with traumatic stress in general, and with refugee populations specifically, know these results are far beyond what can be expected with traditional approaches to helping. A more complete description of the project and references are available from Robert L. Bray at the Thought Field Therapy Center of San Diego: Phone 619-579-8615             619-579-8615     , or http://web.archive.org/web/20041205101616/http://www.rlbray.com/.

Recommended Self-Help Product for Trauma and Disaster Relief:  TFT and Trauma: Treatment and Theory

Source: . The Thought Field, 4 (4), 1-2. Available:

: http://www.tftrx.com/ref_articles/6refugee.html

Bray, R.L., and Folkes, C. (1999). Thought field therapy and traumatic stress recovery

for refugees and migrants

Key Words: EFT onderzoek, EFT research, Bray, Traumatic Stress, Refugees.

TFT in Kosovo, Carl Johnson.
   

In October 2001 besteedde The Journal of Clinical Psychology (Volume 57. No. 10) een special aan TFT (5 artikeltjes), waarin Dr. Carl Johnson, et. al. het artikel schrijft genaamd "Soothing the Bad Moments of Kosovo."  Dr. Johnson schrijft dat van de 249 trauma's behandeld in Kosovo er 247 succesvol zijn.

Johnson C, Shala M, Sejdijaj X, Odell R, Dabishevci K.

Global Institute of Thought Field Therapy, Winchester, VA 22601, USA. carl@visuallink.com

Trauma in Kosovo was treated with Thought Field Therapy (TFT) during five separate trips by members of the Global Institute of Thought Field Therapy, in the year 2000. Clinicians from Sweden, the United Kingdom, and the United States were joined in Kosovo by four physicians who transported them to remote war-torn villages where patients with severe trauma were treated. Treatment was given to 105 patients with 249 separate traumas. Total relief was reported by 103 of the patients, and for 247 of the separate traumas. Follow-up data averaging five months revealed no instance of relapse. Copyright 2001 John Wiley & Sons, Inc.

PMID: 11526610

Zie het bedankje van de Surgeon General

Key Words: EFT onderzoek, EFT research, Kosovo, Johnson.

Int J Emerg Ment Health. 2002 Spring;4(2):99-103.

Thought field therapy and trauma recovery.

Folkes CE.

San Diego State University/Claremont, CA, USA. crystalfolkes@hotmail.com

People who have been repeatedly exposed to traumatic events are at high risk for Post Traumatic Stress Disorder (PTSD). Refugees and immigrants can certainly be in this category, but seldom seek professional therapy due to cultural, linguistic, financial, and historical reasons. A rapid and culturally sensitive treatment is highly desirable with communities new to Western-style healing. In this study of 31 clients, a pre-test was given, all participants received Thought Field Therapy (TFT), and were then post-tested after 30 days. Pre-test and post-test total scores showed a significant drop in all symptom sub-groupings of the DSM criteria for PTSD. The findings of this study contrast with the outcomes of other methods of treatment, and are a significant addition to the growing body of data on refugee mental health.

PMID: 12166020

key words: EFT onderzoek, EFT research

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. pdf

Abstract

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.

Keywords: Prisoners, veterans, PTSD, memories, affect, trauma, EFT (Emotional Freedom Techniques)
 

Keywords: EFT onderzoek, EFT reserach, PTSD, Quentin, Lubin, 2009.

Treatment of PTSD in Rwandan Child Genocide Survivors
Using Thought Field Therapy

The authors wish to convey gratitude to Dottie Webster and Carol Dall for their assistance and to Pastor Norman Paul Desire for managing the post-treatment follow-up assessments. We thank David Feinstein, Larry Sine, and Silke Vogelmann-Sine for their proofreading and editing. Susan Malspeis’ consultation and review of the statistical calculations used in this paper are gratefully acknowledged. We have much appreciation for Dr. Roger Callahan who developed Thought Field Therapy. We also extend our heartfelt thanks to the teachers, staff, and children of the orphanage that graciously hosted this study. Some of the material contained in this paper was presented at the Third International Association of Thought Field Therapy Conference, Boston, Massachusetts, Oct. 21 – 22, 2007. By way of disclosure of potential conflicts of interest, the authors provide clinical services and conduct trainings in the approach examined here. Correspondence concerning this article should be addressed to Caroline Sakai, 1300 Pali Hwy. #204, Honolulu, Hawaii 96813. E-mail: carolinesakai@gmail.com

Abstract

Thought Field Therapy (TFT), which utilizes the self-tapping of specific acupuncture points while recalling a traumatic event or cue, was applied with 50 orphaned teens who had been suffering with symptoms of PTSD since the Rwandan genocide 12 years earlier. Following a single TFT session, scores on a PTSD checklist completed by caretakers and on a self-rated PTSD checklist had significantly decreased (p < .0001 on both measures). The number of participants exceeding the PTSD cutoffs decreased from 100% to 6% on the caregiver ratings and from 72% to 18% on the self-ratings. The findings were corroborated by informal interviews with the adolescents and the caregivers which indicated dramatic reductions of PTSD symptoms such as flashbacks, nightmares, bedwetting, depression, isolation, difficulty concentrating, jumpiness, and aggression. Following the study, the use of TFT on a self-applied and group utilized basis became part of the culture at the orphanage, and on one-year follow-up, the initial improvements had been maintained as shown on both checklists.

Treatment of PTSD in Rwandan Child Genocide Survivors
Using Thought Field Therapy

The dire psychological consequences of war and organized violence have been extensively reviewed and reported (e.g., Kienzler, 2008; Miller, et al., 2006; Ziegler, 2010). The incidence of posttraumatic stress disorder (PTSD) in children of war is particularly high (Ehnthold & Yule, 2006; Thabet & Vostanis, 2000). In a study of orphans ten years after the 1994 genocide in Rwanda that left more than one million children without parents, 44% of a sample of 68 orphans still met the full criteria for PTSD based on structured interviews (Schaal & Elbert, 2006). Knowledge about effective treatments for populations devastated by war, however, is limited, especially with children and adolescents. The present study investigates the use of Thought Field Therapy (TFT) with 50 adolescents who had been orphaned during the genocide in Rwanda twelve years earlier and who met criteria for PTSD on a standardized PTSD checklist completed by their caregivers at the start of the study.

TFT combines the manual stimulation of acupuncture treatment points, the mental activation of targeted symptoms and traumatic memories, and related procedures. Developed by clinical psychologist Roger Callahan (Callahan, 1981; Callahan, 1995; Callahan, 2001; Callahan & Callahan, 2000), TFT can be taught by a therapist in a clinical setting and is self-administered by the client in clinic and in the client’s own settings.

TFT has been used in the treatment of PTSD with refugees (Folkes, 2002), survivors of genocide (Johnson, 2001), and survivors of other human-made and natural disasters (Feinstein, in press). While such reports suggest that TFT may be an unusually effective treatment for PTSD in the aftermath of catastrophic events, few controlled investigations have been conducted. Two recent randomized controlled trials treating PTSD using a derivative of TFT called Emotional Freedom Techniques have, however, produced strong favorable outcomes (Church, Pina, Reategui, & Brooks, 2009; Church et al., 2010). The current study, based on multiple case data (after Kazdin, 1982), investigated outcomes of TFT treatments with childhood survivors of genocide. The study was conducted in the context of a trauma relief deployment by invitation of the staff at an orphanage in Rwanda.

METHOD

Participants

The study, conducted in April 2006, included 50 students (27 male; 23 female), ages 13 to 18, attending a day school that was part of an orphanage in Rwanda. Of the 400 students attending the school, 188 were old enough to have been survivors of the 1994 genocide in Rwanda 12 years earlier. All completed a PTSD symptom inventory. Those with the most severe symptoms were also rated by their caregivers on a standardized PTSD checklist. Of these, the 50 given the highest scores on the caregiver checklist were selected to be in the study. The 27 males in the study were residents at the orphanage; the 23 females lived with foster parents.

These 50 adolescents were treated by four practitioners over a three-day period. The practitioners included a licensed psychologist, two licensed clinical social workers, and a paraprofessional with extensive training and experience in both TFT and disaster relief procedures.

Measures

A review of psychological interventions for post-traumatic reactions in children and adolescents suggests the importance of utilizing both child and parent measures in clinical studies (Stallard, 2006). In conformance with this suggestion, two standardized checklists to assess participants’ PTSD symptoms were utilized, one completed by the participants and one by their caregivers. The Child Report of Post-Traumatic Symptoms (CROPS) and the Parent Report of Post-Traumatic Symptoms (PROPS; Greenwald & Rubin, 1999) were translated into the native Kinyarwanda language according to recognized standards for test translation and approved by the test’s first author (Greenwald) in 2006.

Because the students were orphans, their teachers—who also served to guide, discipline, and counsel them and in many cases were their only caregivers—did the parental assessments. The PROPS inventory is still valid, according to its first author, if scored by "any adult who is with the child frequently and knows him/her well" (R. Greenwald, personal communication, March 2, 2006). The three caregivers doing the PROPS ratings selected students with whom they were most familiar, and the same caregiver rated the same students on immediate pre- and post-treatment assessments as well as on each of the follow-up assessments.

The CROPS self-inventories were administered the day before the start of treatment in a group setting and then immediately upon the completion of the treatment sessions. The students completed the inventory independently if they were able to read and understand it or with staff assistance if they required help. The therapists were not involved in the administration of either inventory. Another measure, used by the students, was a verbal Subjective Units of Distress (SUD) self-rating (Wolpe, 1973). Students were asked by the therapist to rate their level of distress relative to a traumatic memory or other concern that was a focus of the treatment, on a scale of 0 to 10, at various points during the treatment session as a process measurement.

Procedures

Informed consent content was developed with the school/orphanage staff and presented to the students at an assembly so all received identical information and heard the same answers to the many questions that were asked. The students were told that the visiting therapists were going to see if they might be able to help them with intrusive memories from the genocide, and that they would also be teaching them some ways that might help them to better relax and sleep. They were also told that the therapists wanted to learn from them what was helpful, thus the questionnaires. Participation was completely voluntary. Students were asked to raise their hands to indicate that they understood the intent of the program and that they were willing to participate. There was 100% agreement and ultimate participation. The therapy team was there at the invitation of the orphanage’s director, who was also a university professor in Kigali. While the complications of attempting to obtain Institutional Review Board (IRB) approval in Rwanda at the time made a formal IRB process unfeasible, the possibility was explored and the protections provided by an IRB were discussed with the director and built into the study.

Of the 188 students at the orphanage who were survivors of the genocide, the 50 selected for the study, based on their scores on the PROPS caregiver inventory, each exceeded the PTSD cutoff score, which is 16 (Greenwald & Rubin, 1999).

Thus 100% of the adolescents in the study were rated as being above the PTSD cutoff on the PROPS inventory prior to treatment. These 50 participants were administered the CROPS self-rating inventory one day prior to their first treatment session. Only 72% of these students (36 of 50) met the criteria of PTSD prior to treatment. While this might give the appearance that the caregivers overestimated the students’ level of distress (rating 100% in the PTSD range), discussion of this question with the caregivers led to possible alternative explanations, such as that some of the students may have dissociated from the genocide events or been in denial about or concealing their symptoms on the self-inventory.

The 50 participants were each provided an individual Thought Field Therapy (TFT) treatment session of 20 to 60 minute duration. No pre-set time-limit was established, and the session was able to continue as long as the therapist judged appropriate. The participants were treated with TFT for multiple traumas, anger, rage, guilt, grief, and chronic pain. The TFT basic algorithm level of treatment was utilized, with corrections for psychological reversals as needed. The basic treatment algorithms and psychological reversal corrections utilized in the study are described in Callahan’s (2001) Tapping the Healer Within.

Each therapist was randomly assigned approximately one-fourth of the participants, and each therapist saw each of his or her participants on three consecutive days. On one of those days, the TFT session was administered, on another day a four-minute progressive relaxation technique was taught during a five- to ten-minute session that also involved supportive counseling, and on the other day, a two-minute diaphragmatic breathing was taught during a five- to ten-minute session that also involved supportive counseling. The order for each treatment condition was pre-selected and varied among the students. Kinyarwanda-English translators were used in all sessions.

This design was a last-minute deviation from the original plan, which was to have three TFT sessions administered to each participant on three consecutive days. However, a contingent of three of the seven-member therapist team was unexpectedly called to another part of the continent to assist in an emergent situation, making it impossible for the remaining four therapists to provide three treatment sessions to each of the 50 participants within the three days available.

The brief progressive relaxation and diaphragmatic breathing sessions were introduced to make it possible for each of the participants to still have the intended three sessions with a therapist. In this revised design, the relaxation and breathing sessions were conceived of as placebo conditions—with each of the three treatments provided in random order—allowing the participants to act as their own controls. The data collection strategy, however, improvised at the last moment to accommodate the new developments, was not adequate for an analysis that would allow that objective to be fulfilled. The study is, therefore, properly understood as a systematic investigation of clinical outcomes without a comparison condition.

The CROPS inventories were re-administered immediately following the diaphragmatic breathing and progressive relaxation sessions as well as after the TFT treatment. The PROPS inventories were re-administered within a day of the end of all three sessions, allowing the caregivers time to observe and interact with the students they were responsible for rating. Follow-up assessments were conducted at 3 months, 6 months, and 12 months post-treatment.

RESULTS

Scores on both the PROPS and CROPS inventories were significantly reduced at end of treatment, with reductions holding at one year follow-up. Table 1 shows the mean scores on both inventories prior to treatment, immediately following the treatment sessions, and at one year. Standard deviations and probabilities that the pre- and immediate post-treatment differences were by chance are also presented. Table 2 shows the percentage of students who were above the PTSD cutoff for each inventory pre-treatment, immediate post-treatment, and on one-year follow-up. Table 3 shows a pre-treatment SUD (subjective units of distress) score on the most disturbing trauma memory and a post-treatment score. Other SUD scores were taken throughout the treatment for specific areas of focus (fear of dark, anger, discomfort with other adolescents, etc.), but the table is limited to scores on the most disturbing memory which was, by design, taken at the start and end of the TFT treatment session.

Table 1. Pre-Treatment, Post-Treatment, and 1-Year Mean Scores on Caretaker and Child Reports of Posttraumatic Symptom Inventories in Adolescent Genocide Survivors (N = 50)

Table 2. Percent Meeting PTSD Criteria Pre-Treatment, Post-Treatment, and at 1-Year (N = 50)

Table 3. Subjective Units of Distress Scores in a Single Thought Field Therapy Session with Adolescent Rwandan Genocide Survivors (N = 50)

DISCUSSION

Although each participant received only a single TFT session rather than the three TFT sessions originally planned, all outcome measures exceeded the .0001 level of confidence that the symptom reduction was related to the treatment. These scores were corroborated by informal interviews with the adolescents and the caregivers which indicated dramatic reductions of symptoms such as flashbacks, nightmares, bedwetting, depression, withdrawal, isolation, difficulty concentrating, jumpiness, and aggression. While these scores and impressions from informal interviews provide a faithful accounting of measurable, observable and reported subjective effects of the treatment, therapists not familiar with TFT and related clinical approaches may find these outcomes improbable. They are, however, consistent with reports from other deployment teams using similar interventions (see Feinstein, 2008). Clinicians who have not worked in a setting where trauma at the level of the Rwandan genocide is the common background of an entire community may also find comments about the social context within which the treatment was administered to be informative.

