A systematic review and meta-analysis of randomized and non-randomized trials of Emotional Freedom Techniques (EFT) for the treatment of depression
Citation (APA Style): Nelms, J. & Castel, D. (2016). A systematic review and meta-analysis of randomized and non-randomized trials of Emotional Freedom Techniques (EFT) for the treatment of depression. Explore: The Journal of Science and Healing, 13(6), 416-426. doi:10.1016/j.explore.2016.08.001
Background: Among a group of therapies collectively known as Energy Psychology (EP), Emotional Freedom Techniques (EFT) is the most widely practiced. Clinical EFT is an evidence- based practice combining elements of cognitive and exposure therapies with the manual stimulation of acupuncture points (acupoints). Lacking is a recent quantitative meta-analysis that enhances understanding of the variability and clinical significance of depression reduction outcomes after Clinical EFT treatment.
Methods: All studies (2005–2015) evaluating EFT for sufferers of depression were identified by electronic search; these included both outcome studies and randomized controlled trials (RCTs). Our focus was depressive symptoms as measured by a variety of psychometric questionnaires and scales. We used meta-analysis to calculate effect sizes at three time points including posttest, follow-ups less than 90 days, and follow-ups greater than 90 days.
Results: Twenty studies qualified for inclusion, 12 RCTs and 8 outcome studies. The number of participants treated with EFT included N = 461 in outcome studies and N = 398 in RCTs. Clinical EFT showed a large effect size in the treatment of depression in RCTs. At posttest Cohen’s d for RCTs was 1.85 and for outcome studies was 0.70. Effect sizes for follow-ups less than 90 days was 1.21, and for >= 90 days was 1.11. EFT was more efficacious than DB (Diaphragmatic Breathing) and SI (Supportive Interview) in posttest measurements (p = 0.06 vs DB; p < 0.001 vs SI), and SHE (Sleep Hygiene Education) at follow-up (p = 0.036). No significant treatment effect difference between EFT and EMDR (Eye Movement Desensitization and Reprocessing) was found. EFT was superior to TAU (treatment as usual), and efficacious in treatment time frames ranging from one to 10 sessions. The mean of symptom reductions across all studies was -41%.
Conclusion: The results show that Clinical EFT is highly effective in reducing depressive symptoms in a variety of populations and settings. EFT was equal or superior to TAU and other active treatment controls. The posttest effect size for EFT (d =1.31) was larger than that measured in meta-analyses of antidepressant drug trials and psychotherapy studies. EFT produced large treatment effects whether delivered in group or individual format, and participants maintained their gains over time. This meta-analysis extends the existing literature through facilitation of a better understanding of the variability and clinical significance of depression improvement subsequent to EFT treatment.