 |
|
|
EFT RESEARCH
A pilot study on phobias
By Steve Wells, Kathryn A. Polglase, Henry B. Andrews and Patricia Carrington
Introduction by Patricia Carrington, PhD
Irrational fears of specific objects or situations such as insects, snakes, small animals, elevators, bridges, tunnels, or others, are among the most widespread fears reported according to surveys of the general population. Systematic Desensitization, a behaviorial treatment using deep relaxation combined with mental imagery (typically requiring from 10 to 30 treatment sessions to complete), despite its lengthy course of treatment and varying results, was long considered the treatment of choice for this type of fears.
In recent years, however, researchers discovered that many people can be taught to approach their dreaded object or situation if they simply watch and/or (better yet) participate with a therapist or experimenter who shows them how to handle the situation (or object) without him or herself experiencing either fear or discomfort. This approach, known as “therapist-directed exposure”, is now considered the treatment of choice for these conditions even though it no longer makes use of any relaxation training. Swedish psychologist Lars-Goran Ost has, in fact, devised a single session treatment protocol using this method which requires only one individual session of two to three hours, and has reported excellent results from it. Progress is clearly being made in this area.
There are some obvious drawbacks to “therapist-directed exposure” however and this is where the energy psychology approaches come in. Therapist-directed exposure requires in vivo (i.e. “real-life”) exposure to a feared stimulus, usually in the therapist’s ordinary consulting room, but most of us don’t keep snakes around or large “furry” spiders (and the likes) waiting for a client to appear who is afraid of them. It can be very costly for therapist and patient to go running out “on location” to find these objects -- and it is frequently difficult if not impossible to arrange such a confrontation.
Also, being in the actual presence of the feared object is initially so terrifying to some people that they become MORE anxious not less so because of the treatment itself and refuse to continue with a form of therapy that requires such traumatization. The initial attrition rate can be relatively high in such methods because a substantial number of people refuse to be retraumatized by being in the presence of the feared object without any immediate relief in sight.
In addition, “therapist-directed exposure” requires that the therapist be expertly trained in how to do the modeling. He or she needs to be a special sort of “teacher” who must in addition be GENUINELY unafraid of the object which is being “deconditioned”, whether this be a snake, a very big and fast-moving spider, or whatever, and completely comfortable handling it. The method is also at its most effective if the therapist is present to model the correct behavior while the treatment is going on, it doesn’t lend itself as well to “homework” where the person can go off on their own and work on their problem by themselves (as is often simply done with EFT for example), although Ost has experimented with giving out client manuals for this purpose with limited success.
Improvements are clearly needed here and this is where the energy therapies enter the picture. Steve Wells’ ground breaking pilot study on the use of EFT (a leading meridian based energy intervention) for the treatment of specific phobias is an opening wedge. It’s importance is obvious.
An impressive wealth of clinical data on EFT (see the EFT website for a sampling) suggested to Steve that EFT might achieve the same results as “therapist-directed exposure” BUT without the drawbacks of the latter, and PERHAPS could achieve these results in an even shorter time than Ost’s 2-3 hour individual protocol. Accordingly, he decided to compare EFT with a Diaphragmatic (Deep) Breathing technique for the treatment of specific phobias of small animals and insects. This is a a strategic investigation, and one expertly carried out by Wells and his research team.
You will have the opportunity to read the summary of the results he obtained below so I will not tell you in advance what they are. What I will say is that in a meticulously executed manner these researchers have completed the first in what I predict will be a series of major confirmations of the effectiveness of EFT (and through association other related energy therapies as well) for treating a wide variety of clinical conditions which up until now have been the sole province of the traditional behavior therapies.
Those of us in the energy psychology field have, of course, been experiencing the remarkable effects of these techniques for years. I myself used a single algorithm variation of Roger Callahan’s original method (I called it “Acutap”) for more than 17 years and have now switched to EFT which is almost identical to Acutap but which I find superior to it in several ways. The wealth of clinical experience I have acquired using this general approach is so impressive as to be, in my opinion, incontrovertible evidence of its clinical effectiveness -- and their are many other therapists who agree with me strongly.
The energy psychology methods have the potential of revolutionizing the way that psychotherapy is practiced worldwide, in addition to their use for medical and educational purposes. There is one major difficulty in the way of this however (besides the problem of acceptance by the “Old Guard” which is always present) and this is the fact that we have as yet no SYSTEMATIC body of research in this area to cite as a basis for further studies when applying for grants or submitting to journals, or for achieving acceptance within our society’s institutions. Without this we will be stopped in our tracks before we can really move.
A body of related research (that is, a series of studies which build one upon the another) is an absolute necessity if we are to establish the validity of these methods in the scientific community -- it’s the way things are done. To be sure, a few scattered studies have been conducted on TFT and on some other methods, but none of these were closely related to existing research in behavior therapy nor were they carried out with the rigorous controls that must be used if they are to constitute “serious” scientific evidence.