Social context

Each year, beginning on the anniversary of the start of the genocide, Rwandans observe a one-week mourning period (sometimes longer for survivors, and observed as a two-week mourning period at the orphanage). They stop work and school, attend programs of solemn remembrance, and perform personal commemorations for loved ones lost while refraining from singing, dancing, and other forms of celebration. Many visit the Kigali Memorial Center, which was opened in April 2004 on the 10th Anniversary of the Rwandan genocide. The Center is built in the city of Kigali on a site where an estimated 250,000 victims of the genocide are buried in mass graves. The Center includes exhibitions of all the major genocides around the world while emphasizing the Rwandan genocide, where close to one million died during 100 days of continuous murder and torture. The memorial includes thousands of photos of babies and children who were lost, as well as graphic descriptions and photos of the actual genocide. Upon visiting the memorial, the American team involved in the current study found themselves using TFT to self-treat for the traumatic experience of viewing the haunting images, mass graves, and other evidence of a massacre of such unimaginable magnitude.

While the Kigali Memorial Center and annual two-week mourning period are part of the country’s healing and determination that lessons be learned so such human atrocities never happen again, visits to the Center and the concentrated focus on the genocide can also be re-traumatizing for those who lived through the horrors. Many of the orphans experienced intensification of their symptoms during the orphanage’s two-week annual observance. Cultural beliefs may also unwittingly intensify symptoms. For instance, Rwandan psychiatrist Dr. Athanase Hagengimana observed that the Rwandan reaction to trauma is often somatic and frequently involves panic symptoms such as shortness of breath (Wulsin & Hagengimana, 1998). In Rwandan culture, shortness of breath may be interpreted as having been caused by an ancestor who never received proper burial. During the genocide, proper burials were often not feasible, so normal reactions to re-experiencing the trauma during the two-week observance could resurface and exacerbate the unsolvable dilemma that loved ones had not received proper burial, as well as to engender a sense of powerlessness in the presence of the symptom (Hagengimana et al., 2003). While previous studies have shown that TFT can be helpful in addressing the somatic manifestations of trauma (Sakai et al., 2001), such cultural dynamics must be understood by the therapist.

The current study and its one-year follow-up were, by design, both carried out during the two-week anniversary observance. Besides the practical matter that the orphans were then available for treatment, planning the follow-up assessments during the mourning observances allowed a more robust test of the durability of the treatment outcomes as any reactivated PTSD was likely to be at its height during this period. An interesting observation at the one-year follow-up interviews and assessments was that participants who reported a return of trauma symptoms at the start of the anniversary observance consistently demonstrated to the team, unsolicited, how they had self-treated using TFT and described how their symptoms remitted.

Illustrative case vignettes

Two accounts of the 50 TFT treatment sessions (both cases treated by the first author as part of the current study) illustrate PTSD treatments using TFT within this social context.

First case.

A 15-year-old girl, one of the few survivors from her village, was three at the time of the genocide. Her family and other villagers had taken refuge inside the local church. At dusk, men bearing machetes stormed into the church and started a massacre. The girl related how her father told her to run and not look back for any reason. She started to run as fast as she could. However, she heard her father yelling and screaming in a frenzied, frantic way, "like a crazy man." Even though she remembered that he had said not to look back, she kept hearing him scream and turned to see what was happening. She watched, horrified, as a group of men with machetes murdered her father.

Every day following the attack, which had occurred 12 years earlier, she had flashbacks ("daymares") of seeing her father being killed as well as unrelenting nightmares about the scene. As we added tapping on the specific acupuncture points to her telling of the story, her heart-wrenching sobbing and depressed affect suddenly transformed into smiles. When I asked her what happened, she reported having accessed fond memories. For the first time she could remember her father and family playing together. She said that until now she had no childhood memories besides the genocide.

Then I directed her back to her feelings when she thought about what had happened in the church. The interpreter, who was a pastor, looked at me hesitantly, as if to ask: "Why are you are bringing it back up again when she was doing fine?" But we needed a complete treatment. The girl started crying again as she remembered seeing other people being killed. She recalled how she had escaped, and she realized that her father’s quick thinking had saved her life by getting her to run while distracting the perpetrators' attention.

We continued to work through each of the traumatic events using the same tapping protocol. She cried upon re-experiencing each of the horrors she witnessed while hiding outside with another young child. After about 15 or 20 minutes focusing and treating the intense disturbing affect brought up by this and a number of other scenes, she started laughing. I asked her what was coming up for her and she talked about her father. Her mother didn’t want the children eating sweet fruits because they were not good for their teeth. But her father would sneak them home in his pockets and when her mother wasn’t looking, he would give them to the children. She was laughing wholeheartedly, and we laughed with her. We processed a number of additional scenes. Finally when asked "What comes up now as you remember what happened at the church," she said thoughtfully, and without tears, that she could still remember what happened, but that it was no longer vivid as if it were still happening. It was now faded in the distance, like something from long ago. She started to talk about other fond memories. Her depressed countenance and posture were no longer evident. When she was seen again during the next two days, she described how for the first time she had no flashbacks or nightmares and was able to sleep well. She looked cheerful and told us how elated she was about having happy memories about her family.

Second case.

A 13 year-old-boy related that he was terrified of the dark. There was no electricity or lights at the orphanage, so he would sit on his bed when the sun went down and tremble. He would be shaking and scared until the other children came to bed. Genocide traumas often occurred at dusk. We focused on his fear of the dark, and the genocide stories he had been told by older survivors. He grinned from ear to ear as the TFT treatment algorithm was completed. He proudly announced at the end of the session, "I am not afraid of the dark any more."

When we arrived the next day, he excitedly greeted our bus and was bubbling over with joy. He had been able to play with the other children after dusk until bed time the night before. He was “high fiving” the treatment team with exuberance and a broad, triumphant grin. Not being able to play with the others after dark had made a huge difference in the quality of his life at the orphanage. He said he wanted to show how he felt inside, and he did a somersault and said he finally felt free! He was so appreciative of what he referred to as “getting my life back” that when we were leaving Rwanda, he tried to give me one of his three marbles as a gesture of appreciation. His only possessions were his clothes, his slippers, his blanket, and three marbles.

Follow-up assessments

The 3-month, 6-month, and 12-month assessments all used PROPS and CROPS ratings as well as informal interviews. The elimination or strong reduction of nightmares and flashbacks (daymares) were frequently mentioned. The three teachers who did the original ratings were available for all three subsequent assessments and each rated the same students they had rated immediately before and after the treatment. All 50 adolescents were also available for each of the subsequent assessments (a few were no longer at the orphanage but were notified and voluntarily returned for the assessments).

Follow-up mean scores were significantly lower than pre-treatment scores on all measures. At one year, they were almost identical to the scores immediately following treatment (PROPS mean score of 8.52 immediately after treatment and 8.24 a year later; CROPS mean scores of 10.68 and 11.71, respectively). However, at the 3-month follow-up, the orphanage was in a crisis that might have led to its having to close. This had the orphans, as well as their caregivers, under a great deal of fear and stress. This fear and stress was reflected in the 3-month ratings, which spiked to 16.69 on the PROPS (still, the pre-treatment score was 35.23) and 17.08 on the CROPS (pre-treatment score was 23.55). By the 6-month follow-up, the crisis had passed and the mean scores had come down to close to the immediate post-treatment scores (PROPS 8.86; CROPS 14.70).

These follow-up ratings, however, reveal very little about the lasting impact of the initial treatment sessions. After working with the 50 adolescents that were part of this study during the first three days of the two-week mourning period, the treatment team turned its attention to the remaining 350 children. Since the initial 50 had the greatest signs of psychological disturbance, and also because they were participants in this study, they all received individual treatments. Group sessions were often used with the remaining children, while individual sessions were reserved for those whose responses in the group sessions indicated a need for individualized attention. As a result, tapping for psychological difficulties, whether traumatic memories or problematic emotions, became part of the community’s culture. If a boy woke up screaming in the middle of the night, his bunkmates would guide him in tapping to help him go back to sleep. Sometimes one child would start self-tapping for an undisclosed problem and seven or eight others would start self-tapping as well. This mutual support was particularly evident to the treatment team upon returning for the one-year follow-up, seeing and hearing about the students helping one another with reactions to the genocide anniversary. The low scores on PTSD symptoms at one-year follow-up suggest that a) the initial TFT session or b) the subsequent self-application of TFT helped preserve the gains recorded immediately after the first treatment session, but it is not clear which, or if the combination was necessary.

Limitations of the Study and Implications for Further Investigation

The current investigation was an uncontrolled outcome study utilizing a standardized self-report inventory, a standardized caregiver inventory, both patterned after DSM IV criteria for PTSD, and SUD self-ratings. A randomized controlled trial that compared TFT with a wait list control and a recognized PTSD treatment such as CBT, using the same measures, would be a next step for future investigations.

In the current investigation, the therapists who provided the treatment also designed the study, selected the assessment instruments, supervised the data collection, chose the person who performed the statistical analysis, and wrote the final narrative. While scientific procedures were adhered to faithfully, allegiance to the approach being studied and other biasing factors may have influenced the findings.

Outcome assessments were based on self-reports by the participants (SUD and CROPS ratings) and on subjective reports (PROPS ratings) by teachers or caregivers who were involved in the lives of each participant, leading themselves to subjective bias. Confidence in the current findings could have been strengthened if independent observer-assessors had been used or if the outcome assessments were supplemented by more in-depth measures. Possibilities to consider for subsequent research might include (a) formal interviews structured around PTSD criteria or (b) behavioral measures such as school grades or frequency of incidents where disciplinary action was required.

The relaxation and breathing sessions, initially introduced to control for placebo effects and other artifacts, ultimately became confounding variables. While there is no evidence or logic suggesting that four minutes of training in a relaxation technique and two minutes of training in a breathing technique would reverse severe longstanding PTSD, their influences on the clinical outcomes could not be ascertained. However, at the one year follow-up, there were no reports of self-administered progressive relaxation or diaphragmatic breathing, with the participants reporting and demonstrating use of TFT when asked what they found to be most useful to them.

A minor confounding variable in the study was that after the participants received their TFT session, they became enthused about the relief they experienced and spontaneously shared what was helpful to them with their classmates or bunkmates. As a result, some of the participants were already familiar with and had preconceptions about the treatment protocol before receiving their TFT session. In addition, the field conditions were such that, although the participants were beyond hearing distance while waiting to be treated, they could observe those being treated at the far end of the warehouse classroom. As they watched crying, depressed, or angry classmates come into smiles and laughter, they keenly observed what they were doing that seemed to bring about these changes. The meridian tapping was visible, and a few of the children learned the basic procedure as they waited for their turn. This and the sharing of the method with peers who had not yet had their treatment session may have created an unmeasured expectation effect in a small proportion of the participants.

The meaning of the one-year follow-up CROPS and PROPS scores is unclear. The increase in PTSD symptoms at the three-month follow-up and the reduction down to post-treatment levels at the one-year follow-up may have been a result of the crisis that was occurring at the orphanage at the time of the three-month follow-up, as speculated above, but the trend may have been due to entirely different, unknown factors. Moreover, since use of tapping procedures for emotional difficulties became part of the culture at the orphanage, the impact of the initial treatment cannot be separated from the impact of the change in culture which perpetuated the use of TFT as a self- or group-initiated psychological relief measure. The combination, however, seemed potent and it is standard procedure that following TFT treatments, clients are taught to use the method on a self-help basis routinely or as-needed.

CONCLUSIONS

The last-minute change in design, where only a single TFT treatment session was administered, instead of the three that were initially planned, seemed likely to compromise the study. In the end, however, it provided the basis of one of the most striking dimensions of the study’s findings: a single TFT session of 20 to 60 minutes brought about a marked reduction in symptoms of a large majority of adolescents who had suffered with severe PTSD for more than a decade. Controlled research studies are now needed to substantiate these preliminary findings.

A recent randomized controlled trial referred to earlier (Church et al., 2009) also used a one-session treatment design, working with 16 institutionalized adolescent boys in Peru, all of whom had been abused and showed symptoms of PTSD on standardized inventories. The reduction in PTSD symptoms, following a single session of a derivative of TFT for the 8 participants in the treatment group, was highly significant (p < .001) while none of the 8 participants in the wait list control group showed a significant change on subsequent testing. Neither the authors of this study nor of the Peru study (D. Church, March 21, 2010, personal communication), however, are recommending that a single session is the ideal format for treating longstanding PTSD. The single-session design in both cases was done for expediency, and both teams of investigators were surprised by the strength of the outcomes. Both teams also recognized that additional sessions might have benefited an unknown proportion of the participants.

As a post-script, after the treatment team completed the initial two-week individual and group treatments with the 400 children and adolescents, they trained the caregivers so they could follow up as needed as well as introduce the approach to children new to the orphanage. Reports have been encouraging that the skills could be successfully transferred from the treatment team to the staff to the children. With the wounds of massive and wide-scale trauma appearing in so many parts of the world, an approach that appears unusually effective and that can be readily taught to and implemented by community leaders would seem worthy of intensive investigation.

REFERENCES

Callahan, R.J. (1981). A rapid treatment for phobias. The proceedings of the International Journal of Applied Kinesiology.

Callahan, R. J. (1995). A Thought Field Therapy (TFT) algorithm for trauma: A reproducible experiment in psychotherapy. Paper presented at the 105th Annual Convention of the American Psychological Association.

Callahan, R. J. (2001). Tapping the healer within. New York: Contemporary.

Callahan, R. J., & Callahan, J. (2000). Stop the nightmares of trauma: Thought Field Therapy. Chapel Hill: Professional Press.

Church, D., Hawk, C., Brooks, A., Toukolehto, O., Wren, M., Dinter, I., & Stein, P. (2010, April). Psychological trauma in veterans using EFT (Emotional Freedom Techniques): A randomized controlled trial. Poster session at the 31st Annual Meeting & Scientific Sessions of the Society of Behavioral Medicine, Seattle, April 7-10, 2010. Retrieved April 7, 2010, from http://www.stressproject.org/documents/ptsdreport.pdf

Church, D., Pina, O., Reaegui, C., & Brooks, A. (2009, October). Single session reduction of the intensity of traumatic memories in abused adolescents: A randomized controlled trial. Paper presented at the Eleventh Annual Toronto Energy Psychology Conference, October 15-19, 2009, from http://soulmedicineinstitute.org/children.pdf

Committee on Treatment of Posttraumatic Stress Disorder. (2008). Treatment of posttraumatic stress disorder: An assessment of the evidence. Washington, D.C.: Institute of Medicine of the National Academies.

