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Effectiveness of Emotional Freedom Techniques on occupational stress for preschool teachers

Dissertation
Author: Teresa Haynes
Abstract:
Occupational stress may be directly related to teacher burnout and general job dissatisfaction within the teaching profession. While research has shown that teaching is among the most stressful of occupations, there is currently limited research on the implementation or effectiveness of stress management programs. The present study examined the effectiveness of Emotional Freedom Techniques (EFT) on the reduction of stress for preschool teachers. The study was conducted according to a single-subject design (N=2), in which levels of stress and anxiety were measured before and after the five-week training of EFT. Following the completion of training, both participants in the study reported decreased levels of stress and anxiety. However, at six month follow up, results were more varied.

2 TABLE OF CONTENTS Acknowledgments 5 Abstract 6 Tables 4 I. Introduction 7 Statement of Problem 8 Statement of Purpose 9 Assumptions and Limitations 9 II. Literature Review 11 Occupational Stress 11 Burnout 12 Occupational Stress, Burnout, and the Teaching Profession 13 Addressing Occupational Stress 15 Emotional Freedom Techniques 17 History of EFT 17 Neurological Foundations of EFT 19 Research Supporting EFT 21 Risks of EFT 23 III. Method 24 Samples Employed 24 Instruments Used 24 Outcome Questionnaire 24

Running head: EMOTIONAL FREEDOM TECHNIQUES

3 Occupational Stress Inventory 25 State-Trait Anxiety Inventory 26 Perceived Stress Scale 27 Procedures 28 Design 29 Results 31 IV. Discussion 38 V. References 42 VI. Appendix A: Occupational Stress Index 51 Table 1: OCI Participant 1 52 Table 2: OCI Participant 2 53 VII. Appendix B: Outline of Workshop/Training Sessions 54 VIII. Appendix C: Copy of Informed Consent 55

Running head: EMOTIONAL FREEDOM TECHNIQUES

4 Figures/Tables Figure 1: Participant 1 Perceived Stress Scale 31 Figure 2: Participant 2 Perceived Stress Scale 32 Figure 3: Pre, Post, and Follow-up Participant 2 STAI 34 Figure 4: Pre, Post, and Follow-up Participant 1 STAI 35 Figure 5: Pre, Post, and Follow-up Participant 2 Outcome Questionnaire 35 Figure 6: Pre, Post, and Follow-up Participant 1 Outcome Questionnaire 36

Running head: EMOTIONAL FREEDOM TECHNIQUES

5 Acknowledgments Page It is my pleasure to thank those that made this dissertation possible. I am heartily thankful to my dissertation chair, Dr. Louis Hoffman, whose encouragement, guidance, and support from the initial to the final level enabled me to develop an understanding of the subject and an understanding of the process of completing a dissertation. I would like to thank committee member Dr. John Hartung, whose knowledge and passion for Energy Psychology was invaluable in creating my interest and expanding my knowledge and passion for EFT. Additionally, I would like to thank committee member Dr. Allen Cornelius, whose abilities and knowledge as a statistician helped me shape and accurately describe my research results. Lastly, I offer my incredible love and appreciation to all of those who supported me in any respect during the completion of the project. Specifically, my mother who has never lost faith, my sister who has always been a rock in my life, and my husband, whose invaluable support made this entire adventure possible.

Running head: EMOTIONAL FREEDOM TECHNIQUES

6 Abstract Occupational stress may be directly related to teacher burnout and general job dissatisfaction within the teaching profession. While research has shown that teaching is among the most stressful of occupations, there is currently limited research on the implementation or effectiveness of stress management programs. The present study examined the effectiveness of Emotional Freedom Techniques (EFT) on the reduction of stress for preschool teachers. The study was conducted according to a single-subject design (N=2), in which levels of stress and anxiety were measured before and after the five-week training of EFT. Following the completion of training, both participants in the study reported decreased levels of stress and anxiety. However, at six month follow up, results were more varied.

