Emotional Freedom Techniques

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cara susanna

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I just saw this article that the VA has approved Emotional Freedom Techniques (EFT) for mental health conditions.

Veterans Administration Approves EFT (Emotional Freedom Techniques) Treatment | HuffPost

Any thoughts on this? I was under the impression that there wasn't a lot of research showing the efficacy of EFT.

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I've never heard of this treatment before, but I took a look at the references listed.

The two meta-analyses are from "Explore: The Journal of Science & Healing," which I have also never heard of before.

Explore: The Journal of Science & Healing - Wikipedia

Explore: The Journal of Science & Healing is a bimonthly peer-reviewed interdisciplinary journal that publishes papers on alternative medicine. It was established in 2005 and is published by Elsevier. The executive editor is faith healing advocate Larry Dossey, and the co-editors-in-chief are hypnotherapist, acupuncturist, and herbalist Benjamin Kligler, an associate professor at the Albert Einstein College of Medicine,[1] and parapsychologist Dean Radin. The journal has been described as a "sham masquerading as a real scientific journal" which publishes "truly ridiculous studies",[2] such as Masaru Emoto's claimed demonstration of the effect of "distant intention" on water crystal formation.[3]

Editorial team[edit]
The executive editor of Explore is Larry Dossey, an advocate for faith healing and other alternative medicine approaches that have no grounding in science.[17] The co-editors-in-chief are BenTAU jamin Kligler, who practices Ericksonian hypnotherapy, acupuncture, and herbalism,[18] and parapsychologist Dean Radin, who has been described by Steven Novella as having a "dedicated ideology and a poor history" and a "reputation for creatively massaging data."[19] Radin is the Chief Scientist of the Institute of Noetic Sciences which explores phenomena which "do not necessarily fit conventional scientific models."[20] He also works with the Parapsychological Association which describes itself as "a professional organization ... engaged in the study of psi (or 'psychic') experiences, such as telepathy, clairvoyance, psychokinesis, psychic healing, and precognition."[20]

Sadri Hassani, a retired professor of physics who maintains the website Skeptical Educator,[21] said of the journal "The editorial board of Explore says it all! [...] When the executive editor himself publishes books on "knowing the future" and the "healing power of prayer;" and when coeditors-in-chief engage in the exploration of phenomena that do not necessarily fit conventional scientific models and do research on telepathy and psychic healing, what is the purpose of "peer-review?"".[20]

And if you look at the meta-analyses themselves, the "very large" effect sizes for PTSD was only present for EFT compared to waitlist or treatment as usual (I'm not sure how they're defining TAU in this case or if it was consistent across studies) and there was no difference found compared to CBT or EMDR (which is also incorporates pseudoscience). For depression, the effect sizes were present for waitlists, treatment as usual, diaphragmatic breathing, supportive interview, and sleep hygiene education, which seems pretty unimpressive, because they aren't really comparing it to mainline depression interventions.

I don't really understand why the VA is buying into this, though I don't really know why they bought into EMDR. Maybe the people making these decisions aren't scientists or providers with science or research backgrounds, allowing them to be impressed with purported research results and evidence they didn't even look into.
 
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I just saw this article that the VA has approved Emotional Freedom Techniques (EFT) for mental health conditions.

Veterans Administration Approves EFT (Emotional Freedom Techniques) Treatment | HuffPost

Any thoughts on this? I was under the impression that there wasn't a lot of research showing the efficacy of EFT.

Sadly, nothing that happens at the VA with regard to mental health surprises me anymore...inside or outside the consulting room.

Like you, I don't really understand why the 'big chiefs' (who are they?) in the VA mental health hierarchy have 'bought into' a lot of things...including things like full-time caregivers for PTSD/depression/mTBI (cough-cough SUDS/AXIS II), service animals, equine therapy, Mental Health Suite, 'Mental Health Treatment Coordinators' etc. etc.-- all the while bowing before the upcoming Joint Commission "practice outcome measurement/monitoring" schemes that essentially will mandate a single-case design research project be completed for every mental health case you treat--which isn't necessarily a bad thing, just logistically impossible without modifications to the current caseload arrangements. The VA is haunted and it gets spookier the higher up the organization you go.
 
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Sadly, nothing that happens at the VA with regard to mental health surprises me anymore...inside or outside the consulting room.

Like you, I don't really understand why the 'big chiefs' (who are they?) in the VA mental health hierarchy have 'bought into' a lot of things...including things like full-time caregivers for PTSD/depression/mTBI (cough-cough SUDS/AXIS II), service animals, equine therapy, Mental Health Suite, 'Mental Health Treatment Coordinators' etc. etc.-- all the while bowing before the upcoming Joint Commission "practice outcome measurement/monitoring" schemes that essentially will mandate a single-case design research project be completed for every mental health case you treat--which isn't necessarily a bad thing, just logistically impossible without modifications to the current caseload arrangements. The VA is haunted and it gets spookier the higher up the organization you go.

