EFT Tapping: The Nine Points, the Setup Phrase and the Evidence

About this tool

EFT tapping stands for Emotional Freedom Techniques, a self-help routine in which a person taps with their fingertips on a fixed sequence of points on the hand, face and upper body while saying a short phrase about whatever is bothering them. It was assembled in the 1990s by Gary Craig, an engineer by training, who simplified a longer procedure called Thought Field Therapy developed by the psychologist Roger Callahan. EFT spread largely through self-published manuals, workshops and later the internet rather than through clinical training, which is part of why its evidence and its popularity have never been well matched.

The routine itself is short and specific, which is one reason people find it easy to take up. You name the problem in a sentence. You rate your distress from 0 to 10, a measure usually called the subjective units of distress or SUD scale, borrowed from behavior therapy. You tap the side of the hand while saying a setup statement that names the problem and adds a line of self-acceptance. Then you tap through the sequence of points, repeating a short reminder phrase at each one. Then you rate again, and repeat if the number is still high.

The nine points, in the order usually taught, are: the side of the hand below the little finger, often called the karate chop point, which is used for the setup; then the inner edge of the eyebrow, the side of the eye on the bone, under the eye on the cheekbone, under the nose, the crease of the chin, the inner edge of the collarbone, about four inches below the armpit, and finally the top of the head. Tapping is light, with two fingertips, around five to seven taps at each point. Either side of the body is fine, and some people tap both.

The setup statement has a standard shape: 'Even though I am dreading the presentation on Thursday, I deeply and completely accept myself.' The reminder phrase is a short tag used at each point to keep attention on the problem: 'the presentation'. Note what those two elements actually are. The setup is a specific, acceptance-based statement held in mind while attention stays on a distressing thought. That is exposure plus an acceptance framing, which are two ingredients with a large independent literature behind them, and it is worth keeping in view when we get to the question of what is doing the work.

On mechanism, we are not going to tell you something the evidence cannot support. EFT is often grouped under the label energy psychology and explained as clearing blockages in acupuncture meridians. There is no established anatomical basis for meridians, and we do not present that explanation as fact. The honest position is that nobody has demonstrated a mechanism specific to the tapping, and that the components EFT shares with ordinary psychotherapy are the better-supported candidates. You can use the technique without accepting the story attached to it, and plenty of people do.

What the trials show, taken at face value, is positive. Morgan Clond's 2016 meta-analysis in the Journal of Nervous and Mental Disease pooled 14 studies with 658 participants and reported a substantial effect for EFT on anxiety against control conditions, while noting there were too few comparisons with established treatments such as cognitive behavioral therapy to judge the two against each other. Bridget Sebastian and Jerrod Nelms's 2017 meta-analysis of seven randomized trials for post-traumatic stress disorder concluded that a course of four to ten EFT sessions was efficacious across several populations, and reported no adverse effects in the studies reviewed.

The caveats matter at least as much as the effect sizes, and they are rarely quoted alongside them. The trials are mostly small, frequently unblinded, and often run by people who train or practice the method, a well-documented source of inflated effects across psychotherapy research. An evidence brief from the US Department of Defense's Psychological Health Center of Excellence noted that the inclusion criteria in this literature were not restricted to adults diagnosed with post-traumatic stress disorder. The literature also recycles its own studies: a 2024 commentary by Rory Pfund, Cassandra Boness and David Tolin found that five of the six trials in a 2023 EFT meta-analysis had already appeared in the 2017 one, and disputed the claim that EFT meets the American Psychological Association's Division 12 criteria for an empirically supported treatment.

The most informative study is an old and awkward one. Wendy Waite and Mark Holder compared standard EFT against tapping on points chosen at random, against tapping on a doll rather than on oneself, and against no treatment, in a sample of students with self-reported fears. Self-reported fear fell in all three tapping conditions and did not differ meaningfully between them. That is what researchers call a dismantling study, and it points somewhere specific: the active ingredients are probably the ones every condition shared, namely holding the feared thing in mind, saying something accepting about yourself, and the structured attention of the procedure.

If that is right, EFT is best understood as a packaged delivery of ordinary therapeutic ingredients: brief imaginal exposure to a distressing thought, a self-acceptance statement, slow repetitive physical action, careful measurement of distress before and after, and, in the research settings, contact with a practitioner. None of that makes it useless. A routine that is free, portable, takes four minutes and reliably gets people to face a distressing thought while saying something kind about themselves has real value. It just means there is no reason to believe the points on the face are the reason, or to pay a great deal for a specialist version.

Where it fits and where it does not. It is reasonable to try on everyday material: nervousness before something, a stuck irritation, a worry loop, a craving, the low-grade dread of a task. It is not a reasonable way to self-treat post-traumatic stress disorder alone, whatever the meta-analyses say, because the method involves deliberately bringing a distressing memory to mind and the trials were run with practitioners present. Trauma-focused treatments with far larger evidence bases exist, including prolonged exposure, cognitive processing therapy and EMDR. If a memory is the problem, the right first step is a therapist, not a worksheet.

Two practical cautions. First, if the number climbs rather than falls, stop; rising distress is a signal to put the material down rather than to do another round. Second, treat the rating as what it is, a self-report snapshot of how a moment feels, not a measurement of anything underneath. A drop from 8 to 3 tells you the exercise helped today; it does not tell you a problem is resolved. If you would rather work on the thought itself than tap on it, the CBT worksheet at Thought Record (CBT) covers the same situation with better-established methods, and Grounding Techniques is the safer option when the aim is simply to come down.

The worksheet below is our own layout: the standard EFT sequence recorded in a form you can keep, with the ratings as the part that actually tells you something. Use it a handful of times on different issues before deciding whether the technique does anything for you. Pay attention to which issues it moves and which it does not, and compare it honestly against something simpler, like two minutes of slow breathing at Box Breathing. If tapping wins, keep it. If it does not, you have spent twenty minutes finding that out instead of a few hundred on a course.

Reviewed by Michael Callans, MSW
Checked the point sequence and setup wording against the standard published protocol, and confirmed that the evidence section reports the meta-analyses, the dismantling study and the 2024 commentary without overstating any of them.

References

1. Clond M. Emotional Freedom Techniques for anxiety: a systematic review with meta-analysis. Journal of Nervous and Mental Disease. 2016;204(5):388-395. doi:10.1097/NMD.0000000000000483
2. Sebastian B, Nelms J. The effectiveness of Emotional Freedom Techniques in the treatment of posttraumatic stress disorder: a meta-analysis. Explore. 2017;13(1):16-25. doi:10.1016/j.explore.2016.10.001
3. Waite WL, Holder MD. Assessment of the Emotional Freedom Technique: an alternative treatment for fear. The Scientific Review of Mental Health Practice. 2003;2(1):20-26.
4. Pfund RA, Boness CL, Tolin DF. Commentary: Emotional freedom techniques for treating post traumatic stress disorder: an updated systematic review and meta-analysis. Frontiers in Psychology. 2024;15:1308687. doi:10.3389/fpsyg.2024.1308687
5. Psychological Health Center of Excellence. Evidence Brief: Emotional Freedom Technique for Posttraumatic Stress Disorder. US Department of Defense; 2021. https://health.mil/Reference-Center/Publications/2021/04/26/PHCoE-Evidence-Brief-Emotional-Freedom-Technique-for-Posttraumatic-Stress-Disorder-508

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