Tapping their Patients’ Problems Away?

Abstract

Objective: The objective was to learn about the characteristics of psychotherapists who use energy meridian techniques (EMTs). Methods: We conducted an Internet-based survey of the practices and attitudes of licensed psychotherapists. Results: Of 149 survey respondents (21.4% social workers), 42.3% reported that they frequently use or are inclined to use EMTs. EMT therapists reported higher use of a number of techniques from different theoretical orientations, reliance on intuition in decision making, positive attitudes toward complementary and alternative treatments, erroneous health beliefs, and importance placed on the intuitive appeal of evidence-based treatments. EMT therapists also had lower scores on a test of critical thinking. Conclusions: Results suggest that a number of characteristics differentiate therapists who are inclined to use EMTs, which can aid in future educational efforts.

Keywords

energy psychology critical thinking evidence-based practice complementary and alternative medicine thought field therapy emotional freedom techniques

Introduction

Energy meridian techniques (EMTs) are employed in several alternative and currently controversial psychological therapies to treat a variety of mental health problems and illness (Devilly, 2005; Feinstein, 2008; Gaudiano & Herbert, 2000; Lohr, Hooke, Gist, & Tolin, 2003; Pignotti, 2007). Sometimes referred to as psychological acupuncture, EMTs involve therapists instructing clients to tap on specific points on their bodies corresponding to invisible “energy meridians” that are the putative causes of psychological problems (Callahan & Callahan, 2000). A variety of related approaches currently emphasize EMTs and are sometimes referred to as energy psychology (Gallo, 2002), including thought field therapy, emotional freedom technique, touch and breath, Tapas Acupressure Technique, and Be Set Free Fast. The current study was an attempt to understand the characteristics of therapists who use EMTs. What follows is a brief review of EMT history, theory, practice, and past research for the unacquainted reader.

The original approach using EMTs is called thought field therapy (TFT) and was created by Roger Callahan, a clinical psychologist. Callahan (1997) reported that he accidentally discovered EMTs while treating a client who had a treatment-resistant phobia of water. Inspired by his recent study of acupuncture points that he learned during an applied kinesiology (Goodheart, 1993) course, Callahan claims that when he instructed the client to tap the area under her eye, she experienced an immediate cure of her lifelong phobia. Callahan subsequently developed the formal techniques of TFT (Callahan & Callahan, 2000). Trauma, certain “energy toxins,” and other biological predispositions are theorized to cause disturbances, which Callahan calls “perturbations,” in the body’s energy meridians. Callahan proposes that these disrupted energy meridians are the root cause of all psychological problems. In order to correct perturbations, clients are instructed by the therapist to tap on different parts of their bodies in specific sequences called “algorithms.” In addition, clients are told to roll their eyes, count, and hum a song at various points of the treatment to solidify the changes resulting from the tapping and activate the left and right brain hemispheres. Callahan states that the “thought field” is “attuned” (e.g., like a radio picking up a signal) when people think about what is distressing them, which permits the diagnosis of perturbations. The tapping is theorized to add energy into the meridian system, correcting the disturbance and eliminating the distress at its source. Typically, clients are asked to provide a subjective unit of distress (SUD) rating (e.g., 1 = no distress to 10 = worst level of distress) while thinking of what is bothering them. A SUD rating is again taken following the tapping, and if the distress is not eliminated the tapping is repeated. Callahan links TFT to a wide variety of sources and traditions, including acupuncture and Chi, unsupported muscle testing procedures from applied kinesiology (Goodheart, 1993; Ludtke, Kunz, Seeber, & Ring, 2001), quantum physics, and even paranormal concepts such as “morphic resonance” (Sheldrake, 1981; Shermer, 2005). Other authors have reported more traditional behavioral (e.g., exposure, cognitive restructuring, relaxation) or biological mechanisms related to EMTs (Commons, 2000; Feinstein, 2008). However, no scientific evidence to date has been offered to support the theory underlying any EMTs (Devilly, 2005; Gaudiano & Herbert, 2000).

Since Callahan first developed TFT, many variants have been created by other therapists employing similar tapping techniques. Perhaps the most popular variation is called emotional freedom technique (EFT), which is developed by Gary Craig (2005), a former Callahan trainee who broke from his mentor after a disagreement about the techniques. Whereas TFT uses a specific set of tapping sequences for each psychological problem, EFT uses a universal algorithm for treating all problems. In EFT, the therapist also asks clients to recite a coping statement while tapping, such as “Even though I have this problem, I deeply and completely accept myself.” Callahan no longer employs these coping statements.