Coughnoshowcallscough
 
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I just saw this article that the VA has approved Emotional Freedom Techniques (EFT) for mental health conditions.

Veterans Administration Approves EFT (Emotional Freedom Techniques) Treatment | HuffPost

Any thoughts on this? I was under the impression that there wasn't a lot of research showing the efficacy of EFT.

Having spent some time doing research into EFT during my undergraduate years, and then spending much of my graduate career working on anxiety and PTSD from an exposure standpoint, here's my take (for what it's worth). I briefly glanced at the article and its opening line is "Emotional Freedom Techniques (EFT) has been approved as a “generally safe” therapy by the US Veterans Administration (VA)." It doesn't seem to suggest that they are labeling it a first-line treatment. Completing a practicum and an internship at 2 different VA's, I can say that I've never seen it offered here. That said, the research I was involved in suggested to me that EFT is efficacious, specifically in the treatment of phobias. However, my personal belief is that the active ingredient is exposure. We were actually in the process of conducting a dismantling study to see whether or not the tapping served any additional purpose but, unfortunately, the PI passed away mid-study and nobody else at the university was familiar with EFT. Like I said, I think it works, the same way I think EMDR works...I don't believe the tapping (or eye-movements) serve any great function but they're likely benign additions. So, if your patient finds EFT more palatable than PE, I say go for it. Just my 2 cents.
 
"Generally safe" sets a low bar for psychotherapy, especially in a large delivery system that is accountable to a population. It might be harmless on a case-by-case basis, but wait until a true believer takes charge of a program, curriculum, or service line.
 
Having spent some time doing research into EFT during my undergraduate years, and then spending much of my graduate career working on anxiety and PTSD from an exposure standpoint, here's my take (for what it's worth). I briefly glanced at the article and its opening line is "Emotional Freedom Techniques (EFT) has been approved as a “generally safe” therapy by the US Veterans Administration (VA)." It doesn't seem to suggest that they are labeling it a first-line treatment. Completing a practicum and an internship at 2 different VA's, I can say that I've never seen it offered here. That said, the research I was involved in suggested to me that EFT is efficacious, specifically in the treatment of phobias. However, my personal belief is that the active ingredient is exposure. We were actually in the process of conducting a dismantling study to see whether or not the tapping served any additional purpose but, unfortunately, the PI passed away mid-study and nobody else at the university was familiar with EFT. Like I said, I think it works, the same way I think EMDR works...I don't believe the tapping (or eye-movements) serve any great function but they're likely benign additions. So, if your patient finds EFT more palatable than PE, I say go for it. Just my 2 cents.

This is interesting. I wish someone had gone on to isolate the tapping and research it as a placebo treatment! I'd like to see more research in this area, so I'm disappointed to hear that the research you were involved in had to end. I knew someone who said he really benefitted from it, but I never really understood its basis or why it would be effective.

I'm a bit surprised that this isn't something Reiki practitioners would teach instead of psychologists and therapists, since the foundation of it seems more in line with spiritual/energetic healing practices rather than traditional psychotherapy.
 
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This is interesting. I wish someone had gone on to isolate the tapping and research it as a placebo treatment! I'd like to see more research in this area, so I'm disappointed to hear that the research you were involved in had to end. I knew someone who said he really benefitted from it, but I never really understood its basis or why it would be effective.

I'm a bit surprised that this isn't something Reiki practitioners would teach instead of psychologists and therapists, since the foundation of it seems more in line with spiritual/energetic healing practices rather than traditional psychotherapy.

Don't forget the 'purple hat.'
 
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"Generally safe" sets a low bar for psychotherapy, especially in a large delivery system that is accountable to a population. It might be harmless on a case-by-case basis, but wait until a true believer takes charge of a program, curriculum, or service line.

