Efficacy of Emotional Freedom Technique (EFT) on Stress and
Anxiety
Research Scholar
Department of Psychology UTD
Barkatullah University
Bhopal Madhya Pradesh, India
Professor
Department of Psychology Excellence College
Bhopal Madhya Pradesh, India
Professor
Department of Psychology Barkatullah University
Bhopal Madhya Pradesh, India
Modern life is filled with stress and anxiety, impacting our mental and physical health. To address this, therapy increasingly incorporates approaches that connect the mind, body, and spirit. One such approach is the Emotional Freedom Technique (EFT), which offers a quick and gentle way to even out the body’s energy. This article reviews the evolution of EFT, its mechanisms, and research findings from 2003 to 2022. Findings indicate that EFT can reduce stress hormones like cortisol, calm the nervous system, and assist with issues such as phobias, PTSD, and chronic pain. By blending talk therapy with a technique similar to acupuncture— without the use of needles—EFT helps individuals regulate their emotions and improve their physical well-being.
Keywords: Emotional Freedom Technique (EFT); Stress; Anxiety; Energy Psychology; Acupressure; Mental Health; Cortisol; Emotional Regulation; Adolescents; Integrative Therapy.
Modern Therapy: Mental health treatments are moving away from traditional talk therapy and medication. They now primarily use "integrative" methods that focus on the connection between the mind, spirit, and the body’s energy. An example is the Emotional Freedom Technique (EFT), which combines standard therapy with stimulation of specific pressure points on the body. Stress is a reaction between the mind and body to everyday pressures. It becomes harmful when it disrupts your normal balance and routine life. Unmanaged stress causes physical changes that can lead to long-term health problems such as high blood pressure, heart disease, obesity, and diabetes. It triggers the body into a 'high alert' state, releasing hormones like adrenaline and cortisol, which impair clear thinking and decision-making.
Anxiety, as defined by the American Psychological Association (APA), is a feeling of tension accompanied by worried thoughts, which can cause physical changes like increased blood pressure. When a threat is perceived, the body responds with the 'fight-or-flight' response, releasing adrenaline to prepare for confrontation or escape. Short-term anxiety helps manage stress, but chronic anxiety—seen in disorders like GAD, Panic Disorder, or Phobias—leads to persistent fear that hampers daily life.
Emotions are complex responses to specific events, comprising three main elements: personal experience (internal feelings), physical responses (bodily reactions controlled by the nervous system), and behaviour (how emotions are expressed or acted out). Experts such as Paul Ekman identify six basic emotions: happiness, sadness, fear, disgust, anger, and surprise. Research highlights the amygdala as a key brain region involved in processing fear.
EFT, or Emotional Freedom Techniques, also known as 'tapping,' is based on the idea that negative emotions and physical symptoms originate from disruptions in the body's energy system. It involves tapping specific 'meridian points' on the body while focusing on particular stressors. The aim is to balance the body's energy, reduce emotional pain linked to difficult memories, and inhibit the fight-or-flight stress response.
The clinical application of EFT uses a standardized protocol designed to reduce emotional distress through simultaneous physical and mental engagement.
The 6-Step Standard Procedure:
1. Identify the Issue: Focus on a specific event, emotion, or physical sensation.
2. Rate Intensity: Assess your current distress level (SUDs) from 0 to 10.
3. Create a Setup Statement: Develop a phrase that acknowledges the problem while emphasizing self-acceptance, such as "Even though I have this [issue], I deeply and completely accept myself."
4. Tap on Points: Stimulate nine specific acupressure points while repeating the statement.
5. Repeat: Continue tapping until the distress level decreases.
6. Evaluate Progress: Reassess your distress level on a 0–10 scale to see if the intervention was effective.
The six-step procedure provides a structured yet flexible framework that enables individuals to identify emotional distress, process distressing thoughts, and gradually reduce psychological discomfort. By combining cognitive awareness with stimulation of acupressure points, EFT aims to restore emotional balance and improve adaptive coping. Because the procedure is simple, inexpensive, and can be self-administered after appropriate training, it has become increasingly popular in clinical practice, educational settings, and stressmanagement programmes.
● Karate Chop (KC): Fleshy part of the hand between the wrist and pinky finger.
● Top of Head (TH): Crown of the head.
● Beginning of Eyebrow (EB): Inner edge of the eyebrow near the nose.
● Side of Eye (SE): Bony area at the outer corner of the eye.
● Under Eye (UE): Bone just below the eye.