Regardless of the versions of EMTs employed, proponents claim to be able to provide quick relief for a variety of psychological problems, including phobias, panic, posttraumatic stress, addictions, sexual problems, anorexia/bulimia, asthma, dyslexia, allergies, vision problems, pain, neuropathy, depression, warts, autism, and anger, among many others (see www.rogercallahan.com, www.eftuniverse.com, and www.thetappingsolution.com for examples). The word “cure” is often used to describe the results of EMTs (Callahan, 1985, 2001). Using a proprietary technique he developed called voice technology, Callahan claims an effectiveness rate of over 97% (Callahan & Callahan, 2000). One therapist claimed to cure her dog of a fear of heights using the trauma algorithm (Danzig, 1998). EFT proponents also have proposed that surrogate tapping (i.e., tapping on yourself to treat someone else) and imaginal tapping (i.e., merely imagining to tap on yourself or someone else) are equally as effective (Flanagan, n.d.; Perry, 2011). Such claims are not supported. For example, the Arizona licensing board sanctioned a psychologist in 1999 for making unsubstantiated claims regarding the effectiveness of EMTs (Foxhall, 1999). Also, the American Psychological Association refuses to sponsor continuing education credit for training in EMTs (Murray, 1999).

Originally, proponents of EMTs claimed that the treatment was so effective that control conditions were unnecessary because the benefits were obvious to anyone who observed them (Callahan, 2000). Therefore, even though these procedures have been practiced by Callahan and others for decades, only recently has controlled research been conducted. David Feinstein (2008), an EMT therapist and proponent, recently published a review of research that he claimed was supportive of EMTs. He argued that anecdotal reports and formal research provide enough evidence for designating EMTs as an empirically supported treatment based on the American Psychological Association’s formal criteria (Chambless & Ollendick, 2001). However, Monica Pignotti, a former TFT therapist who has since renounced the procedures (Pignotti, 2005a, 2007), challenged Feinstein’s conclusions. Pignotti and her coauthor Thyer (2009a) argued that Feinstein’s article showed evidence of bias in that disconfirming studies and critical reviews of the literature were inexplicably excluded from his review. Furthermore, much of the research presented by Feinstein was from the “gray literature” (i.e., unpublished reports, dissertations, conference proceedings, etc.) which has not been subjected to rigorous peer review or was found in proprietary publications (e.g., promotional newsletters). Other EMT studies presented by Feinstein were either misrepresented or employed inferior comparison conditions that did not properly control for placebo factors. Pignotti and Thyer also noted that Feinstein did not disclose financial conflicts of interest in his article since he sells EMT-related products on his website.

Perhaps most importantly, the only published, placebo-controlled studies of both EFT and TFT to date suggest that any benefits observed from the procedures are likely the result of placebo effects. It is unclear why there are so few placebo-controlled trials of these approaches, given that their claims are much easier to test under controlled conditions than traditional psychotherapy given the fact that the putative mechanism (i.e., tapping on the body in certain sequences) can be isolated. One study was done by independent researchers who specifically tested the claims of EFT. Waite and Holder (2003) used EFT to treat 119 university studies with anxiety. Participants were randomized to standard EFT, placebo EFT (i.e., tapping on the arm away from the purported meridian points), model EFT (i.e., tapping on a doll instead of themselves), or nontreatment control (i.e., constructing a paper toy). Results showed that participants demonstrated significantly greater improvements in anxiety in the standard EFT, placebo EFT, and model EFT conditions compared with the nontreatment control. These researchers noted that the tapping groups also may have been inadvertently receiving some degree of exposure to their fears during these treatments, which could have led to some improvement. However, there were no differences between the standard versus placebo or model EFT conditions, suggesting that any improvements observed were largely the result of placebo effects related to the provision of treatment in general. Inexplicably, proponents of EFT interpreted these results as evidence that the techniques are even more robust and powerful than previously thought (Feinstein, 2009).

Another study conducted by a former TFT therapist, who stopped using EMTs following the results of her research, tested Callahan’s voice technology. Voice technology is a proprietary procedure invented by Callahan that trainees purportedly pay over $100,000 to learn (Gaudiano & Herbert, 2000). Voice technology trainees must sign strict nondisclosure contracts so as not to reveal its secrets and therefore few details exist about the procedures. However, Pignotti (2005b) was trained in voice technology and reports that she desired to test the claims because initially she expected that they would be proved correct. Sixty-six participants were quasi-randomly assigned to either standard voice technology (i.e., tapping points selected according to voice technology) or placebo voice technology (i.e., points chosen at random) in single blind fashion. However, improvements in self-reported distress were identical in both groups, and Pignotti concluded that TFT is a placebo treatment.