Running head: EMOTIONAL FREEDOM TECHNIQUES

7 Effectiveness of Emotional Freedom Techniques on Occupational Stress for Preschool Teachers Occupational stress in general has been the focus of research for decades. While occupational stress has been researched across a variety of occupations, the literature indicates that teachers, specifically those who work with high-needs children, experience significant occupational stress (Bertoch, Nielson, Curley, & Borg, 1989). Teachers have been identified as one of the top two stressed professions and some insurance companies have either withdrawn health insurance from teachers or shifted teachers to the high risk class three category because of the stress associated with the teaching profession (Fisher, 1996). Occupational stress has been found to be high among teachers and may have significant effects on teacher burnout (Cunningham, 1983). The large numbers of teachers who leave the profession are alarming. Berliner (1989) reported that in some districts approximately 50% of beginning teachers leave the profession within five years. In a more recent study, teachers are considered at risk for leaving what they perceive as a frustrating profession during the first seven years of employment (Thompson, 1994). High rates of early retirement among teachers have contributed to concerns that many teachers are not fully successful in their work (Vandenberghe & Huberman, 1999). There are two directions of research in understanding successful or effective teachers. One direction focuses on instruction and learning while the other focuses on occupational health including teacher physical and affective well being (Klusmann, Kunter, Trautwein, Ludtke, & Baumert, 2008). Successful teachers are characterized as experiencing low stress, showing no symptoms of burnout, and reporting high job satisfaction (Kyriacou, 2001; Maslach & Leiter, 1999). If occupational stress may affect a teacher’s performance, absenteeism, and personal feelings

Running head: EMOTIONAL FREEDOM TECHNIQUES

8 toward children, then it is important that teacher stress be addressed to maximize the educational experience of children. (Johnson & Vickers, 1982) Statement of Problem Although the need is high, there are few studies showing the effectiveness of interventions to help teachers deal with stress, and the number of schools implementing stress management programs is low. Professional organizations such as the National Educational Association (NEA) have discussed the issue of employee stress through several articles in their professional publications (Hopkins, 2001; Kopkowski, 2007; Zauber, 2002). Although the 1986 representative of the NEA “urged” its local affiliates to develop stress management program, decades following that statement, initiatives to address the problem of teacher stress are not common (National Education Association, 2010). There is some research on the use of brief psychoeducational techniques to reduce occupational stress for the purpose of increasing job satisfaction and performance, and decreasing burnout and turnover (Kagan, Kagan, & Watson, 1995). Although teacher stress is a significant problem, it has not been sufficiently researched in terms of effective interventions. Emotional Freedom Technique (EFT) is a variation of Energy Psychology (EP) and is comprised of a set of simple physical movements and affirmations designed to bring about shifts in targeted emotions, cognitions, and behaviors (Gallo, 2004). EFT has been shown to be an effective tool in therapeutic settings, in executive coaching, and in a variety of other applications with relatively few sessions and can therefore be considered a brief psychoeducational technique (Oschman, 2003). EFT may be self-administered or administered by a coach or therapist. There exists promising research on the effectiveness of EFT in reducing PTSD symptoms, stress, depression, and anxiety (Church, 2008a; Rowe, 2005; Wells et al., 2003). With this in mind, the

Running head: EMOTIONAL FREEDOM TECHNIQUES

9 purpose of the current study was to assess the efficacy of a 5-week EFT program as a means of reducing stress for teachers. Specifically, the study addressed the following research hypotheses: 1. EFT will modify teacher’s perception of occupational stress in the direction of decreasing their perception of how much stress they are experiencing. 2. EFT will reduce anxiety levels in teachers as measured by decreased scores obtained on the State-Trait Anxiety Inventory. Statement of Purpose Because of the high level of occupational stress within the teaching profession and the relative absence of empirically tested tools for managing stress, additional research relevant to this problem is critical. EFT is a brief psychoeducational tool that can be taught and self- administered and has shown promising results to date in the treatment of stress, anxiety, PTSD symptoms, phobias, and depression. Although there have been numerous studies of the impact of EFT on various psychological conditions, no prior study has examined the effect of EFT on occupational stress and anxiety in teachers. It is proposed that EFT be examined as a potential tool for stress and anxiety reduction. Assumptions and Limitations Several assumptions are made within this study. It is assumed that stress is of concern for educators and that EFT can be reliably measured as a self-administered intervention. An additional assumption made is that measurements used to assess stress and anxiety are valid measures. Finally, the assumption is made that both participants were engaged in the process and dutifully completed all assignments outside of the workshop setting. By definition, an n=1 study has inherent benefits and limitations (Borckardt et al., 2008). While the case-based, time-series design with repeated baseline measures is viewed as a true

Running head: EMOTIONAL FREEDOM TECHNIQUES

10 experiment (Kazdin, 1992), results generated are not applicable to the broader population and cannot replace a randomized controlled trial. The two examples of the n=1 design that are the focus of this study permit tracking of individual responses to specific interventions in real time in order to uncover heuristic questions for future investigation.