The Wells et al. pilot study opens a door to us that was hitherto closed and represents, in this sense, a landmark. It will, of course, need to be followed by more extensive research which will directly compare EFT with “therapist-directed exposure”, in order to have a signficiant impact on the field of psychology (see summary below for reasons) And then there will need to be a series of studies which will tease out the different components of the energy therapy under study, and the different effects achieved by it, and compare these (in REPEATED experiments) to the effects achieved by the traditional treatment approaches.
A study comparing EFT with “therapist-directed exposure” literally cries out to be done, and as soon as possible. It awaits only the right graduate students or research center, and some strategic funding. I am sure that we will see this happen and I intend to work toward this goal with all my energy and any of you who wish to join me in this effort are welcome!
In the meantime, I am proud to have been invited to participate in preparation of the final paper for the Wells’ study, to be submitted to the professional journals. I did not take part in the original research which is entirely the work of Steve Wells and Kathy Polgase under the skillful guidance of Henry B. Andrews, Professor of Psychology at the Curtin University of Technology in Western Australia. Steve has already written up most of the paper, skillfully reviewing the literature and reporting on the methodology and results. I hope to make a minor contribution with respect to the theoretical perspectives and rationale for this study -- then we shall see where we get with our submissions to the peer review journals.
One final point before you read the summary below. Steve has carefully kept it within the required number of words for internet abstracts so keep in mind that it is the final report that will contain the real “meat” and substance of this research. You will be able to hear the exciting details from Steve Wells in person when he presents his paper, and one of Kathy Polgase’s (on the qualitative findings of this study), at our “Energy Psychology Research Session #1” at the Las Vegas Energy Conference in May. Those of you who will attend the conference will also have the opportunity to hear Steve report on the 6 months follow up of the study now underway. Did these excellent results hold up over time? If so, how well? That is the suspenseful question to be answered, and I urge you to “tune in tomorrow!”.
In the meantime, I send my warmest wishes to all of you involved in this exciting new field at this crucial point in its history,
Patricia Carrington, Ph.D.
Chairperson, ACEP Research Committee
SUMMARY OF THE PILOT STUDY
A Meridian-Based Intervention (Emotional Freedom Techniques) vs Diaphragmatic Breathing in the Treatment of Specific Phobias*
by Steve Wells, Kathryn A. Polglase, Henry B. Andrews and Patricia Carrington**
* Draft - Subject to Peer Review ** Copyright (c) by Steve Wells, 2000.
Specific phobias (formerly known as "simple phobias") are the most common of the anxiety disorders. In recent years therapist-directed exposure to the feared object has replaced systematic desensitization as the treatment of choice for these conditions. It has certain drawbacks however, among them being the necessity for "in vivo" exposure and expert therapist modeling. The meridian-based interventions, including Emotional Freedom Techniques (EFT) (Craig, 1995, 1999), have been advocated as efficacious treatments for anxiety-based conditions with the promise of improving treatment efficiency.
This study sought to evaluate EFT treatment for specific phobias by comparing it to a Diaphragmatic (Deep) Breathing (DB) treatment as a control for placebo effects. Thirty-five subjects with phobias of small animals who met DSM-IV criteria for specific phobia were treated using either EFT or DB. Subjects were randomly assigned to EFT (n = 18) or DB (n = 17) and were treated in a single 30-minute treatment.
EFT treatment followed the EFT Basic Recipe (Craig, 1995), while subjects in the DB group were instructed to breathe deeply and to slow down breathing, using a count. Training in DB paralleled EFT treatment in addressing differential aspects of the fear and in the use of a cognitive device, the Reminder Phrase, regularly employed by EFT to focus subject attention on the feared object. Treatment rationales were constructed to reflect similar levels of (low) experimenter demand, and the assistant doing the pre and post testing remained uninformed as to which treatment subjects had received, and had no instruction in either treatment.
Both treatments produced significant improvements in phobic reactions, with the EFT group showing significantly greater improvement than the DB group on four of the five measures. In Intra-group pre-post comparisons the EFT group improved on the Behavioral Avoidance Test (p=<.001), SUDS Level When Imagining Object (p=<.001), SUDS Level During Approach (p=<.001), Fear Questionnaire (p=<.001), and Pulse Rate (p=<.01). The DB group improved on the Behavioral Avoidance Test (p=<.05), SUDS Level During Approach (p=<.01), Fear Questionnaire (p=<.001) and Pulse Rate (p=<.05), but showed no change in SUDS Level When Imagining Object. While both groups improved in pulse rate there was no significant difference between groups with respect to degree of this change. A group EFT treatment (n = 11) also yielded significant improvement on four of the five measures used in this study.
It is of interest that EFT, and to a lesser extent DB, produced highly significant changes in avoidance behavior, a key symptom of phobias. What is more, these results were achieved in a single 30-minute treatment without inducing the anxiety typical of traditional exposure protocols, and they did not require in vivo exposure to the object during the treatment. Since similar levels of imaginal exposure, experimental demand, and cognitive processing were present in the two treatments, this suggests that some additional factor(s) contributed to the results achieved by the EFT treatment. It is postulated that intervening in the body's energy system through the meridian points may have been the differentiating factor.
There is a need to corroborate these findings through comparing EFT to traditional behavior therapies, including therapist-directed exposure, and to investigate other clinical conditions in which EFT may be of value.
| BACK | HOME |