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Emotional Freedom Techniques; An Effective And Efficient Tool For Integrative Cancer Care

Emotional Freedom Techniques; An Effective And Efficient Tool For Integrative Cancer Care.

by Aga Kehinde and Bettina Falkenberg

Original Source Paper: https://www.agakehinde.com/blog-1

 

Stress, anxiety, and emotional distress are present along the entire cancer care pathway. (Gary et al., 2022) Figure1

These factors impact the efficacy of treatments, patient outcomes, recovery time, and cost of care. Most importantly, they present a significant burden to cancer patients, their families and friends, clinicians, and the wider society.

Interest in fostering positive patient outcomes beyond survival is growing among patients, clinicians, and those paying for cancer services. Effective mitigation of these factors requires early identification followed by effective intervention.

A stress reduction technique, EFT is well supported by clinical research (Stapleton, 2022). Benefits include reduced psychological distress, improved quality of life, and a positive impact on various psychological and physical symptoms.

 

What is EFT?

Clinical EFT is a manualised, evidence-based stress reduction technique that utilises elements of cognitive therapy with physical stimulation of acupressure points (Church, 2013a). EFT  is often referred to as ‘Tapping’ as it uses a two-finger tapping process on known acupuncture points. (Church, 2013b)

Clinical EFT includes elements from Cognitive Behavioral Therapy (CBT) and Prolonged Exposure therapy (PE). These include awareness building, imaginal exposure, cognitive reframing, pre-framing, and systematic desensitisation. An additional element to these is the somatic stimulation of the acupuncture points. 

The addition of acupressure to established psychological techniques has been found to contribute to EFT’s therapeutic results.  (Church et al, 2018b).

Clinical EFT has been validated in research studies and has previously met the American Psychological Association (APA) standards for evidence-based psychological practice (Fang et al, 2009). It is currently under review with the APA against the Tolin standards.

EFT is easy to learn and can either be self-applied or with an Accredited EFT Practitioner, which is recommended for more complex issues that require in-depth investigation.

It is a safe, rapid, reliable, and effective treatment for both psychological and medical diagnoses. (Church et al, 2022). 

Treatment is effective whether delivered in person or virtually and self-applied tapping in moments of distress can bring rapid relief. (Church et al, 2017)

Studies have shown that lasting changes can be achieved in 4 – 10 sessions (Sebastian, et al, 2017) after which patients can continue to support themselves using EFT. In very complex cases a longer-term approach may be necessary. 

 

How does it work?

EFT has been shown to regulate the body’s stress response and the hypothalamus-pituitary-adrenal (HPA) axis. When we are under stress, the prefrontal cortex of the brain, our rational thinking brain goes “offline”, and our levels of adrenaline and cortisol increase. EFT allows us to release the intensity of uncomfortable feelings like hurt, anxiety, guilt, fear, overwhelm, or anger and transform them. EFT can transform the recurring thoughts and beliefs underlying our emotional experiences.

It appears that acupoint stimulation sends signals to the limbic system and reduces its arousal  (Feinstein, 2012).  EFT decreases the activity of the amygdala, the brain’s arousal pathway (Dhond, 2007).

Research has shown that the resulting changes last over time indicating that there may be changes in the brain’s neural pathways and memory reconsolidation  (Feinstein, 2015).

Using tapping not only reduces stress immediately but also allows for safely processing memories that may have contributed to the intensity of the current stress response. Quote: “My diagnosis was a big shock. I had recently lost my husband to cancer, it was all a big emotional roller coaster. ..I felt with cancer I had an end date and I would join my husband. ..cancer is the answer to my incredible sadness… I went for EFT therapy which frankly transformed my whole approach to my cancer journey. Things I wasn’t consciously aware of became released, things that were very deep and hidden… At the end of the sessions, I would feel a huge weight off my mind… Tapping made me realise that I wanted to live…” CR, Breast Cancer patient.

EFT treatment is associated with measurable biological effects on brain synchrony, hormonal synthesis, and a wide range of biomarkers. Physiological indicators of health such as Resting Heart Rate, Blood Pressure and Cortisol also improve significantly (Bach et al, 2019).  Research on gene expression indicates EFT has the ability to down/up-regulate genes; e.g., downregulate genes associated with the stress response and up-regulate genes associated with immune functioning and cancer suppression (Maharaj, 2016).

