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Pain, Range of Motion, and Psychological Symptoms in a Population with Frozen Shoulder: A Randomized Controlled Dismantling Study of Clinical EFT (Emotional Freedom Techniques)

Citation: Church, D., & Nelms, J. (2016). Pain, range of motion, and psychological symptoms in a population with frozen shoulder: A randomized controlled dismantling study of clinical EFT (emotional freedom techniques). Archives of Scientific Psychology, 4(1), 38-48.


Clinical EFT (emotional freedom techniques) combines fingertip stimulation of acupuncture points (acupressure) with elements drawn from cognitive and exposure therapies. Numerous studies have demonstrated the efficacy of EFT for depression, anxiety, phobias, posttraumatic stress disorder (PTSD), and other psychological conditions. The current study was designed to measure whether acupressure is an active ingredient in EFT, or whether its effects are due to its cognitive and exposure elements, or factors common to all therapies like sympathetic attention and belief in a positive outcome. In this study, 37 participants with “frozen shoulder” consisting of limited range of motion (ROM) and pain were randomized into a wait list, or 1 of 2 treatment groups. ROM, pain, and psychological conditions such as anxiety and depression were assessed before and after a 30-min treatment session, and 30 days later. One treatment group received clinical EFT, while the other received all the elements of EFT but with diaphragmatic breathing (DB) substituted for acupressure. No statistically significant improvement (1 possibility in 20) in any psychological symptom was found in the wait list group. After treatment, participants in the both the EFT and DB groups demonstrated statistically significant improvements in psychological symptoms and pain. Follow-up showed that both groups maintained their gains for pain, with EFT superior to DB, but only the EFT group maintained their gains for psychological symptoms. Statistically large EFT treatment effects were found for anxiety, pain, and depression. ROM changes were not statistically significant for most measures in any of the groups. The EFT group showed a significant association between reductions in psychological distress and pain. The results are consistent with 5 earlier studies showing that acupressure is an active ingredient in EFT treatment and not an inert ingredient or a placebo. The study adds further support to other clinical trials indicating that clinical EFT is an evidence-based and effective treatment for pain and psychological conditions.

Craig’s Notes

This study measured whether tapping the acupressure points is an active ingredient in EFT, or whether its beneficial effects are due to the cognitive component of repeating the statement, or to other factors like sympathetic attention to the issue and belief in positive outcome.

The paper describes several previous studies demonstrating the efficacy of EFT and showing that tapping was an active ingredient. This study utilized 37 participants who suffered from ‘frozen shoulder’ including limited range of motion and pain. They were divided into 3 groups: a wait list, a group that received clinical EFT, and a group that received all the elements of EFT, but with diaphragmatic breathing substituted for the actual tapping of acupressure points.

The participants’ pain levels, range of motion limitation, and levels of anxiety and depression due to the injury was assessed before and again after their 30-minute treatment session. A follow up assessment was performed 30 days later. Scientific scales and assessment measures were used.

So, what were the results?

Researchers found that EFT tapping improved immediate outcomes in both pain and in psychological factors such as anxiety and depression. Although the “no tapping” EFT did produce improvement in the immediate post treatment assessment, the improvements did not persist over time, as it did with the tapping. These results suggest that tapping is not an inert component of EFT, and these findings are consistent with previous studies. Another consistent finding is that the EFT had a more statistically significant effect on the psychological accompanying symptoms, than it did on the physiological symptoms.

The principal limitation of the study was the small sample size, and so further study is warranted.