Running head: EMOTIONAL FREEDOM TECHNIQUES

11 Literature Review Occupational stress refers to the effects of demands on an individual while performing their professional roles and responsibilities. It has been a major concern of human service and helping professionals including social workers, physicians, nurses, and teachers (Cherniss, 1980; Greenberg & Vallentutti, 1980). Two major consequences of occupational stress are dissatisfaction with work and burnout. One occupation that has been characterized as particularly stressful and experiencing high levels of burnout is that of teaching (VanHorn, Taris, Schaufeli & Schreurs, 2004; Greenglass, Burke & Konarski, 1996). While there have been numerous data to support the high incidence and detrimental effects of occupational stress, there currently exists limited research on the effectiveness of interventions designed to lower stress and stress related symptoms, and to increase occupational well-being and subsequent job satisfaction. Occupational Stress In occupational research, the concept of job satisfaction is one of the most studied aspects of job-related well-being (Weiss, 2002). Occupational well-being can be defined as the “positive evaluation of various aspects of one’s job, including affective, motivational, behavioral, cognitive and psychosomatic dimensions” (Van Horn, Taris, Schaufeli, & Schreurs, 2004, p. 366). The nature of the relationship between job satisfaction and stress is not yet clear. Empirically, there is some evidence that low job satisfaction can be a consequence of perceived stress at the workplace (Wolpin, Burke, & Greenglass, 1991). The effects of stress on physical and psychological functioning have been well established by medical research (Fine, 1996). It is estimated that companies lose about $60 billion every year from lost productivity and spend up to 10% of their profits on stress related

Running head: EMOTIONAL FREEDOM TECHNIQUES

12 disability claims. Health care professionals estimate that as many as 90% of patients they treat suffer from stress-related symptoms and disorders (Gibson, 1993). An epidemiological survey of 17,000 randomly selected people from the Bristol electoral register indicated that about 20% of the working sample reported that they had experienced very high or extremely high levels of stress at work (Smith, Brice, Collins, Matthews & McNamara, 2000). This effect was related to potentially stressful working conditions and associated with impaired physical and mental health. Among the factors studied were levels of stress among specific occupations. Differences between the groups of occupations were found to be highly significant. The profile obtained from the groups indicates that teachers, nurses, and managers have the greatest proportions of high stress. Some researchers regard occupational stress as a cause for low job satisfaction and burnout (Anderson, Barker & Kiewra, 1999; Rusell, Altmaier, & VanVelzen, 1987). Burnout Chronic stress causes debilitating effects on a personal and professional level, and if left untreated can lead to burnout (Farber, 1991). Burnout is a syndrome characterized by emotional exhaustion, depersonalization, and reduced personal accomplishment (Hargreaves, 1994). Burnout was first defined by Freudenberger (1974) as becoming exhausted from excessive demands on energy, strength, or resources. The classic definition of burnout gained momentum within the context of work-related strain in social workers and was given by Maslach (Maslach, & Leiter, 1999), who described it as a psychological syndrome characterized by three symptoms: emotional exhaustion, depersonalization, and reduced personal accomplishment. Maslach (1978), the first to gather empirical data on burnout, defined it as “emotional exhaustion resulting from the stress of interpersonal contact” (p.56). Emotional exhaustion is the