 

How can it help people affected by cancer throughout their care?

Tapping can be particularly supportive for patients who are experiencing the emotional impact and physical side effects of their cancer diagnosis and treatment.

Clinical EFT’s stress-reduction capacity makes it also effective for alleviating multiple psychological conditions, including phobias, PTSD, anxiety, and depression (Church et al., 2022) that are often associated with a cancer diagnosis (Pitman, et al 2018).

EFT can be used as an adjunct to traditional treatment and is effective in reducing the side effects of Tamoxifen in women with breast cancer  (Baker et al, 2015), improving quality of life and reducing fatigue or cancer-related cognitive impairment (Tack, L.,et. al 2021).

EFT significantly reduces pre-surgery anxiety (Thomas et.al, 2017).

EFT offers potential as a technique that health practitioners may use to support the psychosocial aspect of chronic disease healthcare (Kalla et al, 2017).

EFT empowers cancer patients to manage their own emotional well-being at a time when they may feel helpless and frightened. Quote: “It (EFT) gave me something in my toolbox for when I feel anxiety bubbling up. I have something I can go to. I can even do it at work.” SP, Breast Cancer patient.

EFT can effectively reduce the levels of perceived stress, anxiety, and depression (Liu et al, 2017) Quote: “I was very, very distressed and scared. My fear was irrational. I felt out of control, my head was in a frenzy. I couldn’t see a way out… (EFT) helped me put things in perspective, into a much calmer state.” J.G., Breast Cancer patient.

EFT is a tool that is literally at the patients’ fingertips, meaning they can use it any time they need, including before hospital appointments, scans, surgery etc.  It has been well documented that the calmer the patient is, the fewer side effects that seem to arise.

EFT gives patients the opportunity to find renewed meaning in life and to develop emotional resilience, EFT offers promise as a suitable therapeutic approach to help chronic disease patients make sense of their life stories and lived experiences, and consequently, symbolic meanings of diseases (Kalla et al, 2020). Consequently, they are able to deal with the issues that result from their cancer diagnosis and treatment.

By using EFT, we can reconnect with our innate sense of unshakeable well-being by releasing the intensity of emotions and transforming the way uncomfortable feelings like hurt, guilt, fear, or anger may impact our everyday experience. We become more considered and less reactive in our approach to our life.

EFT can help the patient to overcome the fear of treatment and undergo treatment with a more positive attitude Quote: “The second chemo on Friday was a different experience. ..  I feel that the change in my attitude towards the treatment has played a very significant part – and this has come directly from our meetings and EFT.  Welcoming the poison into my body, trusting my body to work with it as it kills the cancer cells floating around my body, all in pursuit of strengthening and revitalising my health and my well-being.  The effect of forgiving and accepting my decision to try again has been extraordinary” RW, Breast Cancer patient.

EFT seems to help patients come to terms with physical changes and body image.

Quote: “I didn’t want the mastectomy. I didn’t want to have the deformity. I believed it would be impossible to start a new relationship… I would never feel confident in my body again… I needed emotional support to understand why I didn’t want to give myself the best chance of living. EFT helped me understand that I wanted to live more than I was worried about the deformity. Now I have a new life and I am really incredibly happy”. CR; Breast Cancer patient.

EFT has the potential to be a powerful tool to improve the care of palliative patients who have distressing emotions (Quilty et al, 2017).

 

What to Expect from the Process

 The EFT process involves clients identifying a concern or an issue they wish to address and rating their level of distress on a Likert-type scale out of 10 (10 is the maximum amount of distress and 0 represents the minimum or a neutral state). This is called a Subjective Unit of Distress (SUDS)(Wolpe 1973).

Participants then state their concerns in a “Set-up Statement,” which assists in tuning them into their level of distress. This is typically stated in this format: “Even though I have this problem (e.g., anger), I deeply and completely accept myself.” 

The first part of the set-up statement emphasises exposure, while the second half frames the traumatising event in the context of self-acceptance. The participant then engages in the tapping process on acupoints while they repeat a shortened phrase to stay engaged (e.g.; angry). This is called the “Reminder Phrase.” The tapping sequence uses 9 acupoints  (see Figure 2) on the face and upper body and is normally repeated until the SUDS rating reduces to one or zero. 

