Citation: Church, D. (2013). Clinical EFT (Emotional Freedom Techniques) as Single Session Therapy: Cases, Research, Indications, and Cautions. In Capture the Moment: Single Session Therapy and Walk-In Service. (Michael Hoyt & Moshe Talmon, eds). Bethel, CT: Crown House.
Clinical EFT (Emotion Freedom Techniques) is an evidence-based practice that combines elements of exposure and cognitive therapies with the manual stimulation of acupuncture points. The research literature indicates it to be efficacious for a number of psychological conditions in a variety of treatment time frames. Randomized controlled trials demonstrate that EFT effectively treats phobias and certain anxiety disorders in one session. A single session also results in a significant drop in cortisol and normalization of the EEG frequencies associated with stress. EFT has the client focus on specific traumatic memories; the emotional intensity of these memories usually diminishes rapidly during treatment. This makes EFT an efficient single-session treatment for emotional distress associated with episodic memories. For conditions such as complex co-morbid PTSD, combination treatments and longer courses are indicated, though even treatment-resistant clients often experience some relief after a single session. Psychological symptoms of PSTD, depression, and anxiety typically reduce simultaneously, along with physical 2 symptoms such as pain and insomnia. Clinical EFT also offers a suite of techniques developed to address treatment barriers such as dissociation and overwhelming emotion.
This review and case series examines the conditions for which a brief course of EFT treatment is appropriate, when it is not indicated, when it can be taught to the client as a form of self-care, and when professional administration is required. It also cautions against generalizing EFTs rapid efficacy for certain conditions; this may contribute to unreasonable expectations in therapist or client. EFT is recommended as a front line primary care intervention to improve mental health and physical symptoms.
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This is not actually a study, but a review of previous studies and a description and analysis of some particular single session case studies.
In one case study, the EFT client had trouble accessing emotions behind his memories and thoughts. His self-reported SUDs levels were low to begin with. After his EFT session, psychological assessments revealed little improvement. However, a test of cortisol levels showed that the client had indeed received quite bit of relief from the stress induced by the memories and thoughts.
A second case history involved performance anxiety—a “global’ complaint which required looking for specific memories and episodes that had brought it about. EFT is most successful when used with specific events. This client reported ‘horrible anxiety’ every day leading up to a performance, although it dissipated during the actual performance. She reported a SUDs score of 10, with the feeling located in her chest. They tapped on three specific memories involving performances, bringing the SUDs for each down to 0. After this when asked to imagine her upcoming performance, her anxiety level had gone down to 0. This is consistent with randomized controlled trials showing that single session EFT significantly reduces performance anxiety.
A third case study worked with the idea that tapping on the ‘worst or the first’ event can lead to relief from a more general problem such as self esteem or procrastination issues. In this case they went to the ‘worst’ childhood beating the client had received from his father, and did several tapping rounds on different moments of the event itself. Eventually the SUDs on this event went down to a 0. The session resulted in a significant cognitive shift in the client regarding his father, and his own sense of self worth.
A 4th case history demonstrates how the soothing somatic input of tapping acupressure points signals the hippocampus that no objective threat is present – even while cognitively recalling a troubling event. A client presented with fear of heights, and when imagining a room with floor to ceiling windows experienced a SUDs of 9, physically feeling it in his throat. When asked for memories related to this feeling, the client came up with some that did not seem related to heights. However, tapping on these memories and bringing them to a 0 resulted in his SUDs when imagining walking into a high building to a 2. This demonstrated that even if practitioner and client cannot cognitively see a relationship between a memory and a presenting issue, the hippocampus can. This shows that it is important to avoid assumptions when practicing EFT.
This paper also discusses the fact that three controlled trials have shown that a single session of EFT can be efficacious in getting rid of a phobia. In contrast, PTSD has been described as a treatment-resistant condition and may require a series of sessions. However, one study involving abused boys living in a group home showed relief of PTSD symptoms with a single session of EFT given by an experienced practitioner, on an individual basis, tapping on various aspects of the ‘worst’ experience of abuse. The author notes that it’s possible that younger PTSD clients may experience quicker results than adults who suffer from PTSD.
Case studies 5 and 6, were with veterans of Vietnam who suffered from specific physical problems due to PTSD from the war. Each showed significant improvements in present day experience, one losing an intolerable sensitivity to touch and another no longer waking up at 2:30 am every morning. Most war veterans also report severe childhood trauma in addition to war trauma, and many experienced significant relief of symptoms after working through the childhood events with EFT.
This paper notes that while single session EFT might relieve the most superficial layer of psychological distress, there might be more conditioned layers that require more treatment.
This paper concludes that single session EFT can provide clients with the experience that even long-standing psychological problems can be relieved with relative ease. This can encourage them to persist with prescribed treatment that may involve other modalities in addition to EFT and result in a greater healing.