About Face: Is Virtual Group Delivery of Clinical Emotional Freedom Techniques (EFT) as Effective as Face-to-Face Group Delivery in Improving Psychological and Physiological Markers of Health?

<b>Introduction:</b> Over 100 studies demonstrate the efficacy of Emotional Freedom Techniques (EFT), an evidence-based therapeutic method. However, most research is on in-person delivery of EFT. Only a few studies examine EFT delivered virtually, and to date no research has provided a direct comparison of group virtual EFT to group in-person delivery. <b>Objectives:</b> Delivery of EFT shifted to online platforms in the wake of the 2020 COVID-19 pandemic. This makes a comparison of virtual delivery to in-person delivery timely. The research question of whether online group delivery is as effective as in-person group delivery is of high clinical relevance, given the increased access and convenience offered by virtual treatment options. <b>Methods:</b> Participants in the online group were a convenience sample of 172 participants drawn from four four-day virtual EFT training sessions. Changes in psychological and physiological symptoms were measured pre, post, and at six-month follow-up using the Patient Health Questionnaire (PHQ-4). The two-item Post Traumatic Stress Disorder (PTSD) Checklist (PCL), the Happiness Scale, and the QuickDASH pain scale. These results were then compared to those of a previously published study of in-person group EFT (<i>n</i> = 203) that used an identical training curriculum delivered face-to-face. Due to COVID restrictions, the physiological measures used in the face-to-face delivery could not be replicated in the virtual group. <b>Results:</b> Online group EFT demonstrated significant improvements in PTSD, anxiety, depression, pain, and happiness (all <i>p</i> < 0.001) pre to post EFT. These improvements were maintained at six-month follow-up for PTSD (<i>p</i> < 0.001), depression (<i>p</i> = 0.048), pain (<i>p</i> = 0.002), and happiness (<i>p</i> < 0.001). Although there was a reduction in anxiety in the online group at six-month follow-up, this did not reach significance (<i>p</i> = 0.102). When compared to the in-person group (pre-COVID), the percent change in symptoms, while still clinically and statistically significant, was for most conditions smaller in the virtual group (post COVID) at both post and follow-up time points. <b>Conclusions:</b> EFT is associated with significant improvements in psychological and physiological conditions including PTSD, anxiety, depression, pain, and happiness, whether delivered virtually in groups or in-person in groups. The psychological and physiological benefits identified in online treatment are similar to those found during in-person delivery, though not as large or clinically significant. This finding is consistent with the literature demonstrating that online treatment is an effective method of delivering psychological therapies. The results reinforce other studies showing COVID produced a significant increase in mental health symptoms. Published treatment guidelines already recommend in-person EFT as an efficient and potentially cost-effective first-line intervention in primary care; virtual group EFT can be similarly recommended.