A recent review of the literature concluded that EMTs lack a valid scientific basis, show nonspecific efficacy, are not superior to other treatments, and display multiple characteristics of pseudoscience (Devilly, 2005). Nevertheless, EMTs remain popular and many therapists appear interested in learning the techniques despite the disconfirming studies presented by researchers and therapists. Therefore, an important question remains: Who is using EMTs? As part of a larger study, we surveyed the practices and attitudes of psychotherapists related to their evidence- and nonevidence-based practices. The sample contained a subsample of respondents who reported using EMTs. Therefore, we compared therapists who did and did not use EMTs on measures of practice characteristics, personality, attitude, and ability. We hypothesized that EMT therapists would be more likely to have an intuitive personality style, exhibit lower critical thinking skills, hold more positive views of alternative therapies and erroneous health beliefs, and have more negative views toward research-informed psychotherapy. We believe that understanding the potential differences between therapists who are and are not attracted to EMTs could help inform future educational and training efforts.

Method

Sample

Participants were recruited from an advertisement that was posted to a variety of psychotherapy-oriented listservs or through “snowball” sampling methods as part of a larger study. The study was approved by the local Institutional Review Board. The listservs with the largest numbers of members that the advertisement was posted to included: Association of Behavioral and Cognitive Therapies, Acceptance and Commitment Therapy, Addiction Technology Transfer, Hypnosis-Hypnotherapy-UK, and Society for a Science of Clinical Psychology. Participants were required to be licensed, current practitioners of psychotherapy, over the age of 21, and with the ability to read and write in English. A total of 288 participants initially consented to participate. Of those people who consented to participate, 149 participants provided enough data to be categorized as to whether or not they used EMT (see below). The mean age of these participants was 47.3 (SD = 11.2), and the majority were female (59.7%) and White (87.3%). Regarding practice characteristics, the mean time licensed was 13.3 years (SD = 10.2). A total of 34.5% were in private practice, 28.3% were in another outpatient practice (e.g., community mental health), 13.1% were in a hospital setting, 4.1% were in a student counseling center, and the remaining were in other settings (e.g., prison, school, residential treatment program, academic research). A total of 45.3% had a doctoral degree. Regarding specific professions, 40.5% were psychologists, 21.6% were social workers, 28.4% were other licensed counselors, 6.1% were psychiatrists, 2.7% were nurses, and 0.7% were other.

Measures

Treatment Approaches and Techniques Questionnaire (TATQ)

The TATQ is a 36-item self-report questionnaire assessing psychotherapists’ use of different techniques (Sharp, Herbert, & Redding, 2008). Responses range from 0 = Never use/would not use to 3 = Almost always use/would definitely use. The techniques listed correspond with 6 primary theoretical orientations in psychotherapy: systems–family systems; cognitive–behavioral, psychoanalytic–psychodynamic; power–energy therapies (e.g., TFT, EFTs); existential–humanistic–phenomenological; and radical behavioral–applied behavior analysis. Factor analysis and associations with theoretical orientation support the overall content validity of the questionnaire (Brown, Gaudiano, & Miller, 2011; Sharp et al., 2008).

A total of 6 items are contained in the TATQ power–energy therapies subscale: muscle-testing/applied kinesiology, touch and breathe technique, body energy work, tapping of acupressure/acupuncture points, stimulation of energy meridians, and bilateral stimulation (e.g., eye movements). The bilateral stimulation item was deleted because it references a technique characteristic of a nonenergy meridian therapy (i.e., eye movement desensitization and reprocessing). The remaining items were summed to obtain an EMT subscale score. Respondents with scores of 0 (never use/would not use) or 1 (sometimes use/would possibly use) on any item were categorized as non-EMT therapists. Those scoring 2 (frequently use/would probably use) or 3 (almost always use/would definitely use) on any item were categorized as EMT therapists.

Evidence-Based Practice Attitude Scale (EBPAS)

The EBPAS (Aarons, 2004) is designed to measure four types of attitudes toward evidence-based practices and the implementation of manualized therapies: (1) level of importance placed of the intuitive appeal of the treatment (EBPAS-Appeal), (2) willingness to adopt the treatment if required to do so by a supervisor or agency (EBPAS-Requirements), (3) openness to learning new treatments (EBPAS-Openness), and (4) negative attitudes toward research as reflected by the perceived divergence between clinical and research practices (EBPAS-Research). The average score for each scale was computed and the research subscale was reverse scored to be consistent with the other scales. The measure contains a total of 15 items, and Aarons (2004) reported that it possesses good internal consistency reliability and validity.

Rational-Experiential Inventory (REI)

The REI is a well-validated measure that is designed to capture a rational versus intuitive personality style (Pacini & Epstein, 1999). In the current study, only the 20-item experiential/intuitive scale was administered. A higher score on the REI indicates greater reliance on intuition in everyday life. An example item for this scale is “I can usually feel when a person is right or wrong, even if I can’t explain how I know.”

Complementary and Alternative Medicine Health Belief Questionnaire (CHBQ)

The CHBQ was designed to measure beliefs in complementary and alternative medicine (CAM) and attitudes toward a holistic approach toward health (Lie & Boker, 2004). An example item is “Complementary therapies include ideas and methods from which conventional medicine could benefit.” The measure includes a total of 10 items and is reported to have good internal consistency and convergent validity with other measures of CAM attitudes (Lie & Boker, 2004).