Ehnthold, K. A., & Yule, W. (2006). Practitioner review: Assessment and treatment of refugee children and adolescents who have experienced war-related trauma. Journal of Child Psychology and Psychiatry, 47, 1197-1210.

Feinstein, D. (2008). Energy psychology in disaster relief. Traumatology, 14, 124–137.

Feinstein, D. (in press). Rapid treatment for PTSD: Why psychological exposure with acupoint tapping is effective. Psychotherapy: Research, Practice, Training.

Folkes, C. (2002). Thought Field Therapy and trauma recovery. International Journal of Emergency Mental Health, 4(2), 99-103.

Greenwald, R., & Rubin. A. (1999). Brief assessment of children’s posttraumatic symptoms: Development and preliminary validation of parent and child scales. Research in Social Work Practice, 9, 61-75.

Hagengimana, A., Hinton, D., Bird, B., Pollack, M., & Pitman, R.K. (2003). Somatic panic-attack equivalents in a community sample of Rwandan widows who survived the 1994 genocide. Psychiatry Research, 117(1), 1-9.

Johnson, C., Shala, M., Sejdijaj, X., Odell, R., & Dabishevci, K. (2001). Thought Field Therapy—Soothing the bad moments of Kosovo. Journal of Clinical Psychology, 57(10), 1237-1240.

Kazdin, A. E. (1982). Single-case research designs: Methods for clinical and applied settings. New York: Oxford University Press.

Kienzler, H. (2008). Debating war-trauma and post-traumatic stress disorder (PTSD) in an interdisciplinary arena. Social Science & Medicine, 67, 218-227.

Miller, K.E., Kukarni, M., & Kushner, H. (2006). Beyond trauma-focused psychiatric epidemiology: Bridging research and practice with war-affected populations. American Journal of Orthopsychiatry, 76(4), 409-422.

Monson, C. M., Schnurr, P. P., Resick, P. A., Friedman, M.J., Young-Xu, Y, & Stevens, S. P. (2006). Cognitive processing therapy for veterans with military-related posttraumatic stress disorder. J Consulting and Clinical Psychology, 74, 898-207.

Sakai, C., Paperny, D., Mathews, M., Tanida, G., Boyd, G., Simons, A., et al. (2001). Thought Field Therapy clinical applications: Utilization in an HMO in Behavioral Medicine and Behavioral Health Services. Journal of Clinical Psychology, 57(10), 1215-1227.

Schaal, S., & Elbert, T. (2006). Ten years after the genocide: Trauma confrontation and posttraumatic stress in Rwandan adolescence. Journal of Traumatic Stress, 19 (1), 95-105.

Stallard, P. (2006). Psychological interventions for post-traumatic reactions in children and young people: A review of randomized controlled trials. Clinical Psychology Review, 26 (7), 895-911.

Thabet, A. A., & Vostanis, P. (2000). Post traumatic stress disorder reactions in children of war: A longitudinal study. Child Abuse & Neglect, 24, 291-298.). Post traumatic stress disorder reactions in children of war: A longitudinal study. Child Abuse & Neglect, 24, 291-298.

Wulsin, L. & Hagengimana, A. (1998). PTSD in survivors of Rwanda’s 1994 war. Psychiatric Times, April, 12-13.

Wolpe, J. (1973). The practice of behavior therapy (2nd ed.). New York: Elsevier.

Ziegler, M. F. (2010). Mental health consequences of trauma: The unseen scars. Clinical Pediatric Emergency Medicine, 11, 57-64.

Bron: http://www.tftcenter.com/articles_treatment_of_ptsd_rwanda.html

Key Words: EFT onderzoek, EFT research, Sakai, 2010, PTSD.

1
Single Session Reduction of the Intensity of
Traumatic Memories in Abused Adolescents:
A Randomized Controlled Trial
Dawson Church, PhD1 Oscar Piña, LPC2 Carla Reategui, LPC3 Audrey Brooks, PhD4
Abstract

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 on the Impact of Events scale (IES), which measures two components of
PTSD: intrusive memories and avoidance symptoms. The experimental group was treated
with a single session of EFT (Emotional Freedom Techniques), a brief and novel
exposure therapy that has been found efficacious in reducing PTSD and co-occurring
psychological symptoms in adults, but has not been subject to empirical assessment in
juveniles. The wait list control group received no treatment. Thirty days later subjects
were reassessed. No improvement occurred in the wait list (IES total mean pre=32 SD
±4.82, post=31 SD ±3.84). Posttest scores for all experimental group subjects improved
to the point where all were non-clinical on the total score (IES total mean pre=36 SD
±4.74, post=3 SD ±2.60, p<0.001), as well as the intrusive and avoidant symptom
subscales. 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.

Keywords: adolescents, PTSD, memories, affect, trauma, EFT (Emotional Freedom
Techniques).

1 Foundation for Epigenetic Medicine, Santa Rosa, California. Please address all correspondence
to dawson@soulmedicine.net. This data was presented at the eleventh annual EP conference,
Toronto, Canada, Oct 17, 2009.
2 Cesar Vallejo University, Trujillo, Peru
3 Cesar Vallejo University, Trujillo, Peru
4 Department of Psychology, University of Arizona at Tucson

Key words: EFT onderzoek, EFT research,

zie de PDF

Maria Salas, PhD, Audrey J. Brooks, PhD, Jack E. Rowe, PhD.

Explore: The Journal of Science and Healing, (2010), 6(5) (in press).

Abstract

This study examined whether Emotional Freedom Techniques (EFT), a brief exposure therapy that combines cognitive and somatic elements, had an immediate effect on the reduction of anxiety and behavior associated with specific phobias.  The present study utilized a cross-over design with participants (N=22) randomly assigned to either diaphragmatic breathing or EFT as the first treatment. Study measures included a behavioral approach test, Subjective Units of Distress Scale, and Beck Anxiety Inventory.  EFT significantly reduced phobia-related anxiety and ability to approach the feared stimulus whether presented as an initial treatment or following diaphragmatic breathing. When presented as the initial treatment, the effects of EFT remained through the presentation of the comparison intervention. Further study of EFT for specific phobias is warranted.

Keywords: Specific phobias, energy psychology, Emotional Freedom Techniques (EFT), anxiety, exposure treatment.

Click here for Explore's home page if you wish to purchase a full text copy of the study.

Peta Stapleton, PhD, School of Medicine, Griffith University

Teri Sheldon, Lakeside Rooms

Submitted for publication and in peer review.

Abstract

Objective: Food craving was hypothesised to be an important intervening causal variable in the development of obesity. This randomised, single-blind, clinical trial tested whether Emotional Freedom Techniques (EFT) reduced food cravings in participants under laboratory-controlled conditions.

Keywords: food, cravings, restraint, weight loss, body mass index, EFT (Emotional Freedom Techniques).

Adv Mind Body Med. 2008 Winter;23(4):10-9.

The heart field effect: Synchronization of healer-subject heart rates in energy therapy.

Bair CC.

PMID: 20664147 [PubMed - in process]

Wetenschappelijk onderzoek naar EFT en slachtofferopvang

NOTE: The following is an expanded version of Feinstein, D. (2008). Energy Psychology
in Disaster Relief. Traumatology. 14(1), 124-137.

Energy Psychology in Disaster Relief

By David Feinstein, Ph.D.

Download as PDF

Abstract

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.

Comments on an earlier draft of this paper by Douglas J. Moore, Ph.D., are gratefully acknowledged.

This paper is part of a course available for Home Study and Continuing Education credit.  Preview the course and exam details.

Energy psychology, as most commonly practiced in clinical and post-disaster situations, is an exposure-based treatment. The effectiveness of exposure therapies with PTSD and other anxiety disorders is well established. Exposure is, in fact, the single modality for which the evidence is sufficient to conclude, according to stringent scientific standards (National Institute of Medicine's Committee on Treatment of Posttraumatic Stress Disorder, 2007), that the method is an efficacious treatment for PTSD. Other treatments that have strong empirical support in treating PTSD, such as cognitive-processing therapy, stress inoculation training, and eye movement desensitization and reprocessing (EMDR ), also generally incorporate substantial exposure components (Keane, Foa, Friedman, Cohen, & Newman, 2007).

In energy psychology, as with other exposure-based treatments, exposure is achieved by eliciting-through imagery, narrative, and/or in-vivo experience-hyperarousal associated with a traumatic memory or threatening situation. Unique to energy psychology is that extinction of this association is facilitated by 1) the manual stimulation of acupuncture or related points that are believed to 2) send signals to the amygdala and other brain structures that 3) quickly reduce hyperarousal. When the brain then reconsolidates the traumatic memory, the new association (to reduced hyperarousal or no hyperarousal) is retained. According to practitioners, this leads to treatment outcomes that are more rapid (less time; fewer repetitions) and more powerful (higher impact; greater reach) than the strategies used by other exposure-based treatments that are available to them, such as relaxation, desensitization, mindfulness, flooding, or repeated exposure. Another clinical strength reported by practitioners is increased precision, and thus less chance of retraumatization. By being able to quickly reduce hyperarousal to a targeted stimulus, numerous aspects or variations of a problem may be identified, precisely formulated, and treated within a single session.

While empirical validation for the effectiveness of the use of acupressure points in energy psychology is still in a relatively early stage, striking treatment successes in the aftermath of severe trauma are being reported by a broad range of credible sources, giving the psychotherapy community cause to assess the method before conclusive research is available. This paper offers a context for such inquiry as well as a framework for applying EP following natural and human-made disasters.

Four Tiers of EP

The efficacy and mechanisms of EP have been matters of controversy (Feinstein, in press), and even as basic a question as whether EP is an isolated technique, equivalent for instance to systematic desensitization, or a more comprehensive psychotherapy, has been an area of confusion. A review of the major EP texts (e.g., Callahan & Trubo, 2002; Diepold, Britt, & Bender, 2004; Feinstein, 2004; Feinstein, Eden, & Craig, 2005; Gallo, 2002; Gallo, 2004; Mollon, 2008) shows four tiers of EP interventions: immediate relief/stabilization, extinguishing conditioned responses, overcoming complex psychological problems, and promoting optimal functioning:

1. Immediate Relief/Stabilization. Much as a paramedic might instruct a patient having an anxiety attack in a breath control technique that is incompatible with hyperventilation, EP utilizes in vivo interventions believed to be incompatible with limbic hyperarousal. Tapping on specified acupuncture points whose stimulation has been shown to decrease activation signals in the amygdala (Hui, et al., 2000), for instance, appears to rapidly decrease elevated emotional responses in stressful situations. This simple procedure is proving itself to be a potent intervention for providing psychological first aid in the immediate aftermath of disaster.

2. Extinguishing Conditioned Responses. Similar techniques are applied for extinguishing a maladaptive conditioned response, such as a phobia or irrational rage. EP exposure treatments target the response to internal or external cues that trigger dysfunctional fear, aggression, or avoidance. By eliminating the limbic hyperarousal caused by the triggering cue, associated problematic affective, cognitive, and behavioral patterns may be interrupted.

3. Overcoming Complex Psychological Problems. An EP approach identifies and targets salient aspects of complex problems. Aspects of low self-esteem, for instance, might include unresolved memories of parental emotional abuse, self-defeating beliefs, exaggerated appraisals of interpersonal threat, and anxiety in social situations. The combination of acupoint stimulation with the mental activation of carefully selected scenes, feelings, or beliefs may be applied to the elements of a complex psychological problem, one by one.

4. Promoting Optimal Functioning. Beyond its uses in helping people cope with and overcome psychological problems, EP interventions may be applied to alter self-concept, affect, and motivation in ways that promote confidence, optimism, courage, peak performance, social skills, and feelings of spiritual connectedness.

At these third and fourth tiers, EP is often integrated with other clinical or personal development approaches. In treating obsessive-compulsive disorders, for instance, strategies from Cognitive Behavior Therapy (CBT) may provide a framework as EP techniques are employed for rapidly reducing activation in response to specific cues. In enhancing personal resilience, strategies from Positive Psychology (such as the "building of buffering strengths" like perseverance or a capacity for pleasure, Seligman, 2002, pp. 6 - 7) may provide a framework as EP techniques are employed to instill such strengths.

EP includes a variety of protocols (at least two dozen variations have been identified) that generally fall within the field of energy medicine (Feinstein & Eden, 2008), much as psychiatry is a specialty within conventional medicine. Energy medicine is recognized by the National Institutes of Health (NIH) as a form of "complementary and alternative medicine" that is based on the supposition that illness results from disturbances in the body's electromagnetic energies and energy fields (National Center for Complementary and Alternative Medicine of NIH, 2005). Energy psychology focuses on these energies for the purpose of alleviating psychological problems and pursuing personal goals. The most well-known variations are Thought Field Therapy (TFT), the Emotional Freedom Techniques (EFT), and the Tapas Acupressure Technique (TAT). TFT is one of the earliest formulations of EP, developed in the 1980s by Roger Callahan. EFT is a streamlined variation of TFT that can be used by the general public outside clinical settings, originated by Gary Craig after studying with Callahan. TAT was developed by acupuncturist Tapas Fleming. All three utilize non-needle methods of stimulating acupuncture points (acupoints) for the purpose of inducing positive psychological change. TFT, EFT, and TAT have been by far the most widely utilized and investigated EP approaches and will be the focus of this paper.

Controversies

As an approach whose procedures may look patently strange (such as tapping on the back of one's hand while humming a tune), whose explanatory models are derived from paradigms based in another culture, and whose advocates have made strong claims of efficacy without adequate research validation, EP has been exceedingly controversial among psychotherapists. Ray Corsini, editor of one of the few standard psychology texts to mention EP, explains his choice to include a chapter on such an "outlandish" approach by noting that TFT "is either one of the greatest advances in psychotherapy or it is a hoax" (2001, p. 689). The Continuing Professional Education Committee (CPEC) of the Education Directorate of the American Psychological Association (APA), developed a special regulation for EP that leans toward the "hoax" appraisal. Rather than following its usual procedure of having APA CE sponsors make their own determinations about a new approach according to established CPEC guidelines, the Committee took the unprecedented step in 1999 of notifying its CE sponsors by a memo that they risked losing their sponsorship status if they offered APA CE credit for courses in TFT (Murray, 1999). This policy was still in effect at the time of this writing and had been broadened to include all energy psychology courses.