● Under Nose (UN): Area between the nose and upper lip.
● Chin Point (CH): Crease between the lower lip and chin.
● Collarbone Point (CB): Junction where the collarbone meets the breastbone. ● Underarm Point (UA): Approximately 4 inches below the armpit.
How EFT Functions in the Body: Nerve Centres: Experts suggest that EFT works because specific body points, known as acupressure points, have more nerves and blood vessels than other regions. For example, the LI4 point contains many more nerves than surrounding skin. Calming the Nervous System: Tapping these points is believed to help regulate the nervous system and reduce stress.
The following studies offer a chronological overview of EFT's effectiveness across various psychological and physiological conditions.
A study by Wells et al. (2003) demonstrated that EFT is more effective than deep breathing exercises for individuals fearing small animals, with improvements lasting between 6 to 9 months.
In 2009, Craig et al. used EEG brain scans on a woman with a long-term brain injury and found that EFT significantly helped her feel more relaxed and centered, indicating it has potential benefits for brain injury symptoms.
2010 (Church and Brooks): They described EFT as a quick "exposure therapy." Their review showed it helps with phobias, depression, and PTSD in both clinics and group workshops.
2011 (Salas et al. / Boath et al.): Studies showed EFT quickly reduces anxiety and fear. For example, a 15-minute session helped college students feel less nervous about public speaking.
2012 (Church et al.): In a large study, EFT was proven to significantly lower stress hormones (cortisol) and improve mental health more than standard "talk therapy" or rest.
In 2013, Church and Brooks found that EFT served as an effective adjunct to addiction treatment in a pilot study (n=28), significantly reducing psychological distress and anxiety at a 90-day follow-up [13]. A broader review by Church established Clinical EFT as an evidence-based practice meeting APA Division 12 standards, supported by 23 randomised controlled trials and 17 within-subjects investigations.
In 2014, Boath et al. utilised a mixed-methods approach with 45 social work students to manage communication-related anxiety. Quantitative results showed significant decreases in subjective distress, while qualitative themes identified the technique as a calming, transferable skill.
In 2018, Latifah and Ramawati's Research found that EFT helped mothers reduce post-surgery pain, and Gaesser's research found that EFT helped gifted students manage anxiety and selfregulate.
In 2019, Ali conducted a study on female university students that showed that EFT tapping significantly lowered their anxiety levels.
In 2020, a meta-analysis by Church et al. investigated whether tapping on acupressure points is an "active ingredient" in EFT. Despite an earlier corrigendum regarding statistical flaws, an independent senior statistician re-analysed the data, confirming a Hedges’ g-value of 0.73 (p < 0.0001). The study concluded that acupressure is essential to the method's health impacts.
2021 Anggreini and Sari found that EFT significantly improved negative body image (n=17) in breast cancer patients [22]. Bakır et al. demonstrated in a trial of 50 nursing students that EFT is an efficient self-treatment for reducing premenstrual syndrome (PMSS) symptoms [21]. Dincer and Inangil found that online EFT interventions effectively reduced stress, anxiety, and burnout among nurses caring for COVID-19 patients.
In 2022, Wati et al. found EFT effective in increasing self-esteem among 115 nursing staff members [23]. Lestari et al. observed that EFT significantly reduced emotional pressure and stress in patients with diabetes mellitus [24]. Stapleton et al. used fMRI (n=24) to show that a six-week online EFT treatment for chronic pain decreased connectivity between the medial prefrontal cortex (mPFC) and the posterior cingulate cortex and thalamus. Participants showed a 21% reduction in pain severity and a 37.1% reduction in anxiety [25]. Finally, Lambert et al. (n=138) demonstrated that EFT improved wellbeing and reduced anxiety in primary school classrooms.
The literature reviewed between 2003 and 2022 consistently demonstrates positive outcomes associated with Emotional Freedom Technique (EFT) across diverse populations and psychological conditions. Randomised controlled trials, pilot studies, systematic reviews, and meta-analyses indicate that EFT significantly reduces stress, anxiety, phobias, symptoms of posttraumatic stress disorder, chronic pain, and psychological distress. Several studies also reported improvements in self-esteem, emotional regulation, communication anxiety, academic performance, and overall quality of life.
Physiological evidence further supports the effectiveness of EFT. Research has shown significant reductions in cortisol levels following EFT interventions, indicating decreased activation of the body's stress response. Neuroimaging studies have additionally demonstrated changes in brain regions involved in emotional regulation, particularly the amygdala, medial prefrontal cortex, and posterior cingulate cortex, suggesting that EFT may influence neural pathways associated with fear, stress, and emotional processing.