Running head: EMOTIONAL FREEDOM TECHNIQUES

13 primary dimension of the Maslach Burnout Inventory-Second Edition (MBI) (Maslach & Jackson, 1993) and is associated with the consequences of burnout, which includes absenteeism, turnover, debilitating performance and substance abuse. Occupational Stress, Burnout, and the Teaching Profession Kyriacou (2001) defined teacher stress as “the experience by a teacher of unpleasant, negative emotions, such as anger, anxiety, tension, frustration, or depression, resulting from some aspect of their work as a teacher” (p. 28). Teacher stress has been the focus of educational concern and research for decades and it has been identified as a particularly stressful occupation. Common identified factors contributing to teacher stress include overcrowded classrooms, discipline problems, violence, excessive paperwork, low salaries, unsupportive parents, and a lack of administrative support (Russell, Altmaier & VanVelzen, 1987). Teachers have been identified as one of the top two stressed professions and insurance rates and deductibles may be higher because of stress for those in the teaching field (Fisher, 1996). Teacher stress has been defined by Kyriacou and Sutcliffe (1978) as “a response of negative affect, usually accompanied by potentially harmful physiological changes, resulting from aspects of the teacher’s job and mediated by the perception that job demands are a threat and by coping mechanisms activated to reduce the threat” (as cited in Sharp & Foreman, 1985, p. 370). In his review of teacher stress, Cunningham (1983) cited numerous symptoms of teacher stress, including fatigue, dissatisfaction, and depression. Anxiety is another common symptom. The large numbers of teachers who leave the profession are alarming. Berliner (1989) reported that in some districts, approximately 50% of beginning teachers leave the profession within five years. In a more recent study, teachers are considered at risk for leaving what they perceive as a frustrating profession during the first seven years of employment (Thompson,

Running head: EMOTIONAL FREEDOM TECHNIQUES

14 1994). Landsmann (1977, 1978, 1979) reported that 75% of the 9,000 teachers responding to a survey indicated that most of their absences during the preceding school year were related to stress or tension. Teacher absenteeism is often the result of exhaustion, illness, and anxiety related health problems (Spanoil & Caputo, 1979). Numerous potentially contributing factors to teacher stress have been explored. Interestingly, demographic characteristics of teachers, such as age, number of years in teaching, gender, and type of class instructed do not appear to be correlated in any systematic way to stress and burnout (Friesen & Williams, 1985; Holland & Michael, 1993; Kyriacou & Sutcliffe, 1978). Russell, Altmaier, and Van Velzen (1987) conducted regression analyses on sociodemographic variables (gender, age, marital status, community size), and job variables (years of teaching experience, grade taught, size of school and class taught, level of education). Results indicated that teacher demographics accounted for only 6% of the variance in stress scores. The only predictor that related significantly to job stressors was age. Younger teachers reported more stressors than did older teachers. It is not clear, however, if older teachers develop better coping strategies or teaching skills and modify their expectations, or if teachers experiencing high stress levels have simply left the teaching profession (Zabel & Zabel, 1982). The literature suggests that special education teachers do not burn out at a higher rate than regular education teachers (Barner, 1982; Farber, 1991). However, teachers of emotionally disturbed students had higher levels of burnout than did teachers of students with other disabilities (Johnson, Gold & Vickers, 1982). The authors found that the reason for the higher levels of burnout was related to teachers feeling fearful of verbal and physical attacks from their students.

Running head: EMOTIONAL FREEDOM TECHNIQUES

15 Several organizationally based sources of stress in the teaching profession have been identified: inadequate time for relaxation and preparation, feeling that one’s personal life is being short-changed for work, insufficient salary, and teaching unmotivated students (Vance, Nutter, & Humpreys, 1989). Additionally, organizational stress factors include work overload, lack of support, and isolation from other adults, and are significant predictors of teacher burnout (Goodlad, 1984; Mazur & Lynch, 1989; Sarason, 1982). Studies that have examined the effect of teacher stress and anxiety on student outcomes suggest a negative trend. Stressed and anxious teachers become less tolerant, less caring, less patient, and less involved with students (Blasé, 1986; Galbo, 1983). When a teacher is under excessive stress, there is less interaction between teacher and students and a decreased use of creative teaching techniques and materials (Blasé, 1986). Sinclair and Ryan (1987) found a significant correlation between student-state anxiety (while being taught) and teacher-state anxiety (during teaching). In summary, “causes” have been identified as interpersonal demands, violence, over crowding and long hours. Proposed “mitigating factors” include experience, coping, and support; and “effects” have been noted both on teachers and on their students. The causes, indeed, need attention, but the focus of the present study is simply on the response of teachers, whatever the reasons for their distress. Addressing Occupational Stress Professional organizations such as the National Educational Association (NEA) have discussed the issue of employee stress through several articles in their professional publications (Hopkins, 2001, Kopkowski, 2007, & Zauber, 2002). Although when founded in 1986, the NEA adopted a resolution regarding personnel stress that urged local school authorities to develop

