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A Randomized Controlled Comparison of Emotional Freedom Technique and Cognitive-Behavioral Therapy to Reduce Adolescent Anxiety: A Pilot Study

Citation: Gaesser, A., Karan, O. A Randomized Controlled Comparison of Emotional Freedom Technique and Cognitive-Behavioral Therapy to Reduce Adolescent Anxiety: A Pilot Study. The Journal of Alternative and Complementary Medicine, Volume 00, No. 0, 2016.


The objective of this pilot study was to compare the efficacy of Emotional Freedom Techniques (EFT) with that of Cognitive-Behavioral Therapy (CBT) in reducing adolescent anxiety.

Design: Randomized controlled study.

Settings: This study took place in 10 schools (8 public/2 private; 4 high schools/6 middle schools) in 2 northeastern states in the United States.

Participants: Sixty-three high-ability students in grades 6–12, ages 10–18 years, who scored in the moderate to high ranges for anxiety on the Revised Children’s Manifest Anxiety Scale-2 (RCMAS-2) were randomly assigned to CBT (n = 21), EFT (n = 21), or waitlist control (n = 21) intervention groups.

Interventions: CBT is the gold standard of anxiety treatment for adolescent anxiety. EFT is an evidence- based treatment for anxiety that incorporates acupoint stimulation. Students assigned to the CBT or EFT treatment groups received three individual sessions of the identified protocols from trained graduate counseling, psychology, or social work students enrolled at a large northeastern research university.

Outcome measures: The RCMAS-2 was used to assess pre-intervention and post-intervention anxiety levels in participants.

Results: EFT participants (n=20; M=52.16, SD=9.23) showed significant reduction in anxiety levels compared with the waitlist control group (n=21;M=57.93,SD=6.02)(p=0.005,d=0.74, 95%CI[-9.76, -1.77]) with a moderate to large effect size. CBT participants (n = 21; M = 54.82, SD = 5.81) showed reduction in anxiety but did not differ significantly from the EFT ( p = 0.18, d = 0.34; 95% CI [-6.61, 1.30]) or control ( p = 0.12, d = 0.53, 95% CI [-7.06, .84]).

Conclusions: EFT is an efficacious intervention to significantly reduce anxiety for high-ability adolescents.

Craig’s Notes

The researchers of this study noted that about 5 million school-age children, between kindergarten and grade 12, struggle with the negative effects of anxiety, about 10% of all school age children. They further note that counseling support for these students is limited due to high case loads for school counselors and other factors. Since high anxiety detracts from optimal functioning as well as creative and intellectual development, the researchers wanted to examine whether EFT might be as effective or more so, than the gold standard treatment (CBT) for adolescent anxiety.

Sixty-three students between ages 10-18 participated in this study and were selected from middle and high schools in two northeastern states. All were in the top 15% of their peer group academically and so were high academic achievers who also suffered from anxiety symptoms.

A pre-treatment 49-item questionnaire was administered to all students (RCMAS-2, which is the most often used anxiety scale for children) before and after the interventions treatments.

The students were divided into an EFT group, a CBT group and a control group. Both the EFT and CBT groups received three sessions from a trained graduate student, with each session no more than two weeks apart. The total treatments were administered over a five-month period. The CBT and EFT participants completed another RCMAS-2 questionnaire soon after the third treatment.

So, what were the results?

Students in the EFT group had significantly lower post-treatment anxiety scores than those in the control group. The students in the CBT group also had decreased anxiety scores, however, only the EFT group had a statistically significant lower decrease compared with the control group. These results indicate that EFT is indeed an efficacious intervention in school settings for reducing anxiety. This is significant, since EFT does not require a trained school counselor to administer, and because students can even learn to treat themselves for minor symptoms of anxiety, thus reducing the burden on the school counselors. The researchers note that if students are given easy-to-use tools like EFT for managing anxiety early in life, it could support maximum development of their talent and well-being potential as well as preventing persistent anxiety problems into adulthood.