Magical Beliefs about Food and Health Scale (MFH)

The MFH is a measure that was designed to measure erroneous health beliefs that are not supported by scientific evidence and correlates with other paranormal beliefs (Lindeman, Keskivaara, & Roschier, 2000). The measure includes 18 items, but only the 10-item general health beliefs subscale was administered in the current study. A sample item from this subscale is “Colors change an organism’s energy vibration in a direction that is beneficial to health.”

Critical Thinking Questionnaire (CTQ)

The CTQ is a test designed for psychotherapists that assesses critical thinking abilities (Gaudiano, Brown, & Miller, 2011; Sharp et al., 2008). The questionnaire items were adapted from the Watson–Glaser Critical Thinking Assessment (Watson & Glaser, 1994) and Cornell Critical Thinking Test (Ennis, Millman, & Tomko, 1985). Internal consistency was found to be adequate (KR-20 = .70). For the purposes of the current study, 8 items from the Interpretation and Deduction subscales were administered, as Sharp et al. (2008) reported that they better differentiated the critical thinking abilities and practices of psychotherapists. First, a hypothetical scenario is presented. For example, “No person who thinks scientifically places any faith in the predictions of astrologers. Nevertheless, there are many people who rely on horoscopes provided by astrologers. Therefore . . .” Statements about the scenario are then presented and respondents choose whether or not they logically follow from the information presented in the scenario. For example, one statement is, “People who lack confidence in horoscopes think scientifically.” The correct answer to this question is “Does Not Follow.”

Results

Based on the TATQ, 42.3% (n = 63) of participants reported using EMTs. EMT versus non-EMT therapists were compared on study variables using independent-samples t tests or chi-square analyses as appropriate. Table 1 depicts descriptive statistics by group on demographic and other professional characteristics. EMT therapists were significantly more likely to possess a nondoctoral degree and be a nonpsychologist professional. Furthermore, EMT therapists reported significantly greater use of all categories of psychotherapy techniques (psychodynamic, family systems, radical behavioral, and existential–humanistic) except cognitive–behavioral on the TATQ, reflecting greater overall eclecticism in practice (see Figure 1).

Figure 1.

Treatment Approaches and Techniques Questionnaire.

Table 1.

Demographic and Professional Characteristics

		Energy meridian technique therapists	Nonenergy meridian technique therapists
		M (SD)	M (SD)	t	p	d
Age		47.7 (10.8)	47.0 (11.6)	0.33	n.s.	.06
Years licensed		13.4 (10.3)	13.3 (10.1)	0.06	n.s.	.01
		% (n)	% (n)	χ²	p	OR
Gender
	Male	38.3 (23)	61.7 (37)	.64	n.s.	1.31
	Female	44.9 (40)	55.1 (49)
Race
	White	41.5 (54)	58.5 (76)	.23	n.s.	1.27
	Non-White	47.4 (9)	52.6 (10)
Degree
	Doctoral	27.3 (18)	72.7 (48)
	Nondoctoral	53.1 (43)	46.9 (38)	9.21	.002	3.02
Primary orientation
	Cognitive–behavioral	28.1 (16)	71.9 (41)	7.23	.007	2.70
	Other	50.5 (46)	49.5 (45)
Psychologist
	Psychologist	30.0 (18)	70.0 (42)	6.21	.013	2.39
	Other	50.6 (45)	49.4 (44)
Social work
	Social worker	56.3 (18)	43.8 (14)	3.26	n.s.	2.06
	Other	38.5 (45)	61.5 (72)
Work setting
	Private practice	40.0 (20)	60.0 (30)	.24	n.s.	1.19
	Other	44.2 (42)	55.8 (53)

Note. Effect sizes are represented as Cohen's d statistic or odds ratios as appropriate. Sample sizes vary slightly in some analyses due to missing data.

Table 2 depicts differences on attitudinal and personality measures. Results demonstrated that EMT therapists were significantly more likely to rely on personal intuition in decision making (REI), endorse more magical beliefs about health that are not supported by scientific evidence (MFH), and have more favorable beliefs about CAM in general (CHBQ). In addition, EMT therapist scored significantly lower on a measure of critical thinking abilities (CTQ). Furthermore, EMT therapists were significantly more likely to place importance on the intuitive appeal of new empirically supported treatments. No significant differences were observed between groups for the other subscales of the EBPAS (see Figure 2).

Figure 2.

Evidence-Based Practice Attitude scale.

Table 2.

