Atlas›Domain XII · Complementary, energy & biofield›Guide 038
Guide XII-038

Thought Field Therapy (TFT)

Roger Callahan1980United States
A 17 · L 63 · M 2019 interventions in the Trinity explorer1 described for recognition only
Client cardCompare
[source: …] where a claim comes from[uncertain] not confirmed in a primary source[synthesis] the writer's reconstruction

1. Introduction

Version followed: Roger Callahan's Thought Field Therapy at the Algorithm level as taught on courses following the Callahan Techniques syllabus (designation "TFT Alg"). The guide follows the session structure described in Callahan and Trubo (2001), Tapping the Healer Within, as reported in a published trial protocol. The Diagnostic level ("TFT Dx", causal diagnosis by muscle testing) and Voice Technology (VT) are described only as published reports describe them. Callahan's own algorithm manuals are proprietary and are not reproduced or paraphrased point by point. [source: Irgens et al. 2017; NCH training listing] [uncertain: the Callahan manuals and books themselves not verified]

Thought Field Therapy (TFT) is a tapping method developed by the American psychologist Roger Callahan from about 1980. He drew on acupuncture meridian theory from Chinese medicine and on applied kinesiology (muscle testing). [source: GoodTherapy; Pasahow 2009] Its founding story, as published, is a client with a long-standing water phobia whose fear reportedly resolved when Callahan had her tap a stomach-meridian point. Callahan then built fixed tapping sequences ("algorithms") for other problems. [source: GoodTherapy] Gary Craig, a student of Callahan, later simplified TFT into Emotional Freedom Techniques (EFT). [source: GoodTherapy]

How change happens, as TFT holds it. Thinking about a problem is said to call up, or "attune", a "thought field". Callahan calls this the most fundamental concept in the TFT system. [source: Callahan & Callahan 2000, p. 143, as cited on Wikipedia — uncertain: secondary, unverified] Distress is attributed to "perturbations", described as encoded information in the thought field, each linked to a meridian point. Tapping the right points in the right order while attuned is held to remove the perturbations and so the distress. [source: Trubo & Callahan 2001, as cited on Wikipedia — uncertain: secondary, unverified; GoodTherapy] These are the method's own energy concepts, described here as TFT holds them.

Researchers who ran a TFT trial offer a different working account. On this account, tapping during imaginal exposure keeps the client anchored in the present, gives a sense of control and of the therapist's presence, and so strengthens exposure. [source: Irgens et al. 2017]

Evidence status (one line): a small body of trials, including a Norwegian randomised trial in agoraphobia where TFT and CBT did not differ significantly and both beat wait-list, and a Rwandan wait-list trial with genocide survivors; reviewers widely regard its energy theory as unsupported, and the American Psychological Association has been reported as saying TFT "lacks a scientific basis". [source: Irgens et al. 2017; Connolly & Sakai; GoodTherapy; Wikipedia — the APA statement uncertain: secondary, unverified]

TFT is a complementary method. It is not a treatment for any physical disease, and this guide presents it for emotional distress only. Callahan's published claims about physical conditions, such as atrial fibrillation, are his own and are not supported here. [source: Wikipedia — uncertain: secondary, unverified] [synthesis]

2. Framework

Levels of practice (the organisation's structure). [source: NCH training listing; Irgens et al. 2017; Pasahow 2009; Wikipedia — uncertain: secondary, unverified]

  • Algorithm level (TFT Alg). The practitioner chooses a pre-set tapping sequence for the type of problem (for example trauma, anxiety, phobia), as listed in the TFT manual. One UK course runs as a one-day online training that "follows the official syllabus approved by Callahan Techniques", and qualifies therapists and coaches to use the designation "TFT Alg". This is the level this guide follows.
  • Diagnostic level (TFT Dx). The practitioner uses muscle testing to find which points to tap for this client and this problem ("causal diagnosis"), and to test for "psychological reversal". In the Norwegian trial, the TFT therapist was certified at Algorithm level in 2003 and at Diagnostic level by Callahan Techniques Ltd in 2005.
  • Voice Technology (VT). This is Callahan's most advanced level. It is described as done by telephone using an undisclosed "technology", with training given by Callahan at a reported fee of $5,000. [uncertain: secondary, unverified] It cannot be learned from published sources, and this guide does not describe it as a usable procedure.
  • Who certifies. Callahan Techniques Ltd certifies the levels it teaches. [source: Irgens et al. 2017] There is no universally recognised independent credentialing body. [source: GoodTherapy] A charitable body, the Thought Field Therapy Foundation (USA), funds humanitarian TFT projects and research. [source: ISRCTN15345050] The ATFT Foundation (Miami, Florida) is a nonprofit whose stated purpose is to support the Association for Thought Field Therapy and further TFT research and education. [source: GuideStar, ATFT Foundation profile] [uncertain: whether the ATFT Foundation and the Thought Field Therapy Foundation are the same body]