Nonetheless, the number of therapists incorporating its methods into their practices has been increasing steadily since the approach was introduced in the 1980s. EFT Insights, an e-newsletter that provides instruction on how to utilize EFT on a professional as well as self-help basis, had 368,000 active subscribers at the time of this writing, and this number was showing a net increase of more than 7,000 per month (G. Craig, personal communication, December 27, 2007). EP is increasingly recognized in Europe, with "Advanced Energy Psychology" qualifying as continuing education for psychologists, physicians, and related professions in several countries, including Germany, Austria, and Switzerland. An international professional organization, the Association for Comprehensive Energy Psychology, was incorporated in the U.S. in 1999 and has developed a comprehensive certification program and ethics code. A review of one of EP's major texts (Energy Psychology Interactive; Feinstein, 2004) in the APA's online book review journal describes energy psychology as "a new discipline that has been receiving attention due to its speed and effectiveness with difficult cases" (Serlin, 2005). The review, by a former APA division president, notes that because EP successfully "integrates ancient Eastern practices with Western psychology [it constitutes] a valuable expansion of the traditional biopsychosocial model of psychology to include the dimension of energy."

Evidence

Although the evidence is still preliminary and the number of randomized clinical trials limited, energy psychology has reached the minimum threshold for being considered an evidence-based therapy, with EFT having met the APA Division 12 criteria as a "probably efficacious treatment" for specific phobias and with TAT having met the "probably efficacious" criteria for maintaining weight loss (Feinstein, in press). Imaginal exposure plus acupoint tapping was shown, for instance, to be superior to imaginal exposure plus diaphragmatic breathing in treating phobias of bugs and small animals (Wells, Polglase, Andrews, Carrington, & Baker, 2003). Three well-designed randomized clinical trials have shown a single EFT session to be more effective than other treatment conditions in alleviating specific phobias, another has shown EP to be effective for treating public speaking anxiety, another for test-taking anxiety, and another in weight control (reviewed in Feinstein, in press). Four additional randomized clinical trials surveyed in the same review reported statistical superiority in speed or effectiveness between EP and another treatment or wait-list condition, but experimental design flaws led the reviewer to categorize each study as having limited generalizability. Two large exploratory outcome studies that did not use control conditions and were published without peer-review (Andrade & Feinstein, 2004; Sakai, Paperny, Mathews, Tanida, Boyd, & Simons, 2001) found EP to produce strong subjective improvement on a spectrum of anxiety disorders and a wide range of other non-psychotic psychiatric conditions. Most research on EP, however, has been limited to anxiety-related disorders, and no randomized clinical trials have been conducted specifically in the treatment of disaster survivors.

Reports from the field, however, show a pattern of strong outcomes following the use of EP both immediately following disasters and in the subsequent treatment of PTSD. Hundreds of reports track the use of EP in the aftermath of wars and ethnic cleansing. Many of these accounts corroborate one another in terms of rapid relief and long-term benefits, yet the state of the art in applying EP following disasters still resides largely with the practitioners who have been carrying out such work. The author interviewed eight EP practitioners who are associated with disaster relief organizations and engaged in e-mail dialogue with the leadership of three of those disaster relief organizations. The purpose of these interviews was to attempt to find where consensus exists among experienced practitioners regarding post-disaster uses of EP and also to collect anecdotal evidence from the field. While such anecdotal reports are only a preliminary form of evidence, they are consistent and compelling enough to warrant attention. Several of these cases are posted.

In one report, the industrial coordinator for Pittsburgh's Critical Incident Stress Management team describes the psychological symptoms and rapid response to EP in a variety of workers who have been involved in the accidental deaths of colleagues and friends. In another report, a disaster worker who utilizes EP describes the almost instant amelioration of symptoms of shock with two women hospitalized for injuries sustained three days earlier during the 1998 bombing of the U.S. embassy in Narobi. In a third, a social worker details the successful three-session treatment of debilitating PTSD symptoms with a woman who had been a close bystander during the World Trade Center bombings.

Carl Johnson, a clinical psychologist retired from a career as a PTSD specialist with the Veteran's Administration (V.A.) has, for nearly two decades, frequently traveled to the sites of some of the world's most terrible atrocities and disasters to provide psychological support using EP methods. About a year after NATO put an end to the ethnic cleansing in Kosovo, Johnson found himself in a trailer in a small village where the brutalities had been particularly severe. A local physician who had offered to refer people in his village had posted a sign that treatments for war-related trauma (nightmares, insomnia, intrusive memories, inability to concentrate, et cetera) were being offered. Johnson described how, as a line of people had formed outside of the trailer, the referring physician told him, with some concern, that everyone in the village was afraid of one of the men who was waiting outside for treatment.

The others in the line had actually positioned themselves as far away from this man as possible. Johnson asked the physician to invite the man into the trailer. Johnson, who after a career in the V.A. is seasoned in working with war veterans, recalled that the man "had a vicious look; he felt dangerous." But he had come for help, so with the physician translating, Johnson asked the man to bring to mind his most difficult memory from the war. Everyone in the village was haunted by traumas of unspeakable proportion: torture, rape, witnessing the massacre of loved ones. As the man brought the trauma to mind, his face tensed and reddened and his breathing quickened. Though he never put his memory into words, the treatment began. Johnson tapped on specific acupoints that he determined to be relevant to the trauma. He then instructed the man, through the interpreter, to do a number of eye movements and other simple physical activities designed to accelerate the process. Then more tapping. Within fifteen minutes, according to Johnson, the man's demeanor had changed completely. His face had relaxed and his breathing normalized. He no longer looked vicious. In fact, he was openly expressing joy and relief. He initiated hugs with both Johnson and the physician. Then, still grinning, he abruptly walked outside, jumped into his car and roared away, as everyone watched perplexed.

The man's wife was also in the group waiting for treatment. In addition to the suffering she had faced during the war, she had become a victim of her husband's rage. The traumas she identified also responded rapidly to the tapping treatment. About the time her treatment was completed, her husband's car roared back to the waiting area. He came in with a bag of nuts and a bag of peaches, both from his home, as unsolicited payment for his treatment. He was profuse and appeared gleeful in his thanks, indicating that he felt something deep and toxic had been healed. He hugged his wife. Then, extraordinarily, he offered to escort Johnson into the hills to find trauma victims who were still in hiding, too damaged to return to life in their villages, both his own people-ethnic Albanians-and the enemy Serbs. In Johnson's words, "That afternoon, before our very eyes, we saw this vicious man, filled with hate, become a loving man of peace and mercy." Johnson further reflected how often this would occur, that when these traumatized survivors were able to gain emotional resolution on experiences that had been haunting them, they became markedly more loving and creative. While survivors, even after a breakthrough session like this, are still left with the formidable task of rebuilding their lives, the treatment disengaged the intense limbic response from cues and memories tied to the disaster, freeing them to move forward more adaptively.

The 105 people treated during Johnson's first five visits to Kosovo, all in 2000, had each been suffering for longer than a year from the post-traumatic emotional effects of 249 discrete, horrific self-identified incidents. For 247 of those 249 memories, the treatments (using TFT) successfully reduced the reported degree of emotional distress not just to a manageable level but to a "no distress" level ("0" on a 0-to-10 "Subjective Units of Distress" scale, after Wolpe, 1958). Although these figures strain credibility, they are consistent with other reports (see below). Approximately three-fourths of the 105 individuals were followed for 18 months after their treatments and showed no relapses-the original memory no longer activated self-reported or observable signs of traumatic stress (Johnson, Mustafe, Sejdijaj, Odell, & Dabishevci, 2001).

Johnson made a total of nine trips to Kosovo between February 2000 and June 2002. His later visits were as much to train local health care providers in TFT as to treat additional patients. The follow-up information on approximately 75 percent of the people he worked with during his first five visits came primarily from physicians who had identified traumatized individuals from their practices and participated as translators in the initial TFT treatments. Since they continued to care medically for the individuals, they were able to provide follow-up on the TFT sessions. Their reports consistently suggested that once a memory had been cleared of its emotional charge, it remained clear, though other memories might subsequently be presented for treatment. The initial session, however, appeared to have durably neutralized the hyperarousal to the traumatic memories that were identified along with producing marked improvement in overall coping and sense of well-being. Reports of these outcomes came to the attention of the chief medical officer of Kosovo (the equivalent of the U.S. Surgeon General), Dr. Skkelzen Syla (himself a psychiatrist), who investigated them and subsequently stated in a letter of appreciation on January 21, 2001:

Many well-funded relief organizations have treated the posttraumatic stress here in Kosova. Some of our people had limited improvement but Kosova had no major change or real hope until . . . we referred our most difficult trauma patients to [Dr. Johnson and his team]. The success from TFT was 100% for every patient, and they are still smiling until this day [and, indeed, in the follow-ups, each was free of relapse].

Johnson kept a simple but ultimately provocative set of statistics during his visits to Kosovo and other areas of ethnic cleansing, warfare, and natural disasters. He tracked the number of people treated, the number of traumatic incidents identified, and the number of incidents where full relief was reported (i.e., hyperarousal to the traumatic memory was completely neutralized according to the person's subjective report). Table 1 shows his tally.

Table 1: Johnson's Tally of Energy Psychology Treatment Outcomes Following Disasters

Johnson, who holds diplomate status with the American Board of Professional Psychology, acknowledges that such figures raise even his own skepticism. While recognizing that "well-controlled research is essential before results like these can be accepted," he affirms that the figures accurately reflect his experiences and that he "recorded them exactly according to what happened." After interviewing Johnson, the author of this paper interviewed several therapists who worked on these teams, and their reports corroborate Johnson's. Johnson emphasizes that reducing the impact of traumatic memories with EP, as reflected in the above numbers, is not the end of a person's healing journey. "Often," however, "it is a new beginning," providing people an opportunity to rebuild their lives without the oppressive emotional weight of their traumatization. To this end, Johnson takes great care to integrate the EP treatment into the context of the local culture's values, social structure, family relationships, and healing traditions to support continued healing and follow-up.

As well as being corroborated by interviews with the therapists who worked with Johnson in Kosovo and in Africa, Johnson's reports are also consistent with what other disaster workers are describing. Clinicians from a wide range of backgrounds are reporting that EP treatments can rapidly clear much of the emotional overwhelm associated with traumatic memories. For example, 29 low-income refugees and immigrants living in the U.S. who were categorized as having the symptoms of PTSD based on having met a cut-off score on the Postrauamtic Checklist-C (PCL-C) were reporting significantly less avoidance, intrusive thoughts, and hypervigilance (p < .05 for each measure) after one to three sessions of TFT (Folkes, 2002).

Particularly poignant are reports that have been coming in from the Trauma Relief Committee of the Association for Thought Field Therapy Foundation about their work with the El Shadai orphanage in Rwanda. Many of the children had seen their parents die by machete during the ethnic cleansing twelve years earlier or were reliving the horrors of the massacre of 800,000 Rwandans. Daily flashbacks and nightmares were common, as were bedwetting, depression, withdrawal, isolation, difficulty concentrating, jumpiness, and aggression. Standardized pre- and post-treatment tests for PTSD (translated into Kinyarwandan) were administered to 50 of these children (27 boys and 23 girls), ages 13 through 18, and a children's PTSD assessment tool for parents and guardians was administered to their caregivers. Treatment, provided in April and May 2006, generally involved three TFT sessions of approximately 20 minutes each. The tests were structured after DSM IV criteria for PTSD. Average symptom scores, based on both the tests taken by the children and the caregivers' observations about the children, substantially exceeded the cutoffs for a diagnosis of PTSD. Scores after the three sessions were substantially lower than the cut-offs. Immediate reductions in flashbacks, nightmares, and other symptoms were common. Retesting a year later showed that the improvements held. Details of these findings are being prepared for publication (C. Sakai, personal communication, March 7, 2008).

Lynn Garland, a social worker with the Veterans' Healthcare System in Boston, reports that she, along with numerous colleagues using EP in the V.A., are having "dramatic results in relieving both acute and chronic symptoms of combat-related trauma" (Feinstein, Eden, & Craig, 2005, p. 17). Members of the TFT Trauma Relief Committee have utilized TFT while providing disaster response services in more than a dozen countries, with strong results, consistent with those in Table 1, being reported (N. Gairdner, personal communication, November 30, 2005). The Humanitarian Committee of the Association for Comprehensive Energy Psychology (ACEP) reports corresponding observations based upon its work with some 300 tsunami victims in Southeast Asia (J. Hartung, personal communication, January 14, 2006). While systematic follow-up was not conducted, the ACEP group-drawing from TFT, EFT, and TAT- describes strong, rapid responses to the psychological aftermath of the disaster, including alleviating anxiety, depression, anger, and physical pain, as well as the successful resolution of earlier traumatic memories activated by the tsunami experience.

TAT was also used following the 2006 earthquake in Indonesia, applied by local relief workers who were provided seminars in the method's disaster relief protocol. Widespread reports of rapid relief led to some 6,000 adults and children receiving the treatment in individual and group settings. TAT has also been used following other natural disasters. Ignacio Jarero, President of the Mexican Association for Crisis Therapy, reports (on the TAT site) the use of TAT with 1,652 children after natural disasters in Mexico, Nicaragua, Colombia, and Venezuela, and its use as an adjunct to training with 642 front line service personnel in those countries. He states, "Children and adults reported significant reductions in SUDS at the completion of the protocol. . . . TAT is our favorite technique to reduce distress because it is easy to teach and apply."

The Green Cross (The Academy of Traumatology's humanitarian assistance program), which deploys counselors to disaster areas with a focus on alleviating the psychological consequences of trauma, is increasingly employing EP methods. The program, founded in 1995 in response to the Oklahoma City bombings, has recently been working closely with the TFT Trauma Relief Committee and the ACEP Humanitarian Committee to expand the number of available relief workers trained in EP methods. According to Green Cross founder Charles Figley, who also served as the chair of the committee of the Department of Veteran Affairs that first identified PTSD: "Energy psychology is rapidly proving itself to be among the most powerful psychological interventions available to disaster relief workers for helping the survivors as well as the workers themselves" (C. Figley, personal communication, December 10, 2005).

A Framework for Post-Disaster Applications of Energy Psychology

A landmark international conference, organized with the intention of developing consensus on the best practices for early psychological interventions following mass violence, was held six weeks after the September 11, 2001, NYC bombings (though it had been scheduled long before that date). An anthology that reports on and furthers the work initiated by the conference (Ritchie, Watson, & Friedman, 2006) provides consensual and evidence-based guidance to mental health workers on how to proceed in the wake of mass violence and other disasters. These reports were used in formulating the following clinical guidelines for applying EP in the aftermath of natural and human-made disasters. For context, also consider the UN Inter-Agency Standing Committee's (2007) Guidelines on Mental Health and Psychosocial Support in Emergency Settings, a widely respected resource that includes 25 "action sheets" on how to implement a coordinated community response to mental health needs in the midst of emergencies.