Personality and Attitudinal Measures

	Energy meridian technique therapists	Nonenergy meridian technique therapists
	M (SD)	M (SD)	t	p	d
Complementary and Alternative Medicine Health Belief Questionnaire	49.0 (10.3)	41.6 (10.7)	4.21	.000	.70
Magical Beliefs about Food and Health-General subscale	2.3 (0.7)	1.7 (0.6)	5.01	.000	.92
Rational/Experiential Inventory-Intuition subscale	3.6 (0.6)	3.1 (0.7)	4.23	.000	.77
Critical Thinking Questionnaire	5.1 (1.8)	5.9 (1.7)	2.75	.007	.46

Note. Effect sizes are represented as Cohen's d statistic.

As differences in education could have affected the results of our other measures, the above analyses were rerun using analyses of variance with degree (doctoral vs. other) entered as a covariate. Results remained significant (p < .05) in all cases reported above.

Discussion and Applications to Practice

As hypothesized, EMT therapists showed many professional and individual differences compared with non-EMT therapists. EMT therapists were less likely to have doctoral degrees or be psychologists. In addition, EMT therapists showed more positive attitudes toward alternative therapies, endorsed more unsupported health beliefs, reported somewhat more negative attitudes toward evidence-based treatments, and demonstrated greater reliance on intuition in decision making. They also demonstrated lower critical thinking abilities on a test designed for psychotherapists.

Overall, 42.3% of the sample endorsed frequent or probable use of EMTs. A total of 56% of social workers specifically endorsed the use of EMTs. In general, the use of unsupported therapies among psychotherapists appears to be high, with a recent study by Pignotti and Thyer (2009b) reporting that 75% of a sample of 191 social workers reported using at least one novel unsupported intervention in their practice, although only approximately 6% reported specifically using EFT and 3% reported using TFT. Sharp et al. (2008) surveyed 79 practicing psychologists and found that 19% reported using EMTs and 9% reported certification in TFT. These rates are lower than that found in the current study, which may be explained by the increasing popularity of these methods over time or our inclusion of nondoctoral level practitioners who appear to be more likely to use EMTs. Furthermore, differences in sampling strategy and methods for assessing technique usage also could account for these discrepancies. However, the use of unsupported techniques is not unique to psychotherapists, as a survey found that 43% of chiropractors in the United States used discredited muscle testing techniques from applied kinesiology (National Board of Chiropractic Examiner, 2000).

Another interesting finding was that EMT therapists endorsed greater use of techniques from most other theoretical orientations in addition to EMTs. Lazarus and Beutler (1993) argued that there is value in technical eclecticism, in which the clinician chooses different techniques based on the evidence base supporting their use given the particular clinical problem being treated. However, survey respondents in the current study reported using various unsupported techniques that appear to better resemble what Lazarus and Beutler called unsystematic eclecticism, which results in idiosyncratic clinical practices that are not logical and rational. Furthermore, this reported use of disparate techniques at first may seem inconsistent with the finding that 26% of survey respondents using EMTs reported that they have a primary cognitive–behavioral theoretical orientation. However, it has been noted that many therapists increasingly report a cognitive–behavioral orientation even though this is not necessarily reflected in their training or practice. Sharp et al. (2008) similarly found that many therapists who formally identified themselves as having a cognitive–behavioral orientation actually reported using techniques from a wide variety of orientations.

Differences found on attitudinal and personality measures also were consistent with past research. Saher and Lindeman (2005) reported that positive beliefs about CAM were associated with intuitive thinking style and magical health beliefs. Similarly, Marks, Hine, Blore, and Phillips (2008) reported that intuitive thinking was associated with increased superstitious beliefs and poorer reasoning abilities in adolescents. Shiloh, Salton, and Sharabi (2002) found that intuitive thinking was inversely correlated with statistical judgments in college students. Other researchers also have found that an intuitive personality style is associated with critical thinking in students (Klaczynski, Faust, & Swanger, 1998; Klaczynski, Gordon, & Fauth, 1997). Wheeler and Hyland (2008) reported that intuitive thinking was associated with greater use of complementary and alternative therapies in an undergraduate sample. Furthermore, Alcock and Otis (1980) reported that nonbelievers in the paranormal scored significantly higher than believers on a general measure of critical thinking. In addition, Gray and Mill (1990) demonstrated a significant relationship between critical thinking abilities and paranormal beliefs in graduate students. More recently, Hergovich and Arendasy (2005) demonstrated that paranormal beliefs were negatively correlated with reasoning abilities in students.

Given the finding that EMT therapists in our study were more likely to possess an intuitive thinking style, it is not surprising that they also placed greater importance on the intuitive appeal of new empirically supported treatments. Importantly, both EMT and non-EMT therapists expressed similar attitudes toward requirements to using and openness to learning new evidence-based treatments. This is consistent with the findings of Pignotti and Thyer (2009b) who reported that therapists who used novel but unsupported treatments also had a generally positive attitude toward evidence-based practices. EMT therapists appear to not necessarily be opposed to using evidence-based treatments in principle; however, they seem to be quite interested in using nonevidence-based treatments as well.