Session phases (Algorithm level). [source: Irgens et al. 2017; Pasahow 2009; GoodTherapy; sequencing of steps 6–8 partly synthesis]

  1. History and target selection. Ask about the first anxiety episode, traumatic incidents, the worst episode and the most recent trigger. Choose one target.
  2. Attunement. The client brings the target vividly to mind, with images, sensations and the most frightening thought.
  3. Baseline rating. The client rates distress on a 0–10 Subjective Units of Distress (SUD) scale.
  4. Algorithm. The client taps the prescribed sequence of points on the hands, face and chest while staying attuned.
  5. Gamut procedure. A brief sequence of eye movements, humming and counting is done while one hand point is tapped, then the main sequence is repeated.
  6. Re-rating and repetition. Rate again after each round. If SUD falls, continue the same algorithm.
  7. If SUD stalls. Find a new focus ("What is the worst thing about that feeling?"). At Diagnostic level, check for and correct psychological reversal, or switch algorithm.
  8. Ending. End at SUD 0 (Pasahow) or 0–1 (GoodTherapy), or at a safe stopping point. Then move to the next aspect or close the session. [synthesis: safe stopping point]

Session count and format.

  • Norwegian agoraphobia trial. Five individual sessions of 50–55 minutes, described as the Norwegian standard based on Callahan and Trubo's guidelines. The authors note that complex problems may need more than one session, and that several sessions help clients learn the tapping. [source: Irgens et al. 2017]
  • Practitioner reports. Initial sessions run about 30–90 minutes and follow-ups about 15–30 minutes. [source: GoodTherapy]
  • Lay-counsellor humanitarian trial (Iraq). Three sessions per participant over six days, with start and end SUD logged each session. [source: ISRCTN15345050]
  • Training workshops. Health professionals have been taught basic methods in two-day workshops. [source: Pasahow 2009]

Criteria for moving on. [source: Irgens et al. 2017; Pasahow 2009]

  • SUD falling: repeat the same algorithm.
  • SUD at 0 with no remaining bodily distress: take the next aspect or the next memory.
  • No change: find a new focus or aspect, or (Dx) correct reversal and re-diagnose.
  • Complex problems: work aspect by aspect with several algorithms.
  • Within psychotherapy, return to formulation-led work once the target is resolved or once tapping is no longer adding anything. [synthesis]

Combining with psychotherapy. The Norwegian trial authors describe TFT as combining imaginal exposure with acupoint tapping, and report that Callahan developed it to enhance CBT. [source: Irgens et al. 2017] Callahan Techniques' own guidance on integrating TFT into a longer psychotherapy is [uncertain: not verified]. In practice:

  • Use TFT as a module inside an overall formulation and treatment plan, for example for discrete fears, trauma memories or cravings and urges. [synthesis]
  • Keep assessment, risk management and the therapeutic relationship as the frame. [synthesis]
  • Record TFT as a complementary technique in the notes. [synthesis]

Professional positions.

  • The American Psychological Association has been reported as saying TFT "lacks a scientific basis". [uncertain: secondary, unverified]
  • In a 2006 Delphi poll, psychologists rated TFT on average as "probably discredited". [source: Wikipedia; GoodTherapy — uncertain: secondary, unverified]
  • TFT was formerly listed on SAMHSA's NREPP registry, which has since been discontinued. [source: GoodTherapy — uncertain: secondary, unverified]
  • Check your own licensing board and professional indemnity insurer before offering TFT. Describe it to clients as complementary. [synthesis]