Who to Treat? About 95 percent of people exposed to a traumatic event will experience some posttraumatic psychological distress (Ritchie, Watson, & Friedman, 2006), and a review of 160 studies on disaster survivors suggests that one-third will develop a clinically significant chronic psychiatric disorder (Norris, Friedman, & Watson, 2002). Estimates of the numbers that will develop PTSD or other disorders that will persist for more than a year after the traumatic event range from 11 to 15 percent (Young, 2006) to 30 percent (Ritchie, Watson, & Friedman, 2006). One possible source of these differences is that the proportion of terrorism survivors who experience clinically significant psychological distress appears to be considerably higher than that for survivors of natural disasters. For refugees, who in addition to trauma face displacement, the proportion who develop PTSD is estimated at 30 to 50 percent (Kluft, Bloom, & Kinzie, 2000).

Existing studies show that most people exposed to highly traumatic events experience symptoms of posttraumatic stress or briefly incapacitating reactions, with some of them being launched into the initial stage of a chronic and potentially incapacitating psychiatric disorder. But we do not currently have reliable models for distinguishing "vulnerable from resilient individuals immediately after a terrorist attack, mass casualty, or natural disaster" (Richie, Watson, & Friedman, 2006, p. 9). Nor is there evidence suggesting that active psychotherapy immediately after a disaster would benefit either group. Numerous other types of early mental health interventions, however, have been developed.

Types of Interventions. Models of early intervention following violence or disasters have developed in response to special situations or populations, such as for soldiers in combat, high risk occupations (e.g., police, firefighters, and emergency medical personnel), rape survivors, survivors of accidents and assaults, and entire communities following a disaster (Ruzek, 2006). Combat psychiatry, for instance, has been evolving since World War I and is oriented toward reducing psychological distress and getting personnel to return to combat. The principles that have endured (known by the acronym PIES) include 1) proximity-administer the treatment close to the traumatic event, 2) immediacy-administer the treatment as soon as possible after the onset of symptoms, 3) expectancy-convey that a crisis reaction is normal and a quick return to the unit is expected, and 4) simplicity-keep the interventions easy to deliver and understand. The pragmatic outcome of getting soldiers to return to combat is well established, but the effectiveness of PIES in reducing longterm damage of trauma has received little empirical examination.

In fact, some psychological interventions immediately following disasters, such as Critical Incident Stress Debriefing, have had unanticipated negative effects (Litz, Gray, Bryant, & Adler, 2002). Debriefing did not prevent vulnerable individuals from subsequently developing PTSD, inadvertently pathologized normal stress reactions, and sometimes interfered with people's natural coping mechanisms. Some individuals are better served by a period of denial so they can rest and recover emotionally before attempting to process a severe trauma. Early interventions may open previous unresolved traumas during a period when the individual is least equipped to reconsolidate them. Some early interventions have also coerced individuals who are uneasy about disclosing personal information into sharing in ways that have negative consequences on their sense of self-worth as well as on their ongoing relationships with co-workers who might be involved in these disclosures. With the unanticipated negative effects of Critical Stress Debriefing often being cited, active psychotherapies that elicit emotional processing or detailed trauma narratives are generally not recommended immediately following a disaster. Ritchie, Watson, and Friedman (2006), for instance, caution against providing therapies whose unintended message is to pathologize normal and transient posttraumatic distress while interfering with the person's innate coping mechanisms.

Cognitive Behavior Therapy and Eye Movement Desensitization and Reprocessing (EMDR) are the only widely-recognized evidence-based treatments for PTSD (American Psychiatric Association, 2004; Britain's National Institute for Clinical Excellence, 2005). While the efficacy of CBT following other traumas is well established, there is no study of its use with disaster survivors, and recommendations about its use immediately following a disaster are offered with caution. Young, for instance, suggests that "subtle, supportive, and judicious use of cognitive reframing techniques may serve as a preliminary effort to help counter the potential negative effects of cognitive distortions" (2006, pp. 114 - 115). Ritchie, Watson, and Friedman advise that "focused cognitive interventions may be best initiated at least several weeks and possibly months after the trauma for those individuals still experiencing significant symptoms" (2006, p. 10).

While EMDR has demonstrated efficacy with PTSD following disasters, such as after the 1999 earthquake in Marmara, Turkey (Konuk, Knipe, Eke, Yuksek, Yurtsever, & Ostep, 2006), it is generally not applied immediately after a disaster. Concerns about retraumatizing the client have been an issue in the use of EMDR, and increasing numbers of EMDR practitioners are incorporating EP into their work with traumatized individuals, finding that EP methods "help a client to process trauma more efficiently" (Hartung & Galvin, 2003, p. xix).

Although the active ingredients in the demonstrated efficacy of EMDR are a matter of debate (Bryant & Litz, 2006), exposure methods are key components of EMDR and CBT, as well as EP. EP practitioners have several ways of modulating exposure. While EP does use imaginal exposure and in vivo contact, the level of distress due to imaginal exposure can be reduced by having the client "see" the scene through the wrong end of binoculars, by the use of "reminder phrases" instead of imagery, and by the "tearless trauma technique," in which the client is thinking about what it would feel like to think about the situation (Feinstein, Eden, & Craig, 2006). All seem responsive to tapping. Of the interviews conducted for this paper, several of the EP practitioners had also been trained in EMDR. Their comments suggested that 1) EP provides greater flexibility in the range of issues that can be addressed, 2) its methods can be more readily modulated by the practitioner to allow better pacing with the client, and 3) this greater flexibility and modulation greatly reduce the chances of retraumatization or abreaction often experienced with EMDR.

Counterintuitive Findings. Several counterintuitive aspects of early interventions have been identified. Levine (1997) has shown that people (as well as animals) who shake and quiver after a trauma are less likely to develop PTSD symptoms, so holding and invasively soothing a person who is shaking may actually interfere with recovery. Debriefing-where trauma survivors share, within a supportive professional context, their experiences, thoughts, and emotional reactions with colleagues and friends who were involved in the same trauma-would seem to make a great deal of intrinsic sense. Yet strong evidence shows that it can interfere with natural coping strategies in resilient people and increase rather than prevent PTSD incidence in vulnerable individuals. Ruzek (2006) discusses several assumptions at the core of various intervention models that should be examined rather than uncritically accepted.

For instance, early intervention mental health education often attempts to "normalize" acute stress reactions. This validates the natural resilience of survivors and helps them understand that their responses are normal and transient rather than signs of personal weakness or mental illness. It serves individuals for whom acute distress symptoms are going to be transient, and may be therapeutic since many affected individuals are highly suggestive immediately following a trauma. But it may also create negative consequences for survivors whose symptoms persist. Research on survivors of mass violence, in fact, shows high percentages with enduring problems, so overemphasis on the fact that most symptoms of acute stress reactions following trauma will spontaneously dissipate over time may stigmatize people who need treatment and ultimately keep them from receiving it. Another assumption, which traces back to combat psychiatry, is that it is important for mental health specialists to actively intervene as soon as possible after the trauma. Various outcome studies, however, along with concerns about pathologizing normal reactions, give "reason to question whether intervening sooner will result in better care" (Ruzek, 2006, p. 20). Common-sense assumptions about working with disaster survivors have sometimes been refuted by clinical observation, and the most viable working assumptions 24 hours after a disaster may be substantially different from the most viable working assumptions three weeks later.

Applications of EP following a disaster must be calibrated to the unique needs and constraints of each individual and to an understanding of the kinds of intervention that are appropriate at various timeframes after the disaster. Ritchie, Watson, and Friedman (2006) include chapters discussing principles for immediate responses to disaster (Ruzek, 2006; Ørner, Kent, Pfefferbaum, Raphael, & Watson, 2006; Young, 2006), interventions one to four weeks after exposure to a trauma (Bryant & Litz, 2006), and longer-term interventions (Raphael & Wooding, 2006).

Immediate Responses to a Disaster. Beyond attending to basic needs such as safety, security, food, shelter, and medical problems directly following a disaster, psychological first aid is defined as "the use of pragmatic-oriented interventions delivered during the immediate-impact phase . . . to individuals who are experiencing acute stress reactions or who appear at risk for being able to regain sufficient functional equilibrium by themselves, with the intent of aiding adaptive coping and problem-solving" (Young, 2006, p. 134). Psychological first aid is meant to be administered within the context of a larger emergency response that includes community-level assessments and responses to mental health and public health needs. While psychological first aid following disasters has not been empirically tested, it is composed of empirically defensible interventions and is "considered ‘safe' because it does not focus on emotional processing or detailed trauma narratives, is not meant to be ‘mandatory,' and should only be used" with individuals who exhibit extreme acute distress reactions or notable risk factors associated with adverse postdisaster mental health outcomes (Young, 2006, p. 135).

After establishing safety and providing basic support and mental health information relevant to the disaster, early mental health responses involve:

1) interventions that address specific traumatic stressors

2) interventions that reduce arousal

3) directing survivors to additional resources through problem-solving
and referral

Specific stressors may include the violent unexpected death of a loved one, witnessing grotesque injuries and death, and loss of critical resources, along with ongoing intrusive images and cognitive distortions that increase distress and maintain an exaggerated sense of threat. Arousal reduction interventions might include education about stress reactions, stress management techniques, and resources; relaxation techniques; cognitive reframing techniques for countering the potential negative effects of cognitive distortions; and psychopharmacological interventions (Young, 2006).

EP is applicable at numerous points within this framework, with particular strengths, according to its practitioners, in the areas of reducing arousal, subduing intrusive memories, stress management, and cognitive restructuring. EP practitioners who are experienced with providing immediate disaster responses tend, however, to be less conservative than Young (and the literature in general) in terms of suggested constraints on emotional processing and eliciting detailed trauma narratives. Such cautions have become prominent in disaster mental health strategies since the negative impact of debriefing has been fully recognized. EP interventions, however, incorporate strategies that practitioners are claiming mitigate these concerns.

Jim McAninch, of Pittsburgh's Critical Incident Stress Management (CISM) team, is often on the scene within hours following accidents that involve fatalities. The mandate of the CISM team includes facilitating "normal recovery process of normal people having normal, healthy reactions to abnormal events." Like most community disaster response programs, McAninch's team is explicitly not meant to provide psychotherapy or to substitute for psychotherapy, yet its stated goals include therapeutic objectives that would fall within the parameters of psychological first aid and other early mental health interventions. McAninch's administrative supervisor was at first highly skeptical about the utilization of EP as part of the CISM disaster response. However, enough instances have now been logged in which TFT was judged to have brought about rapid and striking results in facilitating the emotional recovery of survivors of events involving fatalities that McAninch has been asked to provide TFT training to the entire Pittsburgh CISM Team.

McAninch typically has those who were directly involved in the accident recount or mentally replay what they witnessed, sometimes one-on-one and sometimes with other witnesses and survivors. While focusing on difficult memories or feelings, the person is simultaneously tapping on acupoints that purportedly reduce arousal. In addition to processing the recent event, McAninch notes that, with the accidental deaths and injuries handled by his team, unresolved traumas from a survivor's past are often activated. Treating these, again by stimulating acupoints while the memory is actively engaged, helps the present traumatic incident, in McAninch's experience, to be more easily and rapidly resolved (J. McAninch, personal communication, May 5, 2007).

This use of a readily available technique that quickly decreases arousal is a critical difference between EP and debriefing or other interventions that might ask a person to recount a trauma within days after it occurred. Sophia Cayer, an EFT practitioner who worked with hurricane evacuees in Alabama following Hurricane Katrina explains: "The difference is that with EFT, even if it is only a single session, it doesn't leave the person stranded. It is not a matter of just soothing them and then letting them go. They are given powerful tools they can regularly use as they move through the crisis and beyond" (S. Cayer, personal communication, December 1, 2005).

For instance, Barbara Smith, a trauma specialist who works for a government-funded agency in New Zealand, often takes the official report of a person who has been recently traumatized (Carrington, 2005). She needs the people she interviews to recall and recount their traumatic experiences in detail to complete the necessary paperwork. Since some of them are still in deep shock from the recent incident or from earlier trauma that has been reactivated, and many reexperience the horror and overwhelm of the traumatic event in talking about it, it may take up to four sessions to complete a single report. And even then, the reports might not always be clear or coherent. By simply introducing tapping and having her clients continuously tap specific acupoints while recounting their painful experiences, Smith has found that "the time it takes to collect the crucial information is more than cut in half [and] the reports themselves are more coherent and accurate." She adds that as a side benefit, these trauma victims "learn how to calm themselves from the very first session" (Carrington, 2005).

Smith's use of EP is consistent with the way other practitioners report applying it within the first days or weeks following a trauma. While aggressive probing or invasive uncovering techniques are generally not used by EP practitioners immediately following a disaster, EP is often applied to memories and thoughts the client is already expressing or actively ruminating upon. Rather than utilizing a complete EP protocol, the tapping techniques that are most effective for reducing arousal are taught on a psychological first aid basis (first tier-immediate relief/stabilization, p. 2).

These techniques can be introduced in a simple and matter-of-fact manner. Young (2006, p. 143) provides a 30-second approach for introducing diaphragmatic breathing, gently using words such as: "Everyone feels overwhelmed now, how about we take a few slow deep breaths" [along with a demonstration of diaphragmatic breathing]. This could be followed by suggesting, "Let's add to this now some tapping on stress release points. Just tap where I tap" (first tier--immediate relief/stabilization). Intrusive images, previous memories activated by the trauma, and the affect produced by cognitive distortions may also be the focus while points that reduce arousal are tapped (second tier- extinguishing conditioned responses, p.3).

Still valid, of course, are concerns about retraumatizing a disaster survivor who is beginning to stabilize, about undermining the individual's natural coping strategies, and about inducing the person to process the trauma prematurely when a period of denial would allow the person to rest and regroup. As with any other early mental health intervention, sensitive clinical judgment and an awareness of the known counterintuitive outcomes of well-meaning early responses are critical ingredients for an effective intervention.

Demonstrating how to self-stimulate acupoints that reduce arousal provides a straightforward tool for emotional self-management that, according to EP practitioner reports, is quick, effective, and generally as safe as other relaxation techniques (Young, 2006, points out that in rare cases, any form of relaxation technique may increase anxiety, intrusive images, or dissociative states). Because tapping acupoints, when properly introduced and applied, is relatively noninvasive, even if it does not produce the desired effects, no harm is done by the physical procedure as such. Summarizing his experiences as a member of the TFT Trauma Relief Committee providing postdisaster EP services in Kosovo, Rwanda, the Congo, and New Orleans, Paul Oas observed: "Safety, food, and shelter come before emotional healing, but even under dire circumstances, you can use the tapping procedures to calm people who are hysterical" (P. Oas, personal communication, November 20, 2005).

