EFT Research Paper
Emotional Freedom Techniques for Elderly Patients with COVID-19: A Case Series on Clinical Recovery, Frailty, and Inflammatory Biomarkers
Citation: Emotional Freedom Techniques for Elderly Patients with COVID-19: A Case Series on Clinical Recovery, Frailty, and Inflammatory Biomarkers, by Stepvia Stepvia, Dewi Yennita, Fathiyah Isbaniah, Erlina Burhan, Nina Kemala Sari, has now been published in Frontiers in Psychology.
Link to full paper: This article is an open-access publication https://www.frontiersin.org/articles/10.3389/fpsyg.2025.1627592.
Abstract:
Background/Objectives: Older adults are disproportionately affected by COVID-19 due to immunosenescence and comorbidities, resulting in higher rates of severe illness and mortality. Psychological distress such as anxiety and fatigue further compounds disease burden. Emotional Freedom Techniques (EFT), an integrative psychophysiological approach, has shown potential in enhancing psychological resilience and modulating inflammatory responses.
Methods: We report a case series of five elderly patients with confirmed COVID-19 admitted to Persahabatan Hospital, Jakarta. Each received standard pharmacological care, including antiviral therapy, corticosteroids, and comorbidity management, alongside daily EFT sessions combining acupressure, affirmations, and exposure techniques. Clinical symptoms, frailty status (via WHAS criteria), WHO Ordinal Scale for Clinical Improvement (OSCI), and serum IL-6 levels were monitored over a 30-day follow-up period. Emotional well-being was qualitatively assessed through follow-up interviews and therapist observations of patient engagement and affective behavior.
Results: All patients demonstrated substantial clinical improvement. OSCI scores decreased from baseline values of 3–4 to 1 by the final follow-up, representing a 66–75% reduction in clinical severity. Frailty status improved markedly across all cases. IL-6 levels showed an average reduction of approximately 85%, suggesting a clinically meaningful improvement in systemic inflammation. No residual symptoms or adverse events were reported. Patients also demonstrated enhanced emotional well-being and adherence to EFT through digital guidance.
Conclusion: EFT may serve as a safe and supportive adjunct therapy in elderly COVID-19 patients, potentially accelerating clinical recovery and reducing inflammation and frailty. Further controlled trials are warranted to evaluate broader applicability in geriatric care.
Craig’s Notes:
This research was don by the Dep’t of Internal Medicine in Jakarta, Indonesia where five elderly patients over the age of 65 with confirmed
COVID-19 were admitted to Persahabatan Hospital, Jakarta with a variety of symptoms including high-grade fever, persistent cough, and headache, dry cough, difficulty breathing, fatigue, etc.
Progress was measured by the use of:
- Clinical symptoms
- Frailty status (via WHAS criteria)
- WHO Ordinal Scale for Clinical Improvement (OSCI)
- Serum IL-6 levels were monitored over a 30-day follow-up period.
And the results showed:
- OSCI scores decreased from baseline values of 3–4 to 1 by the final follow-up, representing
a 66–75% reduction in clinical severity. - Frailty status improved markedly across all cases.
- IL-6 levels showed an average reduction of approximately 85%, suggesting a clinically meaningful improvement in systemic inflammation.
- No residual symptoms or adverse events were reported.
What was the EFT intervention you might ask? According to the authors:
In addition to standard pharmacologic care, EFT was introduced as a daily self-help practice under the guidance of trained healthcare
professionals. EFT followed a simplified Clinical EFT protocol adapted for elderly patients in hospital and home settings. Each session lasted 5–10 min and involved three steps: (1) setup statements identifying emotional or physical distress, (2) tapping on eight specific acupressure points on the face and upper body while verbalizing distress-related phrases, and (3) the inclusion of positive affirmations once distress had subsided. Formal use of Subjective Units of Distress (SUD) scores or individualized trauma-focused processing was omitted to improve adherence and accessibility (Bach et al., 2019; Sari et al., 2017). Patients received instruction through in-person guidance, video
demonstrations, and printed modules. Daily digital reminders via the BotMD® application were used to promote adherence during
hospitalization and follow-up. Family members were also trained to assist during recovery. No specialized equipment was required.
The authors state that: EFT facilitated emotional reconstruction, strengthened psychological well-being, and reduced stress, contributing to overall recovery and reduction in frailty and OSCI scores.
This case series highlights the potential benefits of EFT as an integrative intervention for elderly patients hospitalized with COVID-19.
All five patients demonstrated improvements across clinical, functional, and biological parameters—specifically, reductions in OSCI scores, decreased frailty levels, and lowered inflammatory marker IL-6. These improvements may be explained by both physiological and psychosocial mechanisms, including reductions in psychological distress and systemic inflammation, enhanced coping mechanisms, and improved rest and adherence to care protocols.
Authors also state about EFT: EFT is a structured, low-cost mind–body technique that integrates cognitive processing with acupressure tapping. It has been shown to reduce cortisol levels and enhance vagal tone, contributing to improved autonomic regulation (Bach et al., 2019; Sari et al., 2017). These physiological changes support emotional stabilization, which may further enhance recovery in frail elderly individuals. Studies by Bach et al. (2019) and Church et al. (2012) demonstrated that EFT significantly reduces cortisol and enhances parasympathetic activity (Bach et al., 2019; Church et al., 2012), while a more recent study by Rochma et al. (2023) confirmed EFT’s efficacy in reducing anxiety. Given that anxiety can impair immune function and increase susceptibility to infections, these effects are particularly valuable in hospitalized geriatric patients.