Integrating the manual stimulation of acupuncture points into psychotherapy: A systematic review with clinical recommendations.

Abstract

The integration into psychotherapy of protocols using the stimulation of acupuncture points by tapping on them, a form of acupressure, is increasingly appearing in clinical practice. An underlying premise is that the procedure generates activating and deactivating signals which, in real time, impact brain areas aroused by a client’s focus of attention. This makes it possible for a therapist to rapidly facilitate cognitive and neurological changes by shifting the wording and images that accompany the tapping. The approach has been controversial, with both enthusiastic proponents and adamant critics. A total of 309 peer-reviewed, English-language journal articles have focused on this development. The aim of this article is to put these reports into context using a “hierarchy of evidence” model. In a hierarchy of evidence, judgments about the efficacy of a clinical approach are formed according to the relative strength of the types of studies supporting the method. The hierarchy of evidence for psychotherapies that use tapping on acupuncture points includes 28 systematic reviews or meta-analyses, 125 clinical trials, 24 case studies, 26 reports describing systematic observations, 17 mixed-method clinical trials that included a tapping component, and 88 articles addressing clinical procedures, theory, mechanisms, or related issues. Consistency in positive outcomes following the tapping of selected acupuncture points for a range of conditions was identified and weaknesses in study designs discussed. Mechanisms of action are briefly considered and suggestions for integrating acupoint tapping protocols into clinical practice are presented. The article concludes that although further research is needed, the growing evidence base documenting the effectiveness, speed, and durability of the approach appears promising.

The Energy of Energy Psychology

“…Virtually every study that has examined pre-to post-treatment changes in stress-related symptoms following an acupoint tapping session has found statistically significant reductions [1]. For instance, in the very first peer-reviewed randomized clinical trial (RCT) to examine the outcome of a tapping protocol, published in 2003, 18 subjects with a fear of small animals were provided a 30-minute session [40].…”

“…Energy psychology is a psychotherapeutic and self-help approach that has been shown in more than 120 clinical trials to impact a wide range of conditions, to deliver results with unusual speed, and to have durability on follow-up [1]. The approach has been utilized by psychotherapists as well as other health care professionals, athletic teams, performance coaches, business consultants, and disaster relief workers [2].…”

Acupressure in psychotherapy as an unsinkable rubber duck: A reply to Feinstein (2023).

“…In the publication "Integrating the Manual Stimulation of Acupuncture Points Into Psychotherapy: A Systematic Review with Clinical Recommendations," Feinstein (2023) aims to aggregate the evidence on emotional freedom techniques (EFT) across the "hierarchy of evidence" (with meta-analyses at the highest level and anecdotal reports at the lowest level). EFT, which falls under the umbrella of "energy psychology," is described by the author as a therapy that incorporates imaginal exposure and cognitive interventions with acupressure or tapping.…”

“…The rebranding of TFT into EFT likely happened as a result of the TFT being viewed as discredited by experts due to the absence of scientific support for its effectiveness (Bakker, 2013;Norcross et al, 2006), sanctions brought against a therapist in Arizona practicing TFT, and later decisions by the American Psychological Association (APA) to consider TFT an inappropriate subject for Continuing Education courses (Lilienfeld & Lohr, 2000). 1 Despite these actions, Feinstein (2023) notes that many therapists continue to use TFT (or EFT), representing what Randi (2012) referred to as an "unsinkable rubber duck" (i.e., a belief that people continue to hold in spite of evidence to the contrary).…”

“…Although Feinstein (2023) concludes: "The body of research on acupoint tapping that has emerged over the past two decades and the increasing quality of the study designs appears promising" (p. 61), we must disagree for several important reasons. First, EFT is based on the pseudoscientific concept of energy meridians which are neither evidence-based nor falsifiable.…”