Interventions One to Four Weeks after Exposure to a Trauma. After the initial phase of shock and disorientation, mental health interventions between one and four weeks following the disaster have different goals "and employ different strategies than responses that typically occur in the initial days after trauma exposure" (Bryant & Litz, 2006). While managing stress reactions is still a prominent concern, focus shifts to identifying individuals who are at greatest risk of chronic mental health problems and deciding how to use inevitably scarce mental health resources most effectively.

It may not be possible to make accurate distinctions about which survivors are vulnerable to chronic mental health disorders within the first week after a disaster. Even in the first month, symptoms of Acute Stress Disorder (ASD) have not proven accurate indicators of vulnerability to longterm PTSD. ASD was introduced into the DSM IV (American Psychiatric Association, 2000) to account for symptoms such as pronounced anxiety or arousal, intrusive thoughts or flashbacks, acute dissociation, marked avoidance, and other sequela to trauma that may occur two days to four weeks following exposure to an extreme stressor (the same symptom cluster meets the criteria for PTSD if it persists for more than a month). While meeting the criteria for ASD is a sign of high risk for PTSD, ASD symptoms become a better predictor if dissociative reactions are excluded from the criteria-people who meet all the criteria except dissociative symptoms are still highly vulnerable (Bryant & Litz, 2006). Other signs of vulnerability soon after the traumatic event include depression, catastrophic appraisals, functional impairment, and dissociative reactions with or without other ASD symptoms.

Also somewhat complex to interpret is the data on when to offer intensive treatment. Four sessions of CBT were provided to 10 female victims of sexual and nonsexual assault shortly after the assault (usually within two weeks) and outcomes were compared with matched subjects who received repeated assessments (Foa, Heast-Ikeda, & Perry, 1995). Two months following the assault, 70 percent of the assessment group met criteria for PTSD while only 10 percent of the CBT group met those criteria. At five months, however, there were no differences between the groups in the PTSD rates, suggesting that CBT accelerated recovery relative to natural remission, but did not prevent longterm PTSD. A subsequent study by the same lead author, which corrected for some design flaws in the original study, came to the same conclusion. Initial accelerated improvement was found in CBT participants compared with participants who received supportive counseling or assessment only, but by nine months all three groups showed similar PTSD rates (Foa, Zoellner, & Feeny, 2006).

Other studies of trauma survivors, however (reviewed by Bryant & Litz, 2006), suggest that 4 to 6 two-hour sessions of CBT applied two to four weeks following a trauma greatly reduces subsequent incidence of PTSD (e.g., in one well-designed investigation, 67 percent of a supportive counseling control group met the diagnostic criteria for PTSD at six-month followup compared to only 20 percent in the CBT group). Bryant and Litz caution, however, that "there is no research on CBT in the context of mass violence" (2006, p. 167). They also note that if it is not possible to apply CBT within the first few weeks of a trauma due to limited clinical resources or excessive demands on the trauma survivor, therapy for PTSD is still likely to be effective at a later point. Active psychotherapy during the first few weeks following a trauma, particularly approaches that utilize exposure treatments, may, in fact, not be indicated for individuals who were highly anxious prior to the trauma or for those exhibiting severe dissociative reactions, severe substance abuse or dependence, severe ongoing stressors, unresolved prior trauma, or significant suicide threat (Bryant & Litz, 2006).

EP treatments in the weeks following a trauma can continue to focus on lowering anxiety levels, countering intrusive thoughts and images, reducing arousal to previous memories activated by the trauma, and addressing the affect that induces cognitive distortions (second tier, extinguishing conditioned responses, p. 3). While a single EP session is, according to practitioner reports, often effective for work at this level, the option of appropriate follow-up or referral should be insured with individuals showing signs of vulnerability to chronic PTSD or other psychological disorders.

A reported strength of EP in reducing symptoms of acute stress is that it can be efficiently taught as a self-soothing technique in group settings. Participants are also able to experience immediate relief without, as contrasted with debriefing, having to reveal to other group members specific memories or emotions. In one variation, the practitioner works with a volunteer in front of the group. At the same time, the group is instructed to self-apply some of the procedures being used with the volunteer, focusing on the volunteer's psychological distress rather than on their own. A reduction in the emotional intensity of issues audience members had previously identified is subsequently reported by a large proportion of the group.

While no studies have been conducted on the use of this technique in post-disaster situations, there is some evidence for its efficacy with a general population. A within-subjects design was used with 102 participants who attended either of two 3-day EFT workshops open to the general public (Rowe, 2005). The participants were given a well-established, standardized symptom checklist (the Derogatis Symptom Checklist, short form) one month prior to the workshop, immediately prior, immediately after, one month after, and six months after the workshop. No significant difference was found in the mean test scores one month prior to and immediately prior to the workshop. Following the workshop, a highly significant decrease (p < .0005) was found on the checklist's global measure of psychological distress as well as all nine subscales, and these improvements held at the six-month follow-up. While the mechanisms for such outcomes are still unknown, practitioners are consistently describing this finding, and reported applications following disasters seem encouraging.

For instance, about a month following Hurricane Katrina, Roseanna Ellis, an EFT practitioner, and three of her colleagues were asked by the pastor of a small church in Selma, Alabama, to work with his congregation, which was hosting a number of displaced hurricane survivors. Prior to extending this invitation, the pastor had experienced marked relief from symptoms of compassion fatigue as well as from some longstanding personal challenges during a single EFT session with Ellis.

The church held a Wednesday evening "family night" and Ellis and her team were invited to attend it to introduce EFT. Of 30 people in attendance, 13 were evacuees; the others were regular members of the church. After the pastor gave a brief introduction, explaining the framework for the evening, the four practitioners each took a role in the presentation. One explained the theory of stress, one introduced EFT, another described its history, and the fourth demonstrated the tapping points. Then the practitioners worked with individuals in front of the group, one at a time. During the course of the two-hour meeting, each practitioner worked with two or three people. Each demonstration subject was treated for between ten and twenty minutes.

A 52-year-old woman, for instance, who had been forced from her home, tearfully made each of the following statements and rated each as a 10 on the 10-point SUD scale: "I feel lost; I feel displaced; I feel confused and unfocused; I feel angry; I feel all alone; I feel I have no place in this whole world that I can call my home; No one knows where to reach me because they keep moving us from place to place." At the end of twenty minutes, focusing on these one at a time, she appeared calm and in control, reporting that her distress level with each statement was now at 0 of 10. She stated, "I have the world to choose from for my next home . . . I have always wanted to write my life story and was afraid to, but now I am ready . . . I could have died like some of my friends, but God saved me for a purpose . . . Maybe Katrina was the end of my old life and a renewed beginning."

Another woman, who worked for a social services agency, was so overwhelmed with the increase in her case load because of Katrina that she wept while describing it, saying that her distress level was up to a 10. Within six or seven minutes, when it had dropped to a 0 while thinking of her job responsibilities, a smile crossed her face, and she shouted, "Bring ‘em on baby, bring ‘em on!"

For reasons that are not fully understood, EFT seems to help with pain and physical symptoms as well as psychological issues. One man who worked in front of the group had severe pain in his hips and knees, initially at a SUD level of 10. A few minutes of tapping got his self-report down to a 5 on his hips and 3 on both knees. When he had finished, the audience commented on the way he walked off the stage with substantially greater speed and ease than the way he walked onto it.

Before the stage work with these individuals, each audience member identified a personal area of emotional distress and rated it from 0 to 10. They then put their own issues aside as the demonstrations were conducted. But with each person on the stage, the audience self-applied the same procedures being used by the person on the stage. If the person on stage was tapping a set of acupoints while stating, "feeling displaced," the audience was doing the exact same tapping and making the exact same statement. Known as "Borrowing Benefits" (Rowe, 2005), this method is repeatedly reported to bring down the distress level for the original issue identified by a vast majority of audience members, even if there is no treatment that focuses specifically on the personal issues the audience members had selected earlier. And indeed, every person in the audience at the church indicated at the end of the evening that the initial distress level they had identified had decreased when they again tuned into their original issue. Describing the value of using this approach with a group of people who have shared the same trauma, Ellis notes that "Everyone can relate to the shock, grief, anger, displacement, and fear of the unknown. Then seeing other people quickly calm themselves gives hope. And feeling your own emotions rapidly easing is the start of healing" (R. Ellis, personal communication, December 2, 2005).

While this is a method that warrants investigation, its parallels with debriefing need to be carefully weighed. The merits of debriefing may have been contaminated when, after its initial popularity, it began being applied to populations for which it was not designed and by practitioners whose mental health backgrounds and training were far more limited than that of those who originated the approach. EP practitioners can learn from this history. Among the guidelines that are emerging for using EP with groups are that it be made explicit that audience use of the tapping is voluntary, that audience members be instructed not to focus on an issue that is overwhelming, that there is no expectation that audience members will share the issue on which they are focusing,

^ TOP

Green MM. Six Trauma Imprints Treated with Combination Intervention: Critical Incident Stress Debriefings (CISD) and Thought Field Therapy (TFT) or Emotional Freedom Techniques (EFT)Traumatology. 2002; 8:30.b  No. 1, 18-27

 

Ground Zero Almost, Traumatology, 2001, pdf

Wetenschappelijk Onderzoek naar EFT en fobie

In het Journal of Clinical Psychology werd een studie gepubliceerd, die een doorbraak betekende voor de wetenschappelijke erkenning van EFT.

De psycholoog Steven Wells en zijn collega’s uit Australië en de VS, hebben de werking van EFT in de behandeling van een specifieke fobie, van angsten voor kleine dieren en insecten onderzocht. De resultaten waren echt indrukwekkend. Een groep van 19 proefpersonen, die EFT leerden, werden vergeleken met 18 andere personen, die een speciale diafragmale ademhalingstechniek ter angstbeheersing aangeleerd gekregen hadden.

Gemeten werd voor en na de behandeling oa de afstand tot waar mensen het dier konden benaderen, de SUDscore bij voorstellen van het dier, SUDscore bij benaderen dier en een fobie-vragenlijst. ANOVAS toonde aan dat de EFT-groep een significante grotere bevrijding van hun angstsymptomen had Eveneens voelden EFT groep zich bekwaam om in de nabijheid van deze dieren te vertoeven. De resultaten na controle op 6 en 9 maanden waren blijvend.

Deze bevindingen wijzen ernaar dat een enkele EFT behandeling om een specifieke fobie te behandelen daadwerkelijk een verandering in gevoel en gedrag teweeg brengen. Enkele beperkingen van het onderzoek worden ook besproken, en vervolgonderzoek word aanbevolen.

     Steve Wells, Kathryn Polglase, Dr. Henry B. Andrews, Patricia Carrington  
     and Harvey A. Baker, Evaluation of a Meridian-Based Intervation, 
     Emotional Freedom Techniques, for Reducing Specific Phobias of Small 
     Animals, The Journal of Clinical  Psychology 59 (9). 943-966, 2003. 
     PMID: 12945061 
                                   Klik voor PDF van het onderzoek.

Abstract

This study explored whether a meridian-based procedure, Emotional Freedom Techniques (EFT), can reduce specific phobias of small animals under laboratorycontrolled conditions. Randomly assigned participants were treated individually for 30 minutes with EFT (n = 18) or a comparison condition, Diaphragmatic Breathing (DB) (n = 17). ANOVAS revealed that EFT produced significantly greater mprovement than did DB behaviorally and on three self-report measures, but not on pulse rate. The greater improvement for EFT was maintained, and possibly enhanced, at 6 - 9 months follow-up on the behavioral measure. These findings suggest that a single treatment session using EFT to reduce specific phobias can produce valid behavioral and subjective effects. Some limitations of the study are also noted and clarifying research suggested.

TFT and acrophobia

An Experimental Study of TFT™ and Acrophobia

by
Joyce L. Carbonell, Ph.D., TFTdx
Associate Professor, Florida State University

As many practitioners of TFT™ are aware, Dr. Charles Figley and I conducted a Systematic Clinical Demonstration (SCD) study of four therapies, including TFT™. This SCD study utilized clients who had suffered a trauma or who suffered from a phobia. All of the treatments tested were demonstrated to be effective, based on SUD ratings ( subjective units of distress) and other paper and pencil measures. In order to further examine TFT™, one of my students ( Neta Mappa) and I decided to do an experiment to supplement the clinical demonstration. Although there has been a great deal of clinical support for TFT™, there had been no true experimentation. The purpose of the experiment was to determine whether TFT™ would decrease the anxiety level of acrophobics more than a placebo control treatment.

We chose to do our experiment with acrophobics (height phobics) for several reasons. First, this is a fairly common phobia. In addition, there is a screening measure , the Cohen Acrophobia Questionnaire (Cohen, 1973), that can be used to screen people for acrophobia. And, we could also do a behavioral test of the subject's fear of heights both before and after treatment. Finally, there is an TFT™ algorithm for phobias. It was important to be able to use an algorithm to ensure that all subjects received the same treatment.

The subjects in the study were college students who identified themselves as having fear of heights. There were 156 students who signed up for the experiment, indicating that they had a fear of heights. They were all given the screening measure and 49 of them reached the cutoff for height phobics. These 49 subjects who reached the cutoff were then given a behavioral test. They were asked to approach and climb a four foot ladder. We hoped that the ladder was of sufficient height to provoke an acrophobic response, but not so high as to put the subject at physical risk. The floor in front of the ladder was marked off in one foot intervals for four feet. The subject was asked for a SUD rating at each mark, and then again on each step of the ladder. The subjects were free to stop ascending the ladder at any point.

After completing the behavioral test, the subjects were taken to a separate room and were met by another experimenter. They were then asked to give a SUD rating. They were requested to think of a situation related to heights that made them anxious and then rate their anxiety on a scale of 0 to 10. In order to assign the subjects randomly to either TFT™ or a placebo TFT™, they were asked to draw a piece of paper from a box. All of the papers in the box were numbered 1 or 2. Those who drew the number one received the TFT™ algorithm for phobias and those who drew the number two received a treatment that consisted of tapping on various parts of the body that are not used in TFT™. Before any treatment began, all of the subjects were treated for reversal. Then, the experimenter treated them with either with TFT™ or the placebo treatment. After treatment they were asked for a SUD rating. If the SUD was not zero, the treatment was administered again. After the second treatment, post-testing began, regardless of the SUD rating.

After the treatment, subjects were returned to the first experimenter who did post testing with the subjects. It is important to note that the experimenter who did the pre and post tests was unaware of which treatment the subject had received. At the post test, subjects were again asked to approach and climb the ladder, giving a SUD rating at each step, just as they had before treatment.