3. Guiding principles

  • Attunement first. In TFT, tapping is held to work only while the client is thinking about the problem. Practical meaning: keep the target vividly active, and check it is still active every round. [source: Irgens et al. 2017; Callahan & Callahan 2000 via Wikipedia — uncertain: secondary, unverified]
  • Measure every round. A SUD rating before and after each sequence drives every decision. Practical meaning: never decide by impression; ask for the number. [source: Irgens et al. 2017; Pasahow 2009]
  • One aspect at a time. Complex problems are treated aspect by aspect, sometimes with several algorithms. Practical meaning: split a trauma into moments, sensations and meanings, and treat each one. [source: Irgens et al. 2017]
  • Specific sequences for specific problems. TFT holds that the point sequence matters. That is the basis for distinct algorithms and for causal diagnosis. Practical meaning: at Algorithm level, use the sequence your training gave for that problem type rather than improvising. [source: Irgens et al. 2017; Trubo & Callahan 2001 via Wikipedia — uncertain: secondary, unverified]
  • The client taps; the therapist directs. Ideally the client taps their own points on the therapist's instruction. The therapist may tap at the start when the client is highly aroused. Practical meaning: demonstrate on yourself, and ask consent before any touch. [source: Irgens et al. 2017]
  • Firm, never painful. Tap each point about 5–10 times, firmly but without pain or bruising. Practical meaning: watch for over-hard tapping in anxious or self-punishing clients. [source: Irgens et al. 2017]
  • Treat towards zero. Sessions aim at SUD 0 with no remaining negative emotional or bodily state. Practical meaning: keep going while change continues. Within a trauma-informed frame, a safe stopping point outranks reaching zero. [source: Pasahow 2009] [synthesis: the trauma caveat]
  • Blocks are worked with, not blamed. TFT explains a lack of progress as "psychological reversal", a state it holds blocks treatment, and corrects it before continuing. Practical meaning: when progress stalls, look also at ambivalence, secondary gain, safety and readiness, and do not frame non-response as the client's fault. [source: Pasahow 2009; GoodTherapy] [synthesis: clinical reading]
  • Energy concepts are attributed. Thought fields, perturbations, meridians and the body's energy system are TFT's own explanatory concepts. Practical meaning: present them to clients as "how TFT explains it", alongside the exposure-based account, and let the client hold their own view. [synthesis]
  • Informed consent is specific. Practical meaning: before starting, tell the client that TFT is complementary; that it involves self-tapping, possibly therapist touch on the hands, face or upper chest, and possibly muscle testing; that they can stop at any time; and its evidence status in one line. [synthesis]
  • Fidelity needs deliberate support. There is no standardised TFT adherence or competence measure. Practical meaning: use supervision by an experienced TFT practitioner and, with consent, review recordings of sessions. [source: Irgens et al. 2017] [synthesis: the recording practice]
  • Within scope, no disease claims, no sales. Practical meaning: use TFT only for problems you are already competent to treat. Make no claims about physical illness. Do not sell TFT courses, products or VT sessions to your own clients. [synthesis]

4. Intervention inventory

The specific point sequences for each algorithm come from the TFT manual taught on Callahan Techniques courses. They are not reproduced here: learn them on an approved course. [source: Irgens et al. 2017; NCH training listing]

4.1 Informed consent and introduction to TFT

  • Purpose / when: Before the first tapping round, and again when you introduce muscle testing or any touch. [synthesis]
  • Steps:
    1. Explain that TFT is a complementary tapping method used alongside psychotherapy.
    2. Explain what it involves: thinking about the problem, rating distress, and tapping points on the hands, face and upper chest. [source: Irgens et al. 2017]
    3. Name any touch you may use: tapping the client's points yourself, or pressing on an outstretched arm for muscle testing (Dx level). [source: Irgens et al. 2017; Pasahow 2009]
    4. Give TFT's own explanation and the exposure-based one, plus the one-line evidence status.
    5. Confirm the right to stop or decline touch at any time, and offer a hands-off alternative: self-tapping only, with no muscle testing.
    6. Record the consent. [synthesis: steps 1, 4–6]
  • Example language (illustrative): "This is a tapping method called Thought Field Therapy. You'll think about the fear while tapping some points on your hands, face and collarbone area, and we'll track your distress with a 0–10 number. TFT explains it in terms of the body's energy system; researchers who've studied it think the tapping may help you stay grounded while you face the memory. The evidence is limited and mixed. You do the tapping yourself. I'll only touch you if you say yes, and you can say stop at any point."
  • Watch for:
    • Clients who expect a guaranteed instant cure. Published claims of very fast cures can raise expectations. [source: Wikipedia — uncertain: secondary, unverified; GoodTherapy]
    • Clients with a trauma history linked to touch: default to hands-off. [synthesis]
    • Any sign the client feels unable to refuse. [synthesis]

