The effect of emotional freedom techniques on anxiety depression and sleep in older people living with HIV: a randomized controlled trial

January 24, 2025 AIDS, Anxiety, Chronic Health, Depression, HIV, sleep

Citation: Qi W, Xinyi Y, Yuhan W, Wenwen Y, Yan S. The effect of emotional freedom techniques on anxiety depression and sleep in older people living with HIV: a randomized controlled trial. AIDS Res Ther. 2024 Dec 20;21(1):94. doi: 10.1186/s12981-024-00679-4. PMID: 39707382; PMCID: PMC11662501.

Link to Access Full Paper: open access https://pmc.ncbi.nlm.nih.gov/articles/PMC11662501/ 

Abstract

Objective To investigate the effect of Emotional Freedom Techniques on anxiety, depression and sleep in older people living with HIV (PLWH).

Methods 70 older PLWH experiencing anxiety, depression, and sleep disorders were randomly divided into control and experimental groups using a random number table system (RNT), with 35 participants in each group. The experimental group received Emotional Freedom Techniques once a day for 15–20 min as part of their routine care and health counselling, and the intervention lasted for 2 weeks. The control group received standard nursing care and health guidance. The two groups were assessed using the Pittsburgh Sleep Quality Index (PSQI) and the Hospital Anxiety and Depression Scale (HADS) to measure changes in anxiety, depression, and sleep quality before and after the intervention. 

Results There are totally 67 participants in the trial. In the EFT group (n = 33), PSQI scores decreased from 12.36 ± 2.409 to 9.15 ± 2.476(mean ± SD P < 0.001), HA scores decreased from 12.39 ± 2.344 to 9.12 ± 2.176(mean ± SD P < 0.001), HD scores decreased from 11.58 ± 1.969 to 8.94 ± 2.015 (mean ± SD P < 0.001), compared with no change in the usual care group (n = 34). The EFT group showed significantly lower post-intervention scores than the control group on all scales (P < 0.001), indicating the effectiveness of the intervention.

Conclusion Emotional Freedom Techniques can effectively alleviate anxiety and depression in older PLWH and improve their sleep quality.

Keywords: Emotional freedom techniques, HIV, PLWH, Older adults, AIDS, Sleep disorders, Anxiety, Depression

Craig’s Notes: I believe this is now the 3rd trial demonstrating EFT’s effectiveness in helping with sleep difficulties and of course one of many published showing how effective EFT is with various groups suffering from depression and anxidety. In this trial conducted at the Nanjing Public Health Medical Center in China, 70 individuals all over the age of 50 who were positive for HIV disease (PLWH aka People living with HIV Disease) and had elevated levels of anxiety, depresession and sleep difficulties. This study was an RCT lasting for just 2 weeks with the EFT participants tapping 15-20 inutes per day in addition to their regular care and counseling. 67 patients completed the trial, all of whom were male.

Regarding the EFT delivered, team EFT training was delivered by a “Level 2 psychotherapist proficient in EFT” who trained two nursing researchers for 5 days (2 hours per day) including watching videos, theoretical knowledge of EFT, explanations of acupoints, operational points, and techniques on how to guide patients to talk about negative emotions. Patients were monitored for a month via weekly phone calls to monitor adherence, anxiety or depressive symptoms, and sleep patterns.

The RCT aimed to evaluate the effectiveness of EFT for older patients living with HIV. The study results, following a two-week EFT intervention, demonstrated anxiety and depression scores in the test group were significantly lower than at baseline, and also lower compared to the control group (P < 0.001). “These results indicate that Emotional Freedom Techniques can effectively alleviate anxiety and depression and improve the sleep quality in older PLWH.”

Here are other direct quotes from the paper I think are noteworthy:

• One reason EFT aids in releasing negative emotions is its improvement of multiple physiological health markers [13], particularly leading to significant reductions in cortisol levels [28, 29], which are strongly associated with anxiety and depression [30]… Moreover, although EFT is a single technique, its focus on emotions and the creation of a self-declaration expose patients to stimuli they feel anxious about or are trying to avoid. Through positive words and phrases, the individual’s positive thinking is significantly enhanced, thereby reducing negative emotions [32].
• When individuals feel anxious or depressed, their prefrontal cortex are in a state of high arousal [39], leading to difficulties in falling asleep or maintaining a stable sleep state. When the patient’s bad mood is cured, the quality of sleep improves.
• Our study highlights the practicality and utility of EFT as a complementary therapy to mitigate psychological burdens and enhance sleep in older PLWH.
• Future research should focus on exploring the neural mechanisms underlying the effects of EFT and its integration into broader therapeutic frameworks. This would provide deeper insights into optimizing treatment strategies tailored to the specific needs of individuals with chronic health conditions in older age.
• There are several limitations of this study. Due to time constraints, the intervention lasted only two weeks, preventing an assessment of how duration affects EFT effectiveness. Additionally, the study focused solely on older PLWH, further research should explore the characteristics of various age groups and disease types. The followup period was limited to one month, necessitating more in-depth investigation of the long-term effects of EFT. Despite the fact that participants were explained the key points of EFT and sent videos of the operation at the time of group exit, less than 40% of the patients adhered to the use of EFT during the follow-up.

Subsequent studies should consider the promotion of EFT and the cultivation of more EFT therapists.