Before doing any analysis, the groups were compared on their pre-treatment measures to be sure the groups were comparable. Given the random assignment to condition we did not expect the groups to differ on pre-treatment measures and they did not. Although both groups got somewhat better there was a statistically significant difference between those subjects who had received real TFT™ and those who had received placebo, with the TFT™ subjects showing significantly more improvement. There was a significant difference when all the SUD scores were averaged for each subject and the difference was more pronounced when examining the SUD scores of the subjects while climbing the ladder. Thus, those who were treated with TFT™ had less anxiety than those who received the placebo.

The study provides important data about TFT™. While clinical trials demonstrate the usefulness of TFT, they do not have control groups, nor are subjects randomly assigned to condition. In this study, subjects were randomly assigned to condition and there was a placebo treatment. Unlike the SCD study, the goal was not necessarily to reduce the SUD to zero, but to determine if TFT™, administered under controlled conditions, would differ significantly from a placebo treatment that was similar to TFT™. The clinical study and the experimental study, taken together, provide unique support for TFT™. We plan to publish the full results of the study in the future.

Harvey Baker heeft onderzoek gedaan naar EFT bij fobie, in feite een herhalen van Wellls 2003. lees hier meer.

Onderzoek EFT, Research EFT. Havey Baker, 2005.

Zie de pdf

Overig Wetenschappelijk onderzoek maar EFT, TFT, TAT en artikelen in wetenschappelijke bladen

Het NIH onderzoek over TAT - J Altern Complement Med

NIH onderzoek over TAT

Doelstelling: Het handhaven van het afvalresultaat een zeer groot probleem is voor de vetzuchtepidemie. Huidig onderzoek is bedoeld om 3 interventies te vergelijken voor het handhaven van het gewicht na afvallen. Gemiddeld was er minstens 3.5 afgevallen voordat deze 3 groepen begonnen met het onderzoek. 

De National Instutes of Health heeft een pilot (klein onderzoek) gedaan met wetenschappers van het Kaiser Center fo Health Reseach en de Universteit van Arizona om TAT te vergelijken tegen over Qi Gong en tegen over gedragsadvies ten aanzien van het behouden van het gewicht na afvallen. 

Elke groep kreeg 10 uur instructie verdeeld over 12 weken. Na 24 weken had 88% het onderzoek volgehouden. De TAT groep is maar 0.1 kg aangekomen. De  TAT group behield 1.2 kg meer gewicht dan de SDS groep en 2.8 meer dan de QI groep.

Conclusies: het is gerechtigd om meer onderzoek te doen naar TAT.

     Elder C, Ritenbaugh C, Mist S, Aickin M, Schneider J, Zwickey H, Elmer P.
     Randomized trial of two mind-body interventions for weight-loss maintenance.
     J Altern Complement Med 2007 Jan-Feb;13(1):67-78. 
     PMID: 17309380 
                               klik hier voor een pdf van deze informatie.
                                           koop het complete artikel

Keywords: EFT onderzoek, TAT, Research. Elder, 2007

Self-administered EFT (Emotional Freedom Techniques) in individuals with fibromyalgia: a randomized trial

By Gunilla Brattberg, MD

Brattberg, G. (2008). Self-administered EFT (Emotional Freedom Techniques) in individuals with fibromyalgia: a randomized trial. Integrative Medicine: A Clinician’s Journal, August/September.

Abstract

The aim of this study was to examine if self-administered EFT (Emotional Freedom Techniques) leads to reduced pain perception, increased acceptance, coping ability and health-related quality of life in individuals with fibromyalgia. 86 women, diagnosed with fibromyalgia and on sick leave for at least 3 months, were randomly assigned to a treatment group or a waiting list group. An eight-week EFT treatment program was administered via the Internet.

Upon completion of the program, statistically significant improvements were observed in the intervention group (n=26) in comparison with the waiting list group (n=36) for variables such as pain, anxiety, depression, vitality, social function, mental health, performance problems involving work or other activities due to physical as well as emotional reasons, and stress symptoms. Pain catastrophizing measures, such as rumination, magnification and helplessness, were significantly reduced, and the activity level was significantly increased. The number needed to treat (NNT) regarding recovering from anxiety was 3. NNT for depression was 4.

Self-administered EFT seems to be a good complement to other treatments and rehabilitation programs. The sample size was small and the dropout rate was high. Therefore the surprisingly good results have to be interpreted with caution. However, it would be of interest to further study this simple and easily accessible self-administered treatment method, which can even be taught over the Internet.

zie de pdf

Key words: EFT onderzoek, EFT research.

J Clin Psychol. 2001 Oct;57(10):1215-27

Thought Field Therapy clinical applications: utilization in an HMO in behavioral medicine and behavioral health services.

Sakai C, Paperny D, Mathews M, Tanida G, Boyd G, Simons A, Yamamoto C, Mau C, Nutter L.

Thought Field Therapy (TFT) is a self-administered treatment developed by psychologist Roger Callahan. TFT uses energy meridian treatment points and bilateral optical-cortical stimulation while focusing on the targeted symptoms or problem being addressed. The clinical applications of TFT summarized included anxiety, adjustment disorder with anxiety and depression, anxiety due to medical condition, anger, acute stress, bereavement, chronic pain, cravings, depression, fatigue, nausea, neurodermatitis, obsessive traits, panic disorder without agoraphobia, parent-child stress, phobia, posttraumatic stress disorder, relationship stress, trichotillomania, tremor, and work stress. This uncontrolled study reports on changes in self-reported Subjective Units of Distress (SUD; Wolpe, 1969) in 1,594 applications of TFT, treating 714 patients. Paired t-tests of pre- and posttreatment SUD were statistically significant in 31 categories reviewed. These within-session decreases of SUD are preliminary data that call for controlled studies to examine validity, reliability, and maintenance of effects over time. Illustrative case and heart rate variability data are presented. Copyright 2001 John Wiley & Sons, Inc.

 

PMID: 11526608

This is a preprint of the article published in a special issue* of Journal of Clinical Psychology, 57(10), pp.1215-1227 in October 2001, without peer review but with an invited critical review by Jeffrey M. Lohr, pp.1229-1235.

Heart Rate Variability Data 

source: http://www.tftcenter.com/article2.html
                        

Nurs Stand. 2007 Aug 22-28;21(50):24-5

Emotional acupuncture.

Lynch E.

Emotional freedom technique is gaining popularity in the UK for the treatment of psychological problems. Its supporters say it is particularly useful for people who have had traumatic experiences.

PMID: 17896572

Key Words: EFT onderzoek, EFT research, Lynch,

Phobia and Anxiety Treatment by Telephone and Radio

Replication of Callahan's 1986 Study
Glenn Leonoff, Ph.D. • Monterey, California, 1996

Radio listeners with phobias and anxiety states were invited to call radio programs in order to receive live-on-the-air treatment by the investigators. The proprietary Voice Technology™ developed by Callahan (1985) was used as the method of diagnosis for Thought Field Therapy (TFT) treatment in both studies. Each study included 68 subjects.

      Consistent with the procedure in Callahan's study, the results of the present study include the data for all callers who were treated, including those whose treatments were interrupted due to time limitations. Callahan used this stringent procedure in order to minimize selective bias.

      Treatment effectiveness was measured by the callers' own report about their intensity of distress. Callahan used a ten-point (1 to 10) Subjective Units of Distress (SUD) rating scale while Leonoff used an eleven-point (0 to 10) SUD scale.

      Despite the less than ideal conditions of treating psychological disorders on radio programs, a 97 percent success rate was achieved by both investigators. A successful treatment was defined as an improvement of two or more SUD points.

      Callahan's mean pre-treatment distress rating was 8.33 and his mean post-treatment rating was 2.01, representing a 75.9 percent improvement. Leonoff's mean pre-treatment distress rating was 8.19 and his mean post-treatment rating was 1.59, representing a 75.2 percent improvement. Callahan achieved his results in an average time of four minutes and thirty-four seconds. Leonoff required an average time of six minutes and four seconds.

      As in Callahan's study, treatment time included the entire duration of talking to the caller until treatment was completed, including the description and instructions of the treatments not just the actual treatment time itself. Since treatment time entailed the entire time spent in talking with a caller prior to initiation of actual treatment it is believed that personal interaction styles of the practitioners account for some of the difference in these measures. A greater willingness to engage in conversation with a caller prior to initiating the actual treatment resulted in a longer treatment time. A more exact measure of actual treatment duration would have been to measure only the actual treatment time.

     The fact that similar results were achieved a decade apart by two independent investigators with dissimilar professional back grounds and significant differences in their experience and knowledge of TFT procedures, provides strong support for the efficacy, effectiveness, and reliability of the TFT treatment and training procedures. Furthermore, the high success rate supports the diagnostic accuracy of Voice Technology (VT™).

      Callahan was the pioneer and developer of these revolutionary treatment procedures. He undertook his study after approximately six years of refining his methods. Leonoff embarked on his study during the course of his first year of study of the VT™ with Callahan. Thus, there was a distinct difference between the two investigators in their level of technical knowledge, experience, and theoretical understanding of the TFT procedures. The virtually identical therapeutic success demonstrated by the two investigators is an indicator of the power and predictability of the TFT procedures despite the differing levels of expertise between the investigators.

      All the research data of this replication study is preserved on recorded audio tapes and are available for further research.

      The Callahan/Leonoff studies were not intended to investigate the duration of the achieved therapeutic gains. Duration of treatment results is an obviously important clinical issue for any therapeutic procedure. Research concerning the duration of TFT treatment is an important next step in the establishment of an empirical basis for the efficacy of this procedure. Hopefully, the robust findings of the two studies will stimulate more extensive research which will address the issue of duration of TFT results.

      Preliminary research data supporting the duration of successful TFT treatment is provided by the six-month follow-up data from the, “Active Ingredients in Efficient Treatment of PTSD,” study (Figley and Carbonell, 1995). According to the report presented at the International Society for Traumatic Stress Studies in Boston on November 3, 1995, TFT treatment gains were maintained on six-month follow-up. The Figley and Carbonell data provide important corroboration to clinical observations of the enduring results of TFT. Further, there is clinical evidence of TFT therapeutic holding for ten years or more (Callahan, 1990).

      A highly significant aspect of the Callahan/Leonoff research is that the therapeutic success was achieved through a procedure which is based on the diagnosis and treatment of the body energy system. The TFT procedures represent a radical change in the therapeutic paradigm of psychology.

      The diagnostic and therapeutic procedures of TFT are founded on the identification of specific imbalances in the body energy system as identified through specific diagnostic assessment while the subject is engaged in thinking about or experiencing their particular psychological concern.

      Briefly, it is hypothesized that the therapeutic results of TFT demonstrate that the body energy system is the control system for the negative emotions. It is proposed that the PERTURBATIONS (Callahan, 1995) in the thought field are the fundamental causal basis for biochemical, hormonal, neurological and cognitive levels entailed in negative emotions. This theoretical formulation is based on the understanding in modern physics that complex energy fields and their interrelationships are the basis for all matter, including that of the human organism. It is theorized that the stimulation of specifically defined points along the meridian energy system transduces the physical energy generated by TFT tapping procedure into a form of electromagnetic energy which has a direct and positive impact on the thought field.

      The body energy system is not generally known in western clinical practice, though there are isolated pioneers who have ventured to study this level of our organism's functioning and have reported findings with clear implications for the procedures and success of TFT. In the 1940's Harold Saxon Burr of Yale University provided strong evidence that the body is an energy system and that the state of this energy system is critically significant to the development of all living organisms.

      Orthopedic surgeon, Robert O. Becker, MD (1985), established the significance of electromagnetic energy fields to bone healing and developed successful treatment methods based on his findings. Through the application of electromagnetic fields he was able to restore natural healing ability in the human organism in terms of enabling bones which would not heal spontaneously to heal under the influence of governed energy fields. Another fascinating aspect of Becker's research with electromagnetic fields enab1ed him to unleash regeneration of amputated limbs in frogs. The extraordinary aspect of this work was that frogs normally do not naturally regenerate their lost limbs. Yet, treatments based on the application of electromagnetic energy fields actualized this healing potential.

      The relevance of the body polarity state to human health is demonstrated in a study by Louis Langman, MD, “The Implications of the Electro-Metric Test in Cancer of the Female Genital Tract.” (Burr 1972). Langman's findings make a strong case for the relationship between the well being of the human organism and its polarity. In this study Langman found a dramatic difference in polarity between women with cancer of the genital tract and women with no diagnosis of such cancer. Women with diagnosed cancer had negative polarity in the genital tract 96% of the time as compared to women with no known malignancy who showed negative polarity only 5% of the time. This dramatic difference offers further evidence for the importance of the energy system in the health of individuals. Unfortunately there is no known follow-up research to these findings. Callahan reports that these results confirm a relationship seen between psychological reversal (a polarity reversal) and cases of cancer, seen by Callahan and a colleague who specialized in psychological treatment of cancer patients (Callahan, 1992).

      After twenty years of research the eminent radiologist and former president of the Nobel Laureate nominating committee, Bjorn Nordenstrom (1983) of the Karolinska Institute in Sweden published, “Biologically Closed Electric Circuits: Clinical, Experimental and Theoretical Evidence for an Additional Circulatory System”. Nordenstrom provided evidence of a circulatory energy system within the human body which he believes to be as vital to human health as the circulatory blood system. His research led him to believe that disturbances in the body energy system may be involved in the development of cancer and other diseases. Nordenstrom has been successful in producing complete remission from some types of hopeless cancers metastatic to the lung through the application of polarity in electirc currents.

      Pierre de Vernejoul (1985) at Nekker Hospital in Paris, France reports empirical evidence for the existence of the meridian (energy) system. His research team injected radioactive technetium 99m into acupoints and followed the isotope's uptake with gamma-camera imaging. Their findings indicated the radioactive isotope migrated along the classical meridian pathways the Chinese had defined several thousand years ago. Injection of the substance into random locations in the body revealed they followed no determined pathway. The results suggested the meridian system is a separate morphological pathway.

      Treatment procedures directed at the meridian system have been successfully applied not only in TFT but by the disciplines of acupuncture and applied kinesiology. The demonstrated robust effectiveness of TFT offers strong evidence for the significance of the meridian energy system to the rapid treatment of psychological disorders.

      In this era of efforts to find cost-saving health procedures, TFT provides the type of efficient and effective treatment which can help to achieve such objectives in the field of mental health.

      The three levels of training in TFT proficiency (Voice Technology™, Physical Diagnosis, and Algorithms) allow for relatively rapid training of practitioners who are able to provide effective treatment in a variety of health service settings. TFT trained clinicians are able to have access to rapid telephone consultations for clients with complex disorders from practitioners trained in Voice Technology™. Such available consultations provide for therapeutic support at the highest levels of proficiency for clinicians at all levels of TFT training.

REFERENCES

Becker, R. and Selden, G. (1985). The Body Electric: Electromagnetism and the Foundation of Life. William Morrow and Co., NY.