4.2 History-taking and target selection

  • Purpose / when: In the first session, to map what to treat and in what order. [source: Irgens et al. 2017]
  • Steps:
    1. Ask about the first episode (for example, the first panic attack), traumatic incidents, the worst episode and the most recent triggering situation. [source: Irgens et al. 2017]
    2. List the targets.
    3. Screen for exclusions such as psychosis or active suicidality, and for dissociation. [synthesis; the Iraq trial excluded serious mental illness — source: ISRCTN15345050]
    4. Pick a target the client can tolerate. Start with a recent, moderate one before the worst memory. [synthesis]
  • Example language (illustrative): "Let's map it out: when did this first happen, what was the worst time, and when was the most recent? We'll start with one you can bear to think about today."
  • Watch for:
    • Rising arousal during the history itself.
    • Unreported dissociation, such as gaps or spacing out.
    • Targets that are medical symptoms needing medical assessment first. [synthesis]

4.3 Attunement (thinking about the problem / imaginal exposure)

  • Purpose / when: At the start of every round. TFT holds that tapping acts on the "thought field" only while the problem is being thought about. [source: Callahan & Callahan 2000 via Wikipedia — uncertain: secondary, unverified; Pasahow 2009]
  • Steps:
    1. Ask the client to bring the target to mind and make it vivid: what they see and smell, who is there, and the most frightening thought. [source: Irgens et al. 2017]
    2. Focus mainly on the feelings and bodily sensations the image evokes. [source: Irgens et al. 2017]
    3. Keep the client attuned during the tapping, with brief reminders. [source: Pasahow 2009; GoodTherapy]
  • Example language (illustrative): "Bring the moment back now. Where are you, who's there, what do you notice in your body? What's the most frightening thought? Hold that while we tap."
  • Watch for:
    • Avoidance: the client "can't get it" or chats instead of focusing.
    • Over-engagement: flooding or dissociation.
    • A shift to a different memory mid-round. Note it as a new aspect. [synthesis]

4.4 SUD rating

  • Purpose / when: At baseline and after every sequence. It is the decision rule for repeating, changing focus or ending. [source: Irgens et al. 2017; Pasahow 2009]
  • Steps:
    1. Anchor the scale: 0 = no negative emotion, 10 = the worst imaginable. [source: Irgens et al. 2017]
    2. Ask for a number for the specific aspect being treated, including bodily distress (for example, chest pressure). [source: Irgens et al. 2017]
    3. Record the before and after numbers each round, as the Iraq trial counsellors logged them each session. [source: ISRCTN15345050]
  • Example language (illustrative): "Thinking about it right now, how strong is the distress, 0 to 10?" Then: "And now?"
  • Watch for:
    • Numbers given to please you.
    • Ratings that drop while the body still shows arousal.
    • A client who cannot give a number at all; use a body-based or simpler scale instead.
    • How to know it's working: a stepwise fall across rounds, for example 7, then 5, then 3 or lower, as in the trial's illustration. [source: Irgens et al. 2017] [synthesis: the cautions]

4.5 Teaching the tapping technique

  • Purpose / when: In the first round, so the client can do sequences independently in session and at home. [source: Irgens et al. 2017]
  • Steps:
    1. Demonstrate on yourself. Points include sites on the hands and fingers, face, and chest. [source: Irgens et al. 2017] A secondary source lists points such as the eyebrow, side of eye, under eye, under nose, chin, collarbone and under arm. [source: GoodTherapy — uncertain: this list resembles EFT's; TFT algorithms specify their own subsets and orders]
    2. Show the pressure: tap 5–10 times per point, firmly but without pain or bruising. [source: Irgens et al. 2017]
    3. The client taps; you call out each point.
    4. If the client is highly aroused and consents, you may tap the first points for them, then hand over. [source: Irgens et al. 2017]
  • Example language (illustrative): "Use two fingers, firm but comfortable, about five to ten taps here, then I'll show you the next spot. If anything hurts, ease off."
  • Watch for:
    • Over-hard or self-punishing tapping.
    • Tapping sites the client finds triggering, such as under the arm or near the face for some trauma survivors. Skip, adapt, or have the client imagine the point instead. [synthesis]