This lack of discrimination between evidence- and nonevidence-based treatments may be related to the finding that EMT therapists had lower scores on a test of critical thinking, which requires respondents to match evidence with claims. This replicated the finding by Sharp et al. (2008) who also found that lower critical thinking skills were associated with greater use of EMTs in a sample of psychologists. Numerous authors have noted that the promotion of EMTs has been characterized more by pseudoscientific than scientific principles (Gaudiano & Herbert, 2000; Hooke, 1998; Lohr et al., 2003; Pignotti, 2007). Consistent with the characteristics of pseudoscience (Lilienfeld, 1998), EMT proponents often focus on confirming evidence while ignoring disconfirming research (e.g., biased literature reviews by EMT proponents), offer persuasive rhetoric in lieu of scientific evidence (e.g., claims of “rapid cures” and an emphasis on vivid clinical anecdotes), promote proprietary techniques that are not subject to independent evaluation (e.g., Callahan’s voice technology), and use scientific-sounding jargon and concepts associated with long-standing traditions to increase the perception of credibility (e.g., concepts from physics and Chinese medicine). Therapists who have less training in critical thinking may be more susceptible to EMT messages of dramatic cures even though these claims lack supporting evidence.

There are some potential limitations to the current investigation that should be considered. First, the TATQ assesses both therapists' actual use and their inclination to use certain techniques. Therefore, it is possible that the subsample of therapists in the EMT group was simply open to using these techniques even though they were not currently employing them in their practice. It also is possible that group differences on our measures would have been larger in magnitude if we only had included therapists who actively practiced EMTs. Examination of the demographic and professional characteristics of study participants suggests that we were able to collect a diverse sample of therapists. However, it is not possible to know the exact response rate for Internet-based surveys because it is unclear how many respondents viewed the announcement. Furthermore, although we attempted to sample from a variety of research and practice-oriented listservs, it is possible that our survey respondents were more inclined to endorse EMTs compared with samples obtained from random sampling. An additional limitation was that data were cross-sectional and thus cause–effect relationships could not be determined. However, we conducted secondary analyses controlling for degree and therefore group differences cannot be explained solely by education level.

Information from the current study is potentially useful in directing future training and educational efforts. Aarons, Sommerfeld, Hecht, Silovsky, and Chaffin (2009) propose that a good values-intervention fit is essential for the adoption of treatments by clinicians. Furthermore, it is important to point out that research shows that educational programs alone are largely ineffective for changing clinicians’ behaviors (Oxman, Thomson, Davis, & Haynes, 1995). EMT therapists appear to possess certain characteristics that may need to be considered during education efforts, including their greater reliance on intuition and interest in alternative approaches. However, it also is important to point out that most do not appear to be opposed to evidence-based therapies, at least in principle. For example, Stewart, Chambless, and Baron (2012) surveyed 1,291 practicing psychologists and found low endorsement (6.4%) of objections to empirically supported treatments. Therefore, it may be helpful to use more experiential (rather than purely didactic) training programs so that therapists can develop firsthand success with research-supported interventions. Furthermore, therapists should not only be trained in what to use but what not to use, and why (Lilienfeld, 2007). It would appear useful to integrate critical thinking training into educational workshops so that therapists can learn to better differentiate scientific from pseudoscientific claims. Furthermore, the personal and emotional draw and appeal of EMTs may need to be addressed in training programs as well. Recent research suggests that therapist behaviors can be changed more successfully by targeting their perceived emotional and attitudinal barriers to using evidence-based practices (and giving up nonevidence-based practices; Varra, Hayes, Roget, & Fisher, 2008). It will be important to conduct future research to investigate whether targeting individual factors related to affinity toward controversial therapies can improve therapists’ critical thinking skills and the use of evidence-based practices.

Footnotes

Declaration of Conflicting Interests

The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Funding

The authors received no financial support for the research, authorship, and/or publication of this article.

References

Aarons

G. A.

(2004). Mental health provider attitudes toward adoption of evidence-based practice: the Evidence-Based Practice Attitude Scale (EBPAS). Mental Health Services Research, 6, 61–74.

Aarons

G. A.

Sommerfeld

D. H.

Hecht

D. B.

Silovsky

J. F.

Chaffin

M. J.

(2009). The impact of evidence-based practice implementation and fidelity monitoring on staff turnover: evidence for a protective effect. Journal of Consulting and Clinical Psychology, 77, 270–280.

Alcock

J. E.

Otis

L. P.

(1980). Critical thinking and belief in the paranormal. Psychological Reports, 46, 479–482.

Brown

L. A.

Gaudiano

B. A.

Miller

I. W.

(2011). Investigating the similarities and differences between practitioners of second and third wave cognitive-behavioral therapies. Behavior Modification, 35, 187–200.