Running head: EMOTIONAL FREEDOM TECHNIQUES

16 stress management programs, the only implementation of any specific program is a reference to articles found on the web (National Education Association, 2010). However, decades following that resolution, initiatives to address the problem of teacher stress are almost non-existent. Although teacher stress is a significant problem, it has not been sufficiently researched in terms of effective interventions. Few studies have evaluated the effectiveness of specific programs to reduce teacher stress and anxiety (Bertoch, Nielsen, Curley & Borg, 1989; Sharp & Foreman, 1985). Much of the literature recommends the use of stress reduction techniques, but does not provide any support for such recommendations. According to Tunnecliffe, Leach, and Tunnecliffe (1986), “few controlled, outcome research paradigms have been used in investigating the efficacy of approaches to teacher stress management” (p. 124). The most frequently mentioned approaches involve relaxation techniques. A study by Bertoch et al. (1989) designed a program for teachers involving several stress management components: meditation, relaxation and breathing, nutrition, stretching, discussions on holistic living, and assertiveness. Although participants demonstrated significantly lower stress levels than controls on 23 of the 29 variables measured, researchers were unable to determine which components contributed most to stress reduction. A study by Sharp and Foreman (1985) found cognitive behavior training programs to be effective in significantly reducing teachers’ self-reported stress and anxiety. This program focused on training teachers in coping skills and specific techniques for changing cognitive, emotional, and physiological responses to stressors. A more recent article suggests that EFT is one strategy that could be used effectively and safely for employees within organizations (Hartung & Nagireddy, 2010). More specifically, the authors discuss the importance of helping employees to be more resilient and better able to cope

Running head: EMOTIONAL FREEDOM TECHNIQUES

17 with difficult events. EFT is described at length as one of six strategies that can be taught and subsequently self-administered safely and effectively with organizational employees. Emotional Freedom Techniques The emerging field of energy psychology has produced various schools and approaches. Emotional Freedom Techniques, EFT, is one such school, and was developed by Craig (2008). The foundation of EFT involves the utilization of energy meridians corresponding to those described by Chinese medicine. Since the development of EFT, more sophisticated hypotheses to explain its effectiveness for a variety of psychological symptoms have been developed. EFT can be self-administered or administered by a coach or therapist (Church, 2008b). History of EFT Energy Psychology (EP) consists of physical and cognitive procedures designed to bring about change in cognitions, emotions, and behaviors (Gallo, 2004). EP asserts that mental disorders and other conditions are related to disturbances in the body’s energy fields (Feinstein & Eden, 2008). While EP is grounded in established psychological principles, it also utilizes concepts and techniques from non-Western systems (Feinstein, 2008). Of the more than two- dozen variations of EP that can be identified, EFT is one of the most well known (Feinstein, 2008). The origins of EFT date back to over 5,000 years from the ancient Chinese Shaolin and Taoist Monasteries. This is where the subtle energies and meridians that travel throughout the body were first identified. The Eastern healing arts of Acupuncture, Acupressure, Shiatsu Massage and Reflexology were derived from these energy meridians. More recently, the works of George Goodheart, founder of Applied Kinesiology and Roger Callahan, the founder of Thought Field Therapy (TFT) utilized these subtle energies identified decades ago (Gallo, 2002).