4.6 Algorithm (pre-set sequence) treatment

  • Purpose / when: This is the core Algorithm-level intervention. Use it when the problem matches one of the manual's problem types; TFT has one or more algorithms for different negative emotions. [source: Irgens et al. 2017]
  • Steps:
    1. Select the algorithm for the problem type from your TFT training manual. [source: Irgens et al. 2017]
    2. Attune and take a baseline SUD.
    3. The client taps the prescribed sequence.
    4. Do the gamut procedure (4.7).
    5. Repeat the main sequence and re-rate. [source: Pasahow 2009; GoodTherapy]
    6. If the SUD falls, continue with the same algorithm. [source: Irgens et al. 2017]
  • Example language (illustrative): "Keep the scene in mind. Tap here… now here… now here. Take a breath. What's the number now?"
  • Watch for:
    • The SUD falling while the client avoids the image.
    • A change of quality, such as fear turning into anger or guilt. TFT treats that as a new problem type, possibly needing another algorithm. [source: Irgens et al. 2017]
    • How to know it's working: the SUD falls across rounds and the client reports the memory feels more distant or neutral. [synthesis: the second criterion]

4.7 The gamut procedure (often called the "9 gamut")

  • Purpose / when: It is inserted between repetitions of the main sequence, as part of standard algorithms. [source: GoodTherapy; Irgens et al. 2017]
  • Steps: The client continuously taps a point on the hand, the "gamut point" on the back of the hand. While tapping, they move their eyes in set ways, hum briefly, count, and hum again, keeping the problem in mind. Then the main sequence is repeated. [source: GoodTherapy; Irgens et al. 2017 mention eye movements, counting and humming while a hand point is tapped] The exact order of steps follows the manual. [uncertain: the precise steps and the point location differ between secondary sources, and the Callahan manual is not verified]
  • Example language (illustrative): "Keep tapping this spot on the back of your hand and keep the memory in mind. Now follow my instructions with your eyes, then hum a few notes, count to five, hum again."
  • Watch for:
    • Embarrassment or giggling, which can break attunement. Normalise it.
    • Eye-movement discomfort, including in clients with eye or neck conditions. Offer to skip or modify those steps.
    • Dizziness. [synthesis]

4.8 Finding a new focus when the SUD stalls

  • Purpose / when: When a round brings no SUD reduction. [source: Irgens et al. 2017]
  • Steps:
    1. Ask what is worst about the feeling now. [source: Irgens et al. 2017]
    2. Take the answer as the new target: an image, sensation, thought or meaning.
    3. Re-attune, re-rate, and repeat the algorithm, or the algorithm that fits the new emotion.
  • Example language: "What is the worst thing about that feeling?" (wording reported in Irgens et al. 2017). Follow-up (illustrative): "Stay with that part. What number is it?"
  • Watch for:
    • A new aspect that is a different, heavier memory. Check tolerance before moving on. [synthesis]
    • Cycling between aspects without any falling. Consider reversal correction (4.10), a pause, or a return to talking therapy. [synthesis]

4.9 Aspect-by-aspect work on trauma and complex problems

  • Purpose / when: For trauma memories and problems with several emotions, such as fear, guilt and anger. [source: Irgens et al. 2017]
  • Steps:
    1. Split the memory or problem into aspects: moments, sensations, thoughts, emotions.
    2. Treat each aspect with the algorithm for that emotion until its SUD reaches 0 or a safe low, then move on. [source: Irgens et al. 2017; Pasahow 2009]
    3. Re-check the whole memory at the end. [synthesis]
    4. Plan more than one session for complex problems. [source: Irgens et al. 2017]
  • Example language (illustrative): "The fear at the door is down to a 1. What part of the memory still carries charge? The shame afterwards? Let's take that one now."
  • Watch for:
    • Guilt or shame emerging after the fear settles.
    • Grief appearing; it may need space rather than more tapping. [synthesis]
    • How to know it's working: the whole memory can be recalled with a low SUD and the client can stay present. [synthesis]

