EFT and Counselling

1. Christine C. Berger, PhD, LCPC
Old Dominion University
EFT Scientific Symposium 2015
July 4, Staffordshire University

2. Introduction
 As complementary therapies (CT) become more widely
used (Clarke et al., 2015), it would benefit counselors and
other mental health professionals to better understand
their effects on mental health treatment
 The principal investigator has observed that there are 2
emerging models combining CT and counseling: an
integrative counseling model and a team treatment
approach
 The goal of this study is to explore, inform, and encourage
counselors who practice using conventional counseling
methods to include complementary therapies: integrative
counseling model

3. Introduction
 Currently in the counseling field “integrative counseling”
refers to the combination of multiple types of conventional
counseling or including cultural issues in counseling
(Corey, 2012; LaFramboise et al., 1990; Leong, 1996)
 However, psychiatrist James Lake has coined the term
“integrative mental health” which focuses on the inclusion
of integrative therapies with conventional counseling
(Lake, 2009).
 In counseling this integrative term may need modification
but the label refers to mental health professionals who
integrate a CT into their practice

4. Introduction
 The PI met with a professional counselor who practices this
integrative model using Emotional Freedom Techniques
(EFT) as her CT and that was the impetus for this pilot
study.
 There is a large body of research demonstrating the
effectiveness of EFT on a variety of mental disorders
(Boath, Stewart & Rolling, 2014, etc.) but there have not
been in-depth studies about the experience of such a
model from the client and counselor perspective
 A grounded theory approach is exploratory and seeks to
understand a phenomenon from the ground-level up.

5. Research Questions
 Research question 1: What attracted you to this
holistic/integrative model of counseling?
 Research Question 2: Can you describe how this
experience has differed from other counseling or
mental health treatments you may have received
previously?
 Research Question 3: How has EFT/EP specifically
affected your mental health and overall well-being?

6. Research Questions
 Research Question 4: How has the counseling
relationship and process affected your mental health
and overall well-being?
 Research Question 5: How has counseling and
EFT/EP for your issues (trauma) impacted your
spirituality, if at all?

7. Method
 Setting
 Setting was a private mental health counseling practice run by
a licensed professional counselor
 Participants
 Five outpatient clients seeking treatment for a variety of
mental health disorders (alcohol use, other substance abuse,
anxiety, depression, grief and trauma). These clients were all
receiving counseling and EFT
 2 males, 3 females
 Ages ranged from 25 to 55
 4 were Caucasian and one was biracial
 1 Professional Counselor
 We wanted to interview clients who disliked or refused EFT
but none were interested in participating

8. Method
 Data Collection
 Data were collected by principal investigator and two
graduate students who were learning qual methods
 Consents were obtained and data were collected through
audiotaped semi-structured interviews. Interviews lasted
about an hour and were subsequently transcribed
 Data was collected over two months
 Analysis
 The transcribed interviews were entered into NVIVO which is
a software program designed to manage narrative data
 The primary investigator coded each participant transcription
at two levels: open coding and axial coding

9. Method
 Analysis
 After axial coding themes emerged from the data which
created the initial foundation of theory of an integrative
counseling model
 This study stopped short of generating a relational
model as we have not yet achieved theoretical saturation

10. Trustworthiness
 In the data collection process each interviewer was
trained in qualitative interviewing methods by the PI
 Bracketing and Memos: the training encouraged the
use of memos to bracket biases for accurate data
collection. The PI used the memo process at this stage
 Codes were combined and compared to each other to
refine themes and dynamics in the model.
 One graduate student also coded at an open level for
across-interviewer comparisons.

11. Results
 Open coding rendered 113 unique codes for all participant
transcriptions
 Axial Coding produced 7 themes:
 The role of motivation and readiness may improve openness
to a CT
 Integrative model preferred
 Integrative model effective (accomplishes goals, reduces sx)
 EFT is calming/focusing/grounding
 EFT is a key coping tool
 Mechanism is not a client concern
 Counselor provides a safe space

12. Motivation and readiness may
improve openness to model
 EFT2:” I am a more motivated person I think. I when I want
to do something I’m going to do it, and I had decided that I
was not going to be dealing with the depression any more, I
was going to find a way to fix it.
 EFT3: “I think if it had been an earlier time frame for me,
like if I wasn’t ready to kind of delve into all the things, I
wanted to at that point. I wanted to delve into the depths of
myself because I know that was really the only way that I
was gonna move forward. I just didn’t, I really just didn’t
know how to do it.”

13. Integrative Model Preferred
 Some participants had previous counseling and clearly
preferred the integrative model
 EFT2:. “And so I like this technique so much more
because, with him it was like I would see him once a
week, then I would kind of have to wait for another week
for anything to happen, I would just wait for the next
week. Whereas, this was something I could do every day
as many times a day as I wanted and I could experience
immediate relief as opposed to having to wait a full week
just to talk to someone. So, I liked that I was in control
of it as opposed to needing him to help me through
something.”