I think any treatment should be evaluated on a case-by-case basis once you leave the field of academia/research. There is NO treatment that works for every patient. That said, I really don't see what can be harmful about adding in some accu-pressure (which is actually based on Eastern medicinal techniques which have been around far longer than modern day psychotherapy). I'm not trying to be argumentative and, like I said, I don't practice EFT with my patients, but I ultimately believe it's no more harmful than what we currently do. I was trained in exposure for phobias and trauma, and that's what I firmly believe in, but I also know that prolonged exposure can be significantly more damaging to patients when practiced incorrectly or on the wrong patient...maybe even by that "true believer" you spoke about :p
 
I think any treatment should be evaluated on a case-by-case basis once you leave the field of academia/research. There is NO treatment that works for every patient. That said, I really don't see what can be harmful about adding in some accu-pressure (which is actually based on Eastern medicinal techniques which have been around far longer than modern day psychotherapy). I'm not trying to be argumentative and, like I said, I don't practice EFT with my patients, but I ultimately believe it's no more harmful than what we currently do. I was trained in exposure for phobias and trauma, and that's what I firmly believe in, but I also know that prolonged exposure can be significantly more damaging to patients when practiced incorrectly or on the wrong patient...maybe even by that "true believer" you spoke about :p

Sure, all treatments should be evaluated on a case-by-case basis, no matter the setting. I spend most of my time in clinical practice, so I'm well aware that no one treatment approach suits all and that you have to monitor individual treatment response and make adjustments.

On rare occasion I've used various forms of placebo in my practice. I try to be mindful of the ethics of this. So if for instance a patient truly thinks I'm tapping into some mysterious energy field, that doesn't pass my standard for informed consent nor does it clear the ethical bar to base my work on scientific knowledge. However, if I've framed the discussion in terms of the positive influence of rituals, expectancies, imagery, and so forth, then I'm more willing to go there. Lucky for us, it's really never a dichotomy of 'gold standard' EST versus woo. How exhausting that would be. For a patient with PTSD who didn't want to engage in PE, I can think of half a dozen other interventions I might offer that don't involve tapping. :)

Individual clinicians have the luxury of thinking this way. People in charge of systems and accountable to population-level health outcomes do not.
 
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Sure, all treatments should be evaluated on a case-by-case basis, no matter the setting. I spend most of my time in clinical practice, so I'm well aware that no one treatment approach suits all and that you have to monitor individual treatment response and make adjustments.

On rare occasion I've used various forms of placebo in my practice. I try to be mindful of the ethics of this. So if for instance a patient truly thinks I'm tapping into some mysterious energy field, that doesn't pass my standard for informed consent nor does it clear the ethical bar to base my work on scientific knowledge. However, if I've framed the discussion in terms of the positive influence of rituals, expectancies, imagery, and so forth, then I'm more willing to go there. Lucky for us, it's really never a dichotomy of 'gold standard' EST versus woo. How exhausting that would be. For a patient with PTSD who didn't want to engage in PE, I can think of half a dozen other interventions I might offer that don't involve tapping. :)

Individual clinicians have the luxury of thinking this way. People in charge of systems and accountable to population-level health outcomes do not.
Excellent response and very much in line with how I practice and conceptualize. Of course, we utilize the placebo effect. It's not like I'm going to tell a patient that treatment probably won't work and lower their expectancy of a positive outcome. :p
That does not mean that I am going to be deceptive and that that is how I see things like finger tapping or blinking lights. I am certain that I could get positive results combining leeches with exposure therapy, but would that really be ethical since it is not the leech that is effective.
 
I think any treatment should be evaluated on a case-by-case basis once you leave the field of academia/research. There is NO treatment that works for every patient. That said, I really don't see what can be harmful about adding in some accu-pressure (which is actually based on Eastern medicinal techniques which have been around far longer than modern day psychotherapy). I'm not trying to be argumentative and, like I said, I don't practice EFT with my patients, but I ultimately believe it's no more harmful than what we currently do. I was trained in exposure for phobias and trauma, and that's what I firmly believe in, but I also know that prolonged exposure can be significantly more damaging to patients when practiced incorrectly or on the wrong patient...maybe even by that "true believer" you spoke about :p

Indeed. As efficacious as Prolonged Exposure may be for PTSD, I found that some people I worked with just couldn't tolerate talking about the most triggering traumatic experiences in detail every session. "One size fits all" doesn't work for everyone, for sure.
I'm a supporter of some practices that have been around for thousands of years, including meditation/mindfulness/breathing, etc., which have been overwhelmingly accepted by the psychological community because of the strong research support despite origins in religion/spirituality (Buddhism/Hinduism/Taoism). Psychology as a field isn't above isolating concepts/interventions by snatching them from spiritual practices and acting like they're the new hot topic in psychological practice/theory....ACT, MBSR, DBT uses mindfulness....etc.

For those who know EMDR and EFT and other exposure therapies + a physical component (i.e. tapping, eye-movement), does the movement component serve as a distraction/focus of attention for the person instead of the trauma narrative they're telling? If so, it makes sense why people would be more open to those methods than PE, which is full immersion into imaginal exposure with nothing to distract you from the intense feelings.
 
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