Citation: Church, D., Sparks, T., Clond, M. EFT (Emotional Freedom Techniques) and Resiliency in Veterans at Ricks for PTSD: A Randomized Controlled Trial. Explore, June 2016
Prior research indicates elevated but subclinical posttraumatic stress disorder (PTSD) symptoms as a risk factor for a later diagnosis of PTSD. This study examined the progression of symptoms in 21 subclinical veterans. Participants were randomized into a treatment as usual (TAU) wait-list group and an experimental group, which received TAU plus six sessions of clinical emotional freedom techniques (EFT). Symptoms were assessed using the PCL-M (Posttraumatic Checklist—Military) on which a score of 35 or higher indicates increased risk for PTSD. The mean pretreatment score of participants was 39 8.7, with no significant difference between groups. No change was found in the TAU group during the wait period. Afterward, the TAU group received an identical clinical EFT protocol. Post-treatment groups were combined for analysis. Scores declined to a mean of 25 (64%, P o .0001). Participants maintained their gains, with mean three-month and six-month follow-up PCL-M scores of 27 (P o .0001). Similar reductions were noted in the depth and breadth of psychological conditions such as anxiety. A Cohenʼs d 1⁄4 1.99 indicates a large treatment effect. Reductions in traumatic brain injury symptoms (P 1⁄4 .045) and insomnia (P 1⁄4 .004) were also noted. Symptom improvements were similar to those assessed in studies of PTSD-positive veterans. EFT may thus be protective against an increase in symptoms and a later PTSD diagnosis. As a simple and quickly learned self-help method, EFT may be a clinically useful element of a resiliency program for veterans and active-duty warriors.
The researchers offer prior findings which indicate that a high percentage of PTSD cases are of the delayed onset type and that symptoms can be more pronounced over time. They also present several studies that indicate that EFT may actually protect against the development of PTSD in veterans in addition to being effective in reducing PTSD symptoms in veterans and other groups. This is significant in that an estimated 479,000 Vietnam veterans experience PTSD, as well as a significant percentage of veterans of both the Iraq and Afghani wars.
This particular study was intended to see whether EFT might be protective against later PTSD diagnoses in patients with ‘subclinical symptom levels’. Researchers theorize that if EFT is taught to veterans, as well as active-duty soldiers, as a self-help technique to induce resilience, that it might be a means of protecting against the development of PTSD symptoms.
The study analyzed 21 veterans who tested for PTSD at the subclinical level and were recruited via word of mouth or on social media. They were divided into two groups with one group receiving both EFT and TAU (Treatment as Usual), and the other receiving only TAU. Clinical EFT adhering to The EFT Manual was administered as peer-to-peer, self help coaching during sessions, and participants were encouraged to use EFT between sessions to address emotionally triggering events and PTSD symptoms.
Study participants completed assessments before Session 1, after the 3rd and 6th sessions and at three and six-month follow-up intervals. They were asked to compile lists of traumatic events and perform EFT on each. Emotional intensity was self rated. They received one session per week for six weeks. They were assessed for insomnia severity, psychological symptoms, and traumatic brain injury using separate assessment tools that are approved and known in psychology.
So, what were the results?
The results factored in not only the differences between the EFT and Control Group, but also the differences between veterans of the Vietnam war and those of the more recent wars. Researchers noted an overall improvement of symptoms in the EFT group with progressive improvement over the course of the EFT intervention, which was maintained at both follow-ups. Veterans of the more recent conflicts showed greater reductions in symptoms than did Vietnam veterans, but the difference was not statistically significant. Both traumatic brain injury symptoms and insomnia symptoms were significantly reduced in both categories of veterans in the EFT group.
Researchers concluded that EFT is associated with a reduction in subclinical PTSD symptoms and that these results hold over time. The speculate that EFT treatment may reinforce resiliency, preventing later development of clinical PTSD. The benefits extended over both genders and to veterans of all wars, pointing that EFT could be beneficial to be taught as a resilience technique pre-deployment and could help reduce the traumatic impact of subsequent events during war. Researchers also note that the fact that since EFT is still effective when administered by unlicensed life coaches and volunteers, its use could lighten the burden on the VA’s overstretched mental health professionals.
Some study limitations were also addressed: an absence of a control group receiving a proven intervention such as cognitive processing therapy, the self-reporting of the participants, and the fact the improvement might have been influenced by the sympathetic attention that accompanied the EFT. I would add that the small sample of the study is an additional limitation.
Overall, however, the results are promising about the potential of EFT in helping to prevent and reduce PTSD in soldiers and veterans.