14. Integrative Model Preferred
 EFT3: “Where before in traditional therapy I would cry
and I would just kind of stop talking about it, because
that was the only way for me to kind of regroup myself
was to not talk about it when what you really want to do
is talk about it but you can’t, you know and that was
kind of my roadblock with traditional therapy was like I
can’t get past this point of anxiety or I can’t get past you
know, this roadblock of I’m not gonna feel any emotion
about that so it’s kind of been twofold in that 1) it calms
me down so that I can keep talking and 2) it has
removed that wall that I had up and it kind of sneak
attacks you”

15. Integrative Model Effective
 EFT5: “Oh no I could drink like three bottles of wine, I
went from 3 to about 1 too even skipping a couple
days…I would say the counseling with Dr. T and the
tapping have both helped. Yes, and probably the yoga,
they are all holistic. “

16. EFT is calming/focusing/grounding
 EFT2: “It’s definitely been positive. I still like two
nights ago I was stressing about something, I don’t
remember what but I am definitely not feeling the way
I felt when I was meeting with Dr. T but like even
minor stressors it’s just it’s calming and it’s something
that once you learn it you kind of remember it forever I
feel like at least at this point.

17. EFT is a key coping tool
 EFT1: “It’s just very important. If I couldn’t do that, I
couldn’t get through half of what we’ve been going
through”.
 EFT2: (EFT has been)Tremendously positively like I
said I couldn’t focus on anything I was kind of just
laying around and not doing anything, but it kind of
lets me put the stressing to the side and get back to
whatever I need to do or stop stressing and actually be
productive.

18. Mechanism is not a client concern
 Is the energy of EFT creating an outcome or is it a
distraction or focusing technique? Mixed results
 EFT4: “Like I don’t know I think it is cool the whole idea of
chi and the energy source stuff and everything and I don’t
know exactly how it works if it is just distracting me or if
that is doing something when I am doing this and talking
through the problem and all of that. But it has proved
helpful like when I have gone through a couple weeks stint
where I have been doing that every day”.
 EFT3: “When you do it yourself it’s a little bit different.
Umm, when I tap myself, I don’t know how to describe it,
it’s almost like a distraction and a focus at the same time”

19. Counselor Creates a Safe Space
 EFT5: “Yes it was new, the 3rd session I noticed the
poster of EFT tapping points and asked about it and
she said well let’s do it. I told her I had started yoga
and she encouraged me to do yoga. A man at yoga who
had lost his son 20 some years ago had healed through
yoga, I told him about it and he told me to keep seeing
her because he felt it could help me. Today I have
tapped twice. I did not know how I feel about coming
in and opening up to another person”

20. Professional Counselor Perspective
 EFT is especially useful for trauma
 People “literally change before my eyes”
 Use of audio-recorder to “take counselor home with
them”.
 Gentle introduction of EFT offered as a tool
 Discussion of ethics and training
 Important for counselor to practice for experiential
knowledge/credibility and self-care

21. Professional Counselor Perspective
 Exploration of improvement from 10 to 5 and the
challenges of going from 5 to 0
 “And when I say, I see people change in front of my eyes,
I don’t mean that. I mean that I see people shift from an
intensity of a nine or 10down to a five, and pretty
quickly. And then often, in my experience, there’s more
work to get it from a five to a zero. So, in my experience,
that’s where it can take some time. And focus.”

22. Discussion
 Strengths
 Sample included both genders
 There was adequate data to begin to understand the
experience of this integrative model (rich data)
 Certain suppositions were confirmed but there were more
avenues to explore
 Limitations
 Sample did not achieve theoretical saturation for adequate
theory-building
 Not a culturally representative sample
 One mental health professional
 Limited to one CT

23. Discussion
 Initiation or Seeking out of an Integrative Model
 Mechanism: the How of EFT
 Potential specific functions for EFT and counseling
that create the whole
 EFT alone or in the counseling relationship
 IM allows access to deeper emotions
 Reduction in anxiety over time
 EFT as intuitive
 Values did not attract people to EFT, counselor did

24. Discussion
 EFT and counseling seem to be tapping into different
things. Some participants described EFT as managing
anxiety well enough to be more productive with talk
therapy. Others view counseling as addressing specific
issues (reduction of depressive symptoms) and EFT as
helping him manage character defect issues (shame? On
his own).

25. Discussion
 Gender was interesting as the males in the study
seemed to appreciate EFT as a self-help tool whereas
the females discussed it more in relationship/holistic
context. Could be related to ease of learning EFT as
well.

26. Next Phase
 We will connect with other mental health
professionals who are integrating a complementary
therapy into their traditional counseling practice
 After increasing our numbers in this grounded theory
qualitative study we hope to create quantitative studies
of this model. Examples include studies comparing
conventional counseling to integrative counseling
across disorders (efficacy, efficient resolution of
symptoms, satisfaction, etc.)

27. Next Phase
 Trustworthiness
 Theoretical Saturation: We intend to interview about 10-
15 more participants or the amount required to achieve
theoretical saturation
 Member Checks: We will conduct member checks where
we hand the transcripts back to the participants for
verification or clarification
 We will increase the use of memos for bracketing of
biases and more refined questioning