Burr, H. (I972). Blueprint for Immortality: The Electric patterns of Life. Neville Spearman, London.

Ca1lahan, R. (1987). Successful Treatment of Phobias and Anxiety by Telephone and Radio. Collected Papers of the International College of Applied Kinesiology, Winter.

Callahan, R. (1992). Notes on Cancer and Psychological Reversal

Unpublished article.

Callahan, R. (1995). The concept of perturbation. Unpublished article

De Vernejoul, P. “et al” (1985). Etude Des Meridians D'Acpunture Par Les Traceurs Radioactifs. Bull. Acad. Natle. Med, 169, 1071-1075.

Langman, L. (1972). The Implications of the Electro-Metric Test in Cancer of the Female Genital Tract. In Burr, H. Blueprint for Immortality: The Electric Patterns of Life. Neville Spearman, London. 123-154.

Nordenstrom, B. (1983). Biologically Closed Electric Circuits: Clinical, Experimental and Theoretical Evidence for An Additional Circulatory System. Nordic, Stockholm.

Editor's Note: Since Dr. Leonoff submitted this article he has continued to treat clients over the phone. His subject pool is now 79 with 77 successes yielding a success rate of 97%. His mean treatment time is now six minutes one second. -D.F.

source: http://www.tftrx.com/tft4std.html

Thought Field Therapy and its derivatives: rapid relief of mental health problems through tapping on the body

Mollon, P., (2007). Thought Field Therapy and its derivatives: rapid relief of mental health problems through tapping on the body. Primary Care and Community Psychiatry. 12 [3-4] December. 123-127.

Abstract

A genre of psychotherapeutic enquiry, involving work with the body's energy system as well as the mind, began in the 1970s, arising from the field of Applied Kinesiology as elaborated by psychiatrist Dr. John Diamond. Clinical psychologist, Roger Callahan, built on this work to develop simple procedures for the rapid relief of anxieties and phobias. This approach, called Thought Field Therapy, was later applied to trauma and other forms of mental distress. In recent years a number of derivative methods have been developed. These can be combined with conventional psychodynamic or CBT approaches. A variety of forms of evidence support the use of these 'energy psychology' techniques, including a very large South American study.

Keywords: EFT; Emotional Freedom Techniques; Energy Psychology; meridians; Psychoanalytic Energy Psychotherapy; Seemorg Matrix; TAT; TFT; Thought Field Therapy

Key words: EFT, onderzoek, EFT research.

Source: PhilMollon.co.uk lokale kopie (word)

Church, D., & Brooks, A. J. (in press). The Effect of a Brief EFT (Emotional Freedom Techniques) Self-Intervention on Anxiety, Depression, Pain and Cravings in Healthcare Workers. Integrative Medicine: A Clinician's Journal. Abstract This study examined whether self-intervention with Emotional Freedom Techniques (EFT), a brief exposure therapy that combines a cognitive and a somatic element, had an effect on healthcare workers’ psychological distress symptoms. Participants were 216 attendees at 5 professional conferences. Psychological distress, as measured by the SA-45, and self-rated pain, emotional distress, and craving were assessed before and after 2-hours of self-applied EFT, utilizing a within-subjects design. A 90-day follow-up was completed by 53% of the sample with 61% reporting using EFT subsequent to the workshop. Significant improvements were found on all distress subscales and ratings of pain, emotional distress, and cravings at posttest (all p<.001). Gains were maintained at follow-up for most SA-45 scales. The severity of psychological symptoms was reduced (-45%, p<.001) as well as the breadth (-40%, p<.001), with significant gains maintained at follow-up. Greater subsequent EFT use correlated with a greater decrease in symptom severity at follow-up (p<.034, r=.199), but not in breadth of symptoms (p<.0117, r=.148). EFT provided an immediate effect on psychological distress, pain, and cravings that was replicated across multiple conferences and healthcare provider samples. Keywords: Healthcare professionals, burnout, depression, anxiety, pain, craving, EFT (Emotional Freedom Techniques)

The Neurochemistry of Counterconditioning: Acupressure Desensitization in Psychotherapy

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

Abstract

A growing body of literature indicates that imaginal exposure, paired with acupressure, reduces midbrain hyperarousal and counterconditions anxiety and traumatic memories. 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 fight/flight/freeze 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.

Keywords: Counterconditioning, acupressure, amygdala, exposure therapies, anxiety, desensitization

Key words: EFT research, EFT onderzoek

Bron: http://www.stressproject.org/controlled-trials.html lokale pdf

The Effect of Progressive Muscular Relaxation and Emotional Freedom Techniques on Test Anxiety in High School Students: A Randomized Controlled Trial

Sezgin, N., & Ã–zcan, B. (2009). The Effect of Progressive Muscular Relaxation and Emotional Freedom Techniques on Test Anxiety in High School Students: A Randomized Controlled Trial. Energy Psychology: Theory, Research, & Treatment, 1(1), 23-30.

Abstract

This study investigated the effect of Emotional Freedom Techniques (EFT) and Progressive Muscular Relaxation (PMR) on test anxiety. A group of 32 high school students enrolled at a private academy were evaluated using the Test Anxiety Inventory (TAI), which contains Worry and Emotionality subscales. Scores for 70 students demonstrated high levels of test anxiety; these students were randomized into control and experimental groups. During a single treatment session, the control group received instruction in PMR and the experimental group in EFT, which was followed by self-treatment at home. After 2 months, subjects were retested using the TAI. Repeated covariance analysis was performed to determine the effects of EFT and PMR on the mean TAI score, as well as the 2 subscale scores. Each group completed a sample examination at the beginning and end of the study, and their mean scores were computed. Thirty-two of the initial 70 subjects completed all the study’s requirements, and all statistical analyses were done on this group. A statistically significant decrease occurred in the test anxiety scores of both the experimental and control groups. The EFT group had a significantly greater decrease than the PMR group (p < .05). The scores of the EFT group were lower on the Emotionality and Worry subscales (p < .05). Both groups scored higher on the test examinations after treatment. Although the improvement was greater for the EFT group, the difference was not statistically significant.

Keywords: Test anxiety, academic performance, high school students, worry, emotionality, Emotional Freedom Techniques (EFT), Progressive Muscular Relaxation (PMR)

Theoretical and Methodological Problems in Research on Emotional Freedom Techniques (EFT) and Other Meridian Based Therapies

Baker, A. H., Carrington, P., Putilin, D., (2009). Theoretical and Methodological Problems in Research on Emotional Freedom Techniques (EFT) and Other Meridian Based Therapies. Psychology Journal, 6:2, 34-46.

ABSTRACT: Controlled research into Emotional Freedom Techniques (EFT) and other
meridian-based therapies is at its beginnings. We examined several issues facing EFT
researchers, including: the number and type of dependent measures; expectancy effects;
the need for follow-up assessment; a newly proposed procedure for keeping participants
blind; the duration of the intervention; the value of treating the hypothesized Energy
Meridian System and EFT's operations as separate constructs; and the possibility that
EFT's efficacy is mediated by processes long known to be associated with
psychotherapy. Such issues are considered in the context of three recent EFT studies:
Waite and Holder (2003); Wells et al. (2003); and Baker and Siegel (2005). Some
limitations of these studies are delineated and guidelines on EFT research are suggested.

To purchase the full text of the study, click here to go to Psychology Journal's home page.

Bron: www.energypsychology-press.com

lokale pdf

Church, D. (2009). The Effect of EFT (Emotional Freedom Techniques) on Athletic Performance: A Randomized Controlled Blind Trial. Open Sports Sciences Journal, 2, 94-99.

Abstract

The present study investigates the effect of a psychophysiological intervention, Emotional Freedom Techniques (EFT), on athletic performance. It evaluates whether a single EFT treatment can produce an improvement in high- performance men’s and women’s PAC-10 college basketball team members (n = 26). The treatment group received a 15 minute EFT session while a performance-matched attention control group received a placebo intervention of similar duration. Performance was measured on free throws and vertical jump height. The time frame of data collection and treatment simulated an actual basketball game. A statistically significant difference between the two groups was found for free throws (p<.03). On post-test, players who received the EFT intervention improved an average of 20.8%, while the attention control group decreased an average of 16.6%. There was no difference between treatment groups in jump height. When performance was analyzed separately by gender, trends toward significance were found for the women’s team on both performance measures with better results for the EFT intervention group. This indicates that EFT performed as an intervention during the course of an athletic event may improve free throw performance .

Keywords: Basketball, performance, free throws, Emotional Freedom Techniques (EFT), anxiety, stress.

Key words: EFT onderzoekt, EFT research.

zie een lokale pdf van dit onderzoek bron: Open Sports Sciences Journal

zie de pdf

zie de pdf

zie de PDF

Dit is een case study, zie de pdf of de bron

Emotional Freedom Techniques (EFT) as an Effective Adjunctive Treatment in the Neurotherapeutic Treatment of Seizure Disorders

Paul Swingle, PhD.

Energy Psychology: Theory, Research, & Treatment, (2010), 2(1), 29-38.

Abstract

Neurotherapy, including brainwave biofeedback, has been found to be an effective treatment for seizure disorders. A principal component of this treatment is an increase in the amplitude of the Sensory Motor Rhythm (SMR) over the sensory motor cortex in the brain. Electroencephalographic (QEEG) assessment of brainwave activity indicated that Emotional Freedom Techniques (EFT) increased SMR amplitude. The present article reviews the research on the effects of components of the EFT procedure on brainwave functioning that have been found to be beneficial in the treatment of seizure disorders.

Keywords: neurotherapy, seizures, trauma, EFT (Emotional Freedom Techniques), EEG, brain, cortex.

If you wish to purchase the full text of the study, click here to jump to the appropriate page on the Energy Psychology journal web site.

Wetenschappelijk Onderzoek naar EFT: Reviews en overzicht

Link Abstracts in PDF vorm

2004, Energy Psychology: Theory, Indications, Evidence A paper by Joaquín Andrade, M.D., and David Feinstein, Ph.D., which appears in the current version of the Energy Psychology Interactive CD, summarizes clinical observations involving energy-oriented psychotherapy treatments with 29,000 patients from 11 allied treatment centers in South America during a 14-year period. The paper, "Energy Psychology: Theory, Indications, Evidence," also offers preliminary guidelines regarding indications and contraindications for the use of energy-oriented psychotherapy, based on early clinical data. 

Korte vertaling: Dit artikel geeft een samenvatting van onderzoeken naar Energie Psychologie in Zuid-America van 29000 patienten van 11 instellingen over 14 jaar. Onderzocht zijn een breed scala aan klachtensoorten waaronder angststoornissen (incl OCD), depressie en trauma (incl. PTSD). Daaruit komt een lijst met indicatie en contraindicaties. Daaruit vloeien conclusies en aanbevelingen.

EP-Andrade Feinstein, 2004
Feinstein-research, 2005

Research in EP, 2008

Kritisch antwoord, 2008

Wetenschappelijke verklaringen en mechnismes EFT en amygdala

Ronald Ruden: How Tapping Works, Healing the Mind 2005.
Samenvatting:

Why tapping Works - Ronald Ruden - hoe het kloppen (EFT) werkt?

 

Ronald Ruden

Gevoelens, hersenen en zenuwknopen
Gevoelens worden opgeslagen in het limbische systeem, dat wil zeggen de oude kern van de hersens, dit deel van de hersens hebben zelfs de meest primitieve reptielen. In dit gebied zitten hele primaire reacties. In de amygdala word angst geleerd en opgeslagen (ge-encodeerd) door middel van glutamaat. We hebben het dan ook bijv over vechten, vlucten of bevriezen bij angst. Deze gevoelens kunnen zo zeer sterk zijn  dat het moeilijk is om nog helder te denken. In de romp zitten een aantal forse zenuwknopen (buik en maagstreek, hartgebied, en een iets kleinere in het keelgebied) van het abdominale autonome zenuwstelsel. Deze zenuwknopen zorgen voor de bekende gevoelens en lichamelijke sensaties (vlinders, omdraaien, koud, warmte, samentrekken, druk, steek, spanning etc)  in de buik, maag, hartstreek en keel. Dit deel van het zenuwstelsel slaat allemaal herinneringen en ervaringen op, en communiceert deze met het limbische gedeelte van de hersens via de nervus vagus. 

EFT (kloppen) en hersenen  
Eerst denk je aan een herinnering denkt, en daarmee roep je een gevoel op. (Je scoort deze ook op de SUD-schaal.) Het oproepen of activeren van het gevoel zorgt er ook voor dat glutamaat vrijkomt (wat normaal zorgt voor de opslag van angst). We spreken over de basolaterale kern van de amygdala. Het is hier dat een aangeleerde (geconditioneerde) angst word opgeslagen als een verbinding tussen een ongeconditioneerde angstreactie (een in de mens ingebouwde angstreactie) en de geconditioneerde angststimulus word opgeslagen.

Het kloppen zorgt ervoor dat er GABA (gamma aminoboterzuur) en serotonine vrijkomen. (En de GABA zorgt er ook voor dat er serotonine vrijkomt).

GABA en serotonine voorkomen de opslag van glutamaat. Op deze manier roep je op, maar sla je niet meer op wat je hebt opgeroepen. Op deze manier lost een angst op.

WHY TAPPING WORKS - A SENSE FOR HEALING: The Neurobiological Basis of Peripheral Sensory Stimulation
for Modulation of Emotional Response
Ronald A. Ruden, M.D., Ph.D. Healing the Mind (bron), March 2005
Locale pdf

A Model for Disrupting an Encoded Traumatic Memory
by Ronald Ruden, M.D., Ph.D. van Bron: Healing the Mind website
Lokale pdf

Key words: EFT onderzoek, EFT research.

Michael Lamport Commons, The Power Therapies: A proposed mechanism for their action and suggestions for future empirical validation, Traumatology, locale pdf

Paper scheduled for publication in Psychotherapy: Theory, Research, Practice, Training, a journal of the
American Psychological Association, which holds the copyright. This article may not exactly replicate
the final version published in the APA journal. It is not the “copy of record.”
Rapid Treatment of PTSD: Why Psychological Exposure
with Acupoint Tapping May Be Effective
David Feinstein, Ph.D.

Abstract
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 brief psychological
exposure is unusually effective in its speed and power because deactivating signals are sent
directly to the amygdala, resulting in the rapid attenuation of threat responses to innocuous
stimuli. This formulation and the preliminary evidence supporting it could, if confirmed, lead to
more powerful exposure protocols for treating PTSD.
Keywords: Acupuncture, Energy Psychology, Consolidation, Exposure, PTSD
Citation: Feinstein, D. (in press). Rapid treatment of PTSD: Why psychological exposure
with acupoint tapping may be effective. Psychotherapy: Theory, Research, Practice,
Training.

Keywords: EFT research, EFT onderzoek

Zie de PDF, zie bron

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