 

How can I be sure the professional working with me is qualified?

 It is strongly recommended that patients use an Accredited Practitioner found in the international directories of training providers such as ACEP,  EBEFT,  EFT Universe and EFT International Directory .

As an International Professional Body for EFT Practitioners, EFT International is committed to advancing and upholding the highest standards for education, training, professional development, and promotion of the skilful, creative and ethical application of EFT (Emotional Freedom Techniques or “Tapping”) worldwide.

Practitioners listed on this website are recognised EFT International members who have agreed to hold appropriate insurance coverage, who have signed up to follow the Code of Conduct and Ethics and to undertake an annual minimum number of hours of Continuing Professional Development (CPD) and Mentoring. EFT International only accepts members with a high standard of training and has formal feedback, 

 

Limitations on scope of practice and potential side effects

Most studies of EFT have been performed after the Institutional Review Board (IRB) or Ethical approvals boards. These organisations’ procedures require that studies be designed and conducted in a manner that protects human subjects, including a requirement that participants be monitored for adverse events. Over 1,000 subjects have participated in research trials of acupoints without a single adverse event being reported, indicating a high degree of safety. EFT also appears to be safe whether administered by a therapist or life coach or self-administered.

How to access EFT for cancer, free (charity-based) and paid options  

  • Check your local cancer clinic or cancer support charity whether they offer free EFT sessions 
  • YestoLife directory and online workshops 
  • EFT works very well online, therefore patients may be able to access EFT sessions via cancer support charities such as Penny Brohn UK or the Fountain Cente remotely
  • Find an experienced Accredited EFT Practitioner specialising in cancer support on the EFT International Practitioners Directory
  • Try the ONCIO App
  • The Sythnesis Clinic
  • EFT works very well online, therefore patients cay be able to access EFT sessions via cancer support charities, e.g Penny Brohn UK, Fountain Centre or Yes to Life

Use of technologies to enhance the patient experience 

Innovative future technologies may present opportunities to identify and eliminate early-stage stress and emotional burdens.

Information could be integrated into the encounters a person has for diagnostic or treatment interventions, as these moments are opportunities to engage and help maintain progression and stability along the entire pathway.

When EFT is delivered using virtual delivery platforms such as apps and online courses, initial evidence suggests efficacy comparable to in-person application. (Church et al, 2018).

Apps such as ONCIO, the first free app available to anyone affected by cancer, aim to empower patients to practically put integrative oncology tools and strategies into action. It can be offered to patients in the pre-habilitation and rehabilitation stages as part of a personalised care approach.

 

 

 

Content written and approved by:

●      Aga Kehinde, Oncio Expert Panel member,  Cancer Educator and Nurse, coach and Advanced EFT Practitioner

●      Bettina Falkenberg, Advanced EFT Practitioner and Trainer

The content was reviewed with Dr Peta Stapleton and Prof Liz Boath with many thanks for their time and kind comments.

 

Reference list

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Baker, B.S. and Hoffman, C.J. (2015). Emotional Freedom Techniques (EFT) to reduce the side effects associated with tamoxifen and aromatase inhibitor use in women with breast cancer: A service evaluation. European Journal of Integrative Medicine, 7(2), pp.136–142. doi:https://doi.org/10.1016/j.eujim.2014.10.004.

Church, D. (2013). Clinical EFT as an Evidence-Based Practice for the Treatment of Psychological and Physiological Conditions. Psychology, 04(08), pp.645–654. doi:https://doi.org/10.4236/psych.2013.48092.

Church, D., Stapleton, P., Kip, K. and Gallo, F. (2020). Corrigendum to: Is Tapping on Acupuncture Points an Active Ingredient in Emotional Freedom Techniques: A Systematic Review and Meta-Analysis of Comparative Studies. Journal of Nervous & Mental Disease, 208(8), pp.632–635. doi:https://doi.org/10.1097/nmd.0000000000001222.

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Church, D., Stapleton, P., Sheppard, L., & Carter, B. (2018). Naturally Thin You: Weight Loss and Psychological Symptoms After a Six-Week Online Clinical EFT (Emotional Freedom Techniques) Course. EXPLORE, 14(2), 131–136. https://doi.org/10.1016/j.explore.2017.10.009

 

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