Callahan

R. J.

(1985). Five minute phobia cure: Dr. Callahan's treatment for fears, phobias, and self sabotage. Wilmington, DE: Enterprise Publishing.

Callahan

(1997). Thought field therapy: The case of Mary. Electronic Journal of Traumatology, 3, Article 5. Retrieved from http://www.fsu.edu/∼trauma/T039.html

Callahan

R. J.

(2000). A critical analysis of thought field therapy [Letter to the editor]. Skeptical Inquirer, 24, 62.

Callahan

R. J.

(2001). Raising and lowering of heart rate variability: Some clinical findings of thought field therapy. Journal of Clinical Psychology, 57, 1175–1186.

Callahan

R. J.

Callahan

(2000). Stop the nightmares of trauma: Thought field therapy, the power therapy for the 21st century. Chapel Hill, NC: Professional Press.

10.

Chambless

D. L.

Ollendick

T. H.

(2001). Empirically supported psychological interventions: controversies and evidence. Annual Review of Psychology, 52, 685–716.

11.

Commons

M. L.

(2000). The power therapies: A proposed mechanism of their action and suggestions for future empirical validation. Electronic Journal of Traumatology, 6, Article 5. Retrieved from http://www.fsu.edu/∼trauma/v6i2/v6i2a5.htm

12.

Craig

(2005). The evolution of EFT from TFT. Retrieved from http://theamt.com/the_evolution_of_eft_from_tft_by_gary_craig.htm

13.

Danzig

(1998). CT-TFT changes Karma. The Thought Field Newsletter, 4.

14.

Devilly

G. J.

(2005). Power Therapies and possible threats to the science of psychology and psychiatry. Australian and New Zealand Journal of Psychiatry, 39, 437–445.

15.

Ennis

R. H.

Millman

Tomko

T. N.

(1985). Cornell Critical Thinking Tests Level X & Level Z Manual (3rd Ed). Pacific Grove, CA: Critical Thinking Books and Software.

16.

Feinstein

(2008). Energy psychology: A review of the preliminary evidence. Psychotherapy Theory, Research, Practice, Training, 45, 199–213.

17.

Feinstein

(2009). Facts, paradigms, and anomalies in the acceptance of energy psychology: A rejoinder to McCaslin's (2009) and Pignotti and Thyer's (2009) comments on Feinstein (2008a). Psychotherapy Theory, Research, Practice, Training, 46, 262–269.

18.

Flanagan

(n.d.). EFT transforms the life of an elderly tramatized horse. Retrieved from http://www.eftuniverse.com/index.php?option=com_content&view=article&id=8898:eft-transforms-the-life-of-an-elderly-traumatized-horse&catid=8837:animal-work&Itemid=3174

19.

Foxhall

(1999). Arizona board sanctions psychologist for use of Thought Field Therapy. APA Monitor, 30 (8), 13.

20.

Gallo

F. P.

(Ed.). (2002). Energy psychology in psychotherapy. New York: Norton.

21.

Gaudiano

B. A.

Brown

L. A.

Miller

I. W.

(2011). Factors associated with critical thinking abilities in psychotherapists. Cognitive Behaviour Therapy, 40, 137–146.

22.

Gaudiano

B. A.

Herbert

J. D.

(2000). Can we really tap away our problems? A critical analysis of Thought Field Therapy. Skeptical Inquirer, 24, 29–33, 36.

23.

Goodheart

(1993). The applied kinesiology technique. Today's Chiropractic, 22, 56-58.

24.

Gray

Mill

(1990). Critical abilities, graduate education (Biology vs. English), and belief in unsubstantiated phenomena. Canadian Journal of Behavioural Science, 22, 162–172.

25.

Hergovich

Arendasy

(2005). Critical thinking ability and belief in the paranormal. Personality and Individual Differences, 38, 1805–1812.

26.

Hooke

(1998). A review of Thought Field Therapy. Electronic Journal of Traumatology, 3, Article 3. Retrieved from www.fsu.edu/∼trauma/v3i2art3.html

27.

Klaczynski

P. A.

Faust

Swanger

(1998). Adolescent identity: Rational vs. experiential processing, formal operations, and critical thinking beliefs. Journal of Youth and Adolescence, 27, 185–207.

28.

Klaczynski

P. A.

Gordon

D. H.

Fauth

(1997). Goal-oriented critical reasoning and individual differences in critical reasoning biases. Journal of Educational Psychology, 89, 470–485.

29.

Lazarus

A. A.

Beutler

L. E.

(1993). On technical eclecticism. Journal of Counseling & Development, 71, 381–385.

30.

Lie

Boker

(2004). Development and validation of the CAM Health Belief Questionnaire (CHBQ) and CAM use and attitudes amongst medical students. BMC Medical Education, 4, 2.

31.

Lilienfeld

S. O.

(1998). Pseudoscience in contemporary clinical psychology: What it is and what we can do about it. The Clinical Psychologist, 51, 3–9.

