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The Effectiveness of Cognitive Behavioral Therapy and Emotional Freedom Techniques in Reducing Depression and Anxiety Among Adults: A Pilot Study

Citation: Chatwin, H., Stapleton, P., Porter, B., Devine, S., & Sheldon, T. (2016). The Effectiveness of Cognitive Behavioral Therapy and Emotional Freedom Techniques in Reducing Depression and Anxiety Among Adults: A Pilot Study. Integrative medicine (Encinitas, Calif.), 15(2), 27-34.

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Context: The World Health Organization (WHO) places major depressive disorder (MDD), or depression,as the fourth leading cause of disability worldwide. Some studies have found that cognitive behavioral therapy (CBT) represents the most superior approach in treating mild to severe symptoms. Recent literature has indicated a number of limitations to this therapeutic approach. An approach that has received increasing attention within the literature is the emotional freedom technique (EFT). Objective: The current pilot study aimed to evaluate the effectiveness of CBT and EFT in the treatment of depression and comorbid anxiety. Design: The research team designed a pilot study structured as a randomized, controlled trial with 2 intervention arms. Setting: The study took place at Bond University in Gold Coast, Queensland, Australia. Participants: Participants (n = 10) were local community members who had screened positive for a primary diagnosis of MDD. Intervention: Participants were randomly assigned to an 8-wk CBT or EFT treatment program, the intervention groups. A sample of individuals from the community was assessed for comparative purposes (control group) (n = 57). Outcome Measures: Pre- and postintervention, all participants were interviewed using the Mini-International Neuropsychiatric Interview (MINI) 6.0, and they completed the following validated questionnaires: (1) the Beck Depression Inventory, second edition (BDI-2) and (2) the Depression, Anxiety, and Stress Scales (DASS-21). Results: Findings revealed that both treatment approaches produced significant reductions in depressive symptoms, with the CBT group reporting a significant reduction postintervention, which was not maintained with time. The EFT group reported a delayed effect involving a significant reduction in symptoms at the 3- and 6-mo follow-ups only. Examination of the individual cases revealed clinically significant improvements in anxiety across both interventions. Conclusions: Overall, the findings provide evidence to suggest that EFT might be an effective treatment strategy worthy of further investigation.


Craig’s Notes

Researchers note that although Cognitive Behavioral Therapy (CBT) is the ‘gold standard’ in treating anxiety and depression, that several previous studies have demonstrated EFT to also be effective, and in some cases producing results more quickly. This study compares the two therapies.

The 10 final participants were randomly assigned to either an 8-week CBT group, or and 8-week EFT group. A control group received no intervention. Both intervention groups were structured similarly, with participants being assigned activities In-between session to consolidate their learning. Both sets of participants completed follow up questionnaires delivered by email 3 months after completion, and 6 months after completion. Members of the control group were invited to complete an identical questionnaire, with the understanding the researcher was investigating emotional well-being among adults.

The CBT program was based on standard protocols, designed to modify distorted thinking and unhelpful behavior with strategies such as activity scheduling and restructuring of negative thoughts and core beliefs. The EFT program was based on Gary Craig’s protocols, using a set up statement focusing on negative emotions along with a statement of acceptance, followed by tapping through the points. Researchers measured how effective each treatment by having participants assess their feelings with well-established scales for depression, anxiety and stress. Each week they would assess their levels during the past week.

So, what were the results?

Some of the results were inconsistent with previous studies and this might be due to the small sample size, and some differing levels of psychopathology between the two groups. In the case of depression, the CBT group experienced a greater improvement initially – directly after eight-week groups ended. However, after three months and six months, the EFT group ‘caught up’ and by the end of the six-month period there was no significant difference in depression levels between the two groups. In the case of anxiety, although individuals in both groups experienced noteworthy improvement after the 8-week intervention it was not statistically significant. This was surprising, and researchers postulate that it might be because the specific interventions were tailored more to depression than anxiety.

The researchers conclude that further study is needed, but that EFT might well be an effective strategy for treating both depression and anxiety.