Running head: EMOTIONAL FREEDOM TECHNIQUES

18 Although the foundations of EFT can be traced to Acupuncture, the practice was not developed to treat emotional problems, but physical ones. The development of “emotional acupuncture” was indirectly assisted by George Goodheart, a chiropractor, who founded a branch of care based upon a precise method of testing to determine the appropriateness of a form of treatment, now called Applied Kinesiology (Gallo, 2002). Building on the work of Goodheart in the 1970s, an Australian psychiatrist, John Diamond, created “Behavioral Kinesiology.” He added the component of positive affirmation when a person was applying pressure to selected acupuncture points. He used this technique specifically to treat emotional problems. Subsequently, Callahan learned Applied Kinesiology and studied the meridian system of acupuncture in an effort to find better answers to some of the problems his patients faced, including anxiety and phobias (Gallo, 2002). An illustration may be helpful in describing TFT. A patient, “Mary”, described by Callahan (2001) was so debilitated by her hydrophobia that she could not even take a bath without significant distress and she could not walk outside when it was raining. Callahan had been working with Mary for months, trying a variety of therapeutic approaches with minimal success. One day Mary told him that her fearful feeling was located in her stomach. During a session, Callahan guided Mary through tapping with her fingers on the point where the stomach meridian begins, under the eye. Mary supposedly felt instantly free from her fear (Callahan, 2001). This session resulted in the development of TFT in the early 1980s. TFT involved a set of “algorithms” for tapping on specific acupuncture points, with each specific algorithm being appropriate for specific ailments. Identifying the algorithm appropriate for a given patient may require muscle testing (MT), a technique for evaluating the body’s energetic imbalances and identifying suspected

Running head: EMOTIONAL FREEDOM TECHNIQUES

19 energy blockages (Gallo, 1999). MT involves a third party applying slight pressure to a patient’s arm as the patient resists. MT is not generally self-administered and may involve extensive repetitions, and its purported benefits have not been scientifically evidenced. Gary Craig, one of Callahan’s students replaced the elegant but complex TFT algorithms with a single, comprehensive algorithm that involved repetition of all the 14 acupuncture points that comprised Callahan’s more complex system. He proposed this new approach, which he named emotional freedom techniques or EFT, as a simpler yet effective alternative to TFT (Gallo, 1999). Craig (2008) came to the conclusion that EFT’s brief and standardized protocol could treat most problems without the need for MT or lengthy diagnoses, and organized the principle 14 acupuncture points into an easily administered method (Feinstein et al., 2005). EFT may be self-administered or administered by a coach or therapist. Promising research exists supporting the effectiveness of EFT (Baker & Siegel, 2005; Salas, 2003; Sezgin & Ozcan, 2004; Wells, Polglase, Andrews, Carrington, & Baker, 2003). This research includes anecdotal reports, field observations, controlled studies and case studies and it gives the impression of outcomes that are rapid and dramatic. Neuropsychological Foundations of EFT There is considerable debate as to the mechanisms of action of EFT. Proponents believe that the method is effective because it utilizes energy meridians corresponding to the acupuncture meridians described by traditional Chinese medicine (Gallo, 1999). However, other authors have developed more conventional and sophisticated hypotheses to explain the efficacy of EFT, including the activation of biological mechanisms, specifically those connected with the activation of stress in the body. The mechanisms of action of EFT and other energy psychology techniques involve

Running head: EMOTIONAL FREEDOM TECHNIQUES

20 a variety of physiological systems. Lane (2006) described increased regulation of the HPA (hypothalamus-pituitary-adrenal) axis. More specifically, he notes termination of the alarm response in the Sympathetic Nervous System, and replacement with a relaxation response in the Parasympathetic Nervous System. Oschman (2005) described the semiconductive properties of connective tissue, and the transmission of stress- reducing signals through this tissue during energy therapy sessions. Feinstein et al. (2005) indicated that the secretion of neurotransmitters such as serotonin and dopamine released during EFT may decrease stress and increase feelings of well being. Church, Geronilla & Dinter (2009) noted the increased re-uptake of stress hormones such as cortisol and epinephrine during EFT treatment. He further noted an improvement in heart rate variability (HRV). HRV and cortisol are primary stress markers for a variety of genetic, hormonal, and neurological effects of stress. LeDoux (2002) describes the neurological wiring in the brain when faced with a perceived threat, and how traumatic memories may condition the amygdala to respond, resulting in an emotional consciousness. Diepold and Goldstein (2008) used EEG to measure brain states, and found that as emotional intensity of traumatic memories reduced following energy psychology treatment, the neural frequencies associated with stress also reduced. Energy psychology appears to affect multiple physiological systems, especially the structures that regulate the stress response in the body. More research is necessary to determine whether one of these physiological factors, or a combination of them, make up the active mechanism of EFT and other EP therapies. Research Supporting EFT

