Clinician's digest

By Garry Cooper

Energy Therapies Want Respect

Energy therapies like Emotional Freedom Technique (EFT) and Thought Field Therapy (TFT) haven't gotten much respect from the American Psychological Association (APA). Currently the APA's Office of Continuing Education in Psychology refuses even to grant CE credits for workshops in TFT and EFT. In the June 2008 Psychotherapy Theory, Research, Practice, Training, psychologist David Feinstein of Ashland, Oregon, published the first review of the research on energy therapy in an APA refereed journal, and called for APA to accept energy therapy as an empirically supported treatment. However, in June 2009, two authors strongly critiqued Feinstein's review in the same journal.

Feinstein admits that the notion that clients who tap themselves on specific parts of the body to alter electrical pathways to the brain, thus producing rapid changes in feelings, cognitions, and behaviors, does invite skepticism—even though acupuncture, based upon the same principles, has gained mainstream respectability. In his paper, Feinstein based his case partly on the increasing amount of anecdotal evidence of success, videotapes of actual sessions, numerous single-case studies, and eight uncontrolled outcome studies. But such evidence falls far short of the replicable, randomized controlled trial (RCT) that the APA insists constitute empirical support.

"The plural of anecdote is not data," says Florida State University instructor Monica Pignotti, who coauthored one of the responses. The problem with the uncontrolled outcome studies, she and others contend, is that the positive effects could be due to placebo or some other element of treatment unrelated to the tapping. If energy psychology has an effective component, which has yet to be proven, they say it would most likely be exposure—the reexperiencing of trauma in a reassuring, controlled atmosphere.

Feinstein also included results from two RCTs, but his critics contended he ignored at least two other RCTs that didn't support his case. They added that the studies he used had imprecise outcome measures, inadequate selection and exclusion criteria, and faulty statistics that didn't compute effect sizes (considered the most meaningful statistical measure of clinical effectiveness), or ignored treatment dropouts.

Feinstein believes that critics of energy therapy demand a more rigorous standard of proof than for other treatments precisely because it challenges accepted notions of what therapy should be. This argument, his critics point out, has been used to defend fraudulent miracle cures for centuries. "Energy psychology has been around for 25 years," says Pignotti. "That's plenty of time to have accumulated good evidence."

Feinstein is now working on other reviews and articles, intent on bringing energy therapy into the psychology mainstream. It's frustrating and unconscionable, he says, that millions of people around the world are struggling with phobias and PTSD, when such a powerful, quick cure is so near at hand.

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PsychotherapyBrownBag  - Earning Respect   |Registered |2009-11-10 11:24:20 Very interesting stuff! I was directly to this site today and am very glad to have found a new resource for discussions of empirical research. I recently wrote on Psychotherapy Brown Bag about TFT and Monica Pignotti's excellent work to dispel misleading claims of efficacy. When I see situations like this, I understand why somebody passionate about a particular idea would be frustrated by a lack of acceptance by the psychological community. After all, this is their livelihood and they no doubt have come to believe that the approach offers substantial benefits. That being said, it is entirely unclear to me how somebody can look at the research on TFT and somehow conclude that it is empirically supported for any diagnosis. The very nature of science is captured by the direct competition between opposing hypotheses, the objective evaluation of subsequent data, and the development of newer, more precise follow-up hypothese...

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