Overall, the accumulated evidence suggests that EFT is an effective complementary intervention with consistent benefits across different age groups and clinical populations. Although effect sizes vary among studies, the overall trend strongly supports its usefulness as a stress- and anxiety-management technique.
The findings of the present review support the growing body of evidence indicating that Emotional Freedom Technique is an effective complementary intervention for managing stress and anxiety. Unlike conventional psychotherapies that primarily rely on verbal processing, EFT integrates cognitive exposure with somatic stimulation through acupressure tapping. This combined approach may explain its rapid therapeutic effects observed across multiple studies.
One of the most significant findings emerging from the literature is the consistency of positive outcomes regardless of participant characteristics. Students, healthcare professionals, individuals with chronic illnesses, trauma survivors, and patients with psychological disorders all demonstrated measurable improvements after EFT interventions. Such findings suggest that EFT has broad applicability across clinical and non-clinical populations.
Another important aspect highlighted in recent research is the biological basis of EFT. Decreased cortisol secretion, improved autonomic nervous system regulation, and observable changes in brain activity indicate that the benefits of EFT extend beyond subjective psychological improvement. These physiological findings strengthen the scientific credibility of EFT and distinguish it from interventions based solely on relaxation.
Nevertheless, several studies acknowledge methodological limitations, including relatively small sample sizes, short follow-up periods, and variation in treatment protocols. Future research employing multicentre randomised controlled trials, larger samples, and long-term follow-up assessments would further strengthen the evidence base.
Overall, the available literature indicates that EFT represents a promising evidence-based complementary therapy capable of improving emotional well-being while reducing physiological manifestations of stress and anxiety.
Research conducted from 2003 to 2022 demonstrates that the Emotional Freedom Technique (EFT) is an established and efficacious approach for addressing a variety of mental and physical health concerns. Studies suggest that it can: Decrease stress hormones (cortisol), alter neural processing of pain, and reduce symptoms of anxiety and stress. The text characterizes EFT as a safe, rapid, and non-pharmacological intervention that can be utilized independently or in conjunction with practices such as Yoga, Meditation, or Reiki. It promotes positive modifications in both cerebral and physiological chemistry, thereby serving as a reliable method to improve overall well-being.
This article employed a narrative review methodology to examine the effectiveness of Emotional
Freedom Technique (EFT) in managing stress and anxiety. Published studies between 2003 and 2022 were reviewed using peer-reviewed journals, systematic reviews, randomised controlled trials, pilot studies, and meta-analyses. Relevant literature was identified through electronic databases including PubMed, Google Scholar, Scopus, and ResearchGate using keywords such as Emotional Freedom Technique, EFT, stress, anxiety, energy psychology, cortisol, PTSD, and mental health. Only English-language publications that investigated psychological or physiological outcomes following EFT interventions were included. The findings were synthesised descriptively to identify major themes, clinical effectiveness, physiological mechanisms, and future research directions.
Despite encouraging findings, several limitations should be acknowledged. Many of the reviewed studies involved relatively small sample sizes, limiting the generalisability of the findings. Differences in intervention duration, tapping protocols, outcome measures, and followup periods created heterogeneity across studies. Some investigations lacked active control groups or blinding procedures, increasing the possibility of expectancy effects. Furthermore, although evidence supporting physiological mechanisms is increasing, additional neurobiological research is required to fully explain how EFT influences emotional regulation. Future studies should include larger multicentre trials with standardised intervention protocols and longer follow-up periods.
The findings of this review have important implications for mental health practice. Emotional Freedom Technique offers clinicians an inexpensive, non-invasive, and easily teachable intervention that can complement conventional psychological therapies. Because it can be administered individually, in groups, or through guided self-help programmes, EFT has considerable potential in schools, colleges, hospitals, rehabilitation centres, and community mental health settings. It may serve as an adjunctive intervention for stress management, anxiety disorders, trauma recovery, chronic pain management, and emotional regulation. Integrating EFT into counselling and psychotherapy may enhance treatment outcomes while empowering individuals with practical self-regulation skills that promote long-term psychological well-being.
Conflict of Interest: The corresponding
author on behalf of second author, confirms that there are no conflicts of
interest to disclose.
Copyright: © 2026 by Mrs. Neha Jaiswal, Dr. Anupam Shukla, Dr. Bhupinder Singh
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