32.

Lilienfeld

S. O.

(2007). Psychological treatments that cause harm. Perspectives on Psychological Science, 2, 53–70.

33.

Lindeman

Keskivaara

Roschier

(2000). Assessment of magical beliefs about food and health. Journal of Health Psychology, 5, 195–209.

34.

Lohr

J. M.

Hooke

Gist

Tolin

D. F.

(2003). Novel and controversial treatments for trauma-related stress disorders. In Lynn

S. J.

Lilienfeld

S. O.

Lohr

J. M..

(Eds.), Science and pseudoscience in clinical psychology (pp. 243–272). New York, NY: Guilford.

35.

Ludtke

Kunz

Seeber

Ring

(2001). Test-retest-reliability and validity of the Kinesiology muscle test. Complementary Therapies in Medicine, 9, 141–145.

36.

Marks

A. D. G.

Hine

D. W.

Blore

R. L.

Phillips

W. J.

(2008). Assessing individual differences in adolescents' preference for rational and experiential cognition. Personality and Individual Differences, 44, 45–52.

37.

Murray

(1999). APA no longer approves CE sponsorship for Thought Field Therapy. APA Monitor, 30 (11), 5.

38.

National Board of Chiropractic Examiner. (2000). Job Analysis of Chiropractic: A Project Report, Survey Analysis, and Summary of the Practice of Chiropractic Within the United States. Greeley, CO: National Board of Chiropractic Examiner.

39.

Oxman

A. D.

Thomson

M. A.

Davis

D. A.

Haynes

R. B.

(1995). No magic bullets: a systematic review of 102 trials of interventions to improve professional practice. Canadian Medical Association Journal, 153, 1423–1431.

40.

Pacini

Epstein

(1999). The relation of rational and experiential information processing styles to personality, basic beliefs, and the ratio-bias phenomenon. Journal of Personality and Social Psychology, 76, 972–987.

41.

Perry

(2011). A strange tale and my smallest patient. ATFT Update, 17, 16–17.

42.

Pignotti

(2005a). Regarding the October 2001 Journal of Clinical Psychology special issue on thought field therapy: Retraction of conclusiions in the article "Heart rate variability as an outcome measure for thought field therapy in clinical practice". Journal of Clinical Psychology, 61, 361–365.

43.

Pignotti

(2005b). Thought field therapy Voice Technology vs. random meridian point sequences: A single-blind controlled experiment. Scientific Review of Mental Health Practice, 4, 38–47.

44.

Pignotti

(2007). Thought field therapy: A former insider's experience. Research on Social Work Practice, 17, 392–407.

45.

Pignotti

Thyer

(2009a). Some comments on "Energy psychology: A review of the evidence": Premature conclusions based on incomplete evidence? Psychotherapy Theory, Research, Practice, Training, 46, 257–261.

46.

Pignotti

Thyer

B. A.

(2009b). Use of novel unsupported and empirically supported therapies by licensed clinical social workers: An exploratory study. Social Work Research, 33, 5–17.

47.

Saher

Lindeman

(2005). Alternative medicine: A psychological perspective. Personality and Individual Differences, 39, 1169–1178.

48.

Sharp

I. R.

Herbert

J. D.

Redding

(2008). The role of critical thinking in practicing psychologists' theoretical orientation and choice of intervention techniques. Scientific Review of Mental Health Practice, 6, 21–30.

49.

Sheldrake

(1981). A new science of life: The hypothesis of formative causation. Los Angeles, CA: JP Tarcher.

50.

Shermer

(2005). Rupert's resonance. Scientific American, 293, 38.

51.

Shiloh

Salton

Sharabi

(2002). Individual differences in rational and intuitive thinking styles as predictors of heuristic responses and framing effects. Personality and Individual Differences, 32, 415–429.

52.

Stewart

R. E.

Chambless

D. L.

Baron

(2012). Theoretical and practical barriers to practitioners' willingness to seek training in empirically supported treatments. Journal of Clinical Psychology, 68, 8–23.

53.

Varra

A. A.

Hayes

S. C.

Roget

Fisher

(2008). A randomized control trial examining the effect of acceptance and commitment training on clinician willingness to use evidence-based pharmacotherapy. Journal of Consulting and Clinical Psychology, 76, 449–458.

54.

Waite

W. L.

Holder

M. D.

(2003). Assessment of the Emotional Freedom Technique: An Alternative Treatment for Fear. Scientific Review of Mental Health Practice, 2 20–26.

55.

Watson

Glaser

E. M.

(1994). Watson-Glaser Critical Thinking Appraisal-Manual Form S. San Antonio, TX: Psychological Corporation.

56.

Wheeler

Hyland

M. E.

(2008). Dispositional predictors of complementary medicine and vitamin use in students. Journal of Health Psychology, 13, 516–519.