Running head: EMOTIONAL FREEDOM TECHNIQUES

21 Several hundred clinical reports indicating the effectiveness of EFT can be found on the EFT website (Craig, 2008). Clinical reports suggest that by reducing the symptoms of trauma, physical symptoms, arthritis, and colds have also decreased (Feinstein et al., 2005). However, many of these have not been through the necessary peer review process to evaluate their validity and credibility. There are also numerous studies that have found the technique effective for multiple types of psychological distress such as phobias (Wells et al., 2003), anxiety (Rowe, 2005), and Posttraumatic Stress Disorder (PTSD) (Church, 2008a). Most of these studies involve a single session of EFT and the effects have been found to remain over time at both three and six months post intervention. One such study supporting the effectiveness of treating trauma with EFT completed by Church (2008a) identified nine veterans with symptoms of PTSD. The veterans participated in two to three daily sessions of EFT. The results indicated a 63% reduction in PTSD symptoms following treatment. EFT has also been compared with progressive muscle relaxation in the treatment of test anxiety with thirty-two Turkish university students (Sezgin & Ozcan, 2004). Students in the EFT group were taught how to apply EFT tapping procedures while thinking of taking a test. The students were instructed to practice EFT three times a week for two months. The progressive muscle relaxation (PMR) group was given audio instruction for progressive muscle relaxation. While both groups showed a significant decrease in test anxiety, the EFT group’s decrease (53.9 to 33.9) was statistically greater than the decrease for the PMR group (56.3 to 44.9) (Sezgin & Ozcan, 2004). Salas (2003) examined the effectiveness of EFT for the treatment of phobias. This study consisted of a randomized controlled trial comparing EFT with diaphragmatic breathing (DB) for

Running head: EMOTIONAL FREEDOM TECHNIQUES

22 the reduction of anxiety associated with specific phobias. Anxiety was measured using three methods for 22 participants. EFT produced statistically significant reductions in anxiety as measured by all three tests (Salas, 2003). Results indicated that EFT provided more significant and consistent impact on the reduction of anxiety than DB. The effects of self-intervention with EFT on anxiety and depression in heath care professionals were studied by Church (2008b). The study utilized a within-subjects, time-series, repeated measures design. EFT self-application resulted in statistically significant decreases in pain, emotional distress, and cravings. Another study conducted by Church (2008c) investigated whether EFT could make a difference in athletes by treating any stress or anxiety that might underlie their performance. Basketball players who received the EFT intervention scored an average of 21% better in free throws after treatment than the control group. Researchers suggested that EFT used as an intervention during the course of an athletic event may reduce performance stress and improve player function. A study by Rowe (2005) found that a three-day EFT workshop produced statistically significant decreases in depression, anxiety, and other psychological disorders. Participants were recruited from those who had previously signed up for an intensive EFT workshop. Using a time- series, within-subjects, repeated measure design, 102 participants were assessed at the beginning and end of the workshop as well as one-month and six-months following the workshop. Researchers found a statistically significant decrease in all measures of psychological distress from pre-workshop to post workshop. These gains were maintained at three- and six-month follow-up.

Running head: EMOTIONAL FREEDOM TECHNIQUES

23 Risks of EFT Of the hundreds of case reports and studies found on the EFT website, no negative side effects have been reported (Craig, 2008). A risk involved in general in the treatment of trauma is that having clients talk about the trauma will lead not to desensitization but to retraumatization (Van der Kolk, 1996). This concern is minimized with EFT, as clinicians note an absence of abreactions and client distress when using EFT (Mollon, 2007). A survey of psychotherapists who use both EP and other methods such as EMDR and Cognitive Behavioral Therapy found that clinicians preferred the use of EP in cases where clients were asked to recall traumatic memories in order to resolve these core clinical dilemmas (Schultz, 2007).

Full document contains 57 pages
Abstract: Occupational stress may be directly related to teacher burnout and general job dissatisfaction within the teaching profession. While research has shown that teaching is among the most stressful of occupations, there is currently limited research on the implementation or effectiveness of stress management programs. The present study examined the effectiveness of Emotional Freedom Techniques (EFT) on the reduction of stress for preschool teachers. The study was conducted according to a single-subject design (N=2), in which levels of stress and anxiety were measured before and after the five-week training of EFT. Following the completion of training, both participants in the study reported decreased levels of stress and anxiety. However, at six month follow up, results were more varied.