Emotional Freedom Technique (EFT): Psychocutaneous disorders and alternative management in children and adolescents

Children and adolescents can often benefit from nonpharmacological interventions for psychocutaneous disorders with minimal, if any, side effects. Interventions may include acupuncture, aromatherapy, biofeedback, brief dynamic psychotherapy, cognitive-behavioral therapy (CBT) methods, energy acupressure techniques such as Emotional Freedom Technique (EFT), eye movement desensitization and reprocessing (EMDR), hypnosis, mindfulness meditation, music, placebo, and suggestion. Age-appropriate modifications allow these interventions to be tailored to individual patients. Incorporating age-appropriate elements of fun and storytelling often motivates patients to cooperate. Biofeedback can often incorporate a video- or audio-based, game-like approach to engage the patient. CBT must also be age-appropriate, typically beginning at around 8 years of age, and can incorporate storytelling in addition to direct discussion. EFT can be used with pediatric patients, including infants, toddlers, and preschoolers, while EFT can be taught to elementary school–aged and adolescent patients. EMDR can be used with older preschoolers, elementary school–aged, and adolescent patients. Hypnoidal techniques, such as rocking, can be used with infants and toddlers. Older preschoolers and elementary school–aged patients generally shift into imaginative trance quite easily, with a peak of hypnotizability between 8 and 12 years of age. Elementary school–aged and adolescent patients can also be taught self-hypnosis. For individuals with low hypnotizability, distraction is likely to be the key element, while for those with moderate hypnotizability, sensory or time distortion may be key; dissociation or fantasy will predominate for highly hypnotizable individuals. Mindfulness meditation involves focusing on the present moment and accepting experiences as they are and may help reduce stress. Music can help calm anxious children. Placebo interventions may be used when age-appropriate and ethically justified. Carefully phrased suggestions can benefit older preschoolers, elementary school–aged, and adolescent patients.