4.10 Psychological reversal: identification and correction

  • Purpose / when: TFT's response when treatment does not progress. TFT describes psychological reversal as a self-sabotaging state that blocks treatment. [source: GoodTherapy; Pasahow 2009]
  • Steps (as published, Diagnostic level):
    1. Muscle testing shows greater strength when the client makes a self-defeating statement, such as "I want to keep this problem", than when making the opposite statement. [source: Pasahow 2009]
    2. The reversal is corrected by stimulating specific acupressure points. [source: Pasahow 2009]
    3. The correction is confirmed by repeat muscle testing. [source: Pasahow 2009]
    4. Treatment then resumes. At Algorithm level, practitioners are taught a correction step without muscle testing. [uncertain: not verified; the exact point and any accompanying statement follow the Callahan syllabus]
  • Example language (illustrative): "Sometimes the system seems stuck, which TFT calls a 'reversal'. There's a short correction step we can do before carrying on. It's also worth asking: is there any part of you that isn't sure about letting this go?"
  • Watch for:
    • Critics note that this concept can explain away treatment failure. [source: GoodTherapy] Do not use it to blame the client.
    • Explore real ambivalence: the problem may protect against something, or bring care or identity. [synthesis]
    • Recurrent "reversal" suggests reviewing the formulation, safety and readiness. [synthesis]

4.11 Muscle testing (applied kinesiology) — Diagnostic level

  • Purpose / when: TFT uses muscle strength as a marker of "energy" when testing for reversal and diagnosing sequences. [source: Pasahow 2009]
  • Steps (as described): The practitioner tests the strength of a muscle while the client makes a statement or touches a test point. Greater strength is read as a higher energy state. [source: Pasahow 2009] Technique details are taught on Diagnostic-level training. [uncertain: not verified]
  • Touch and consent:
    • Muscle testing involves the therapist's hand on the client's arm.
    • Ask explicit consent before, and check during: "Is it OK that I press on your wrist?"
    • The client may stop at any time. The touch is never sexual.
    • Offer self-tapping algorithms (no muscle testing) as the hands-off alternative.
    • Document consent. [synthesis]
  • Example language (illustrative): "For this step I'd gently press down on your outstretched arm while you resist. Is that all right? You can stop me at any point, and we can skip this and just use the standard sequences instead."
  • Watch for:
    • Discomfort with touch, shoulder problems or pain.
    • Your own expectations unconsciously influencing the test. [synthesis]

4.12 Causal diagnosis — Diagnostic level

  • Purpose / when: To find an individualised sequence when algorithms do not fit or do not work. [source: Pasahow 2009]
  • Steps (as described):
    1. Clear any reversals first. [source: Pasahow 2009]
    2. The client, attuned, touches different acupressure test points with two fingers while being muscle tested. [source: Pasahow 2009]
    3. The point giving the greatest strength indicates the meridian to treat next, and the sequence is built from these results. [source: Pasahow 2009]
    4. After the sequence, a brief additional intervention is done (Pasahow describes it in terms of the occipital lobe, both hemispheres and tapping a specific meridian), then the sequence is repeated until SUD 0. [source: Pasahow 2009] [uncertain: whether this is the gamut procedure is not stated]
  • Example language (illustrative): "Keep the problem in mind and touch this spot with two fingers while I check your arm… now this one."
  • Watch for: the same touch and consent issues as in 4.11. This procedure requires Diagnostic-level training; do not improvise it from this description. [synthesis]

4.13 Voice Technology (VT) — described only

  • Purpose / when: It is described as Callahan's most advanced level, carried out over the telephone using an undisclosed technology. [source: Wikipedia — uncertain: secondary, unverified]
  • Steps: Not published. Training is reported to come only from Callahan, at a fee reported as $5,000. [uncertain: secondary, unverified] A single-blind controlled study comparing VT-derived tapping sequences with random point sequences found no significant difference in change in distress. [source: Pignotti 2005, as reported in The Skeptic (Panayi 2020)]
  • Example language (illustrative), if a client asks: "That's a proprietary telephone method I don't practise. If you're considering paying for it, let's talk through what you'd hope it would do and what the evidence says."
  • Watch for: clients paying high fees for remote sessions instead of continuing treatment, and any conflict of interest if a colleague sells VT sessions. [synthesis]

4.14 Ending a target and closing the session

  • Purpose / when: When the SUD reaches 0 (Pasahow) or 0–1 (GoodTherapy), or when time or safety requires stopping. [source: Pasahow 2009; GoodTherapy]
  • Steps:
    1. Confirm there is no remaining negative emotional or bodily state. [source: Pasahow 2009]
    2. Test by imagining the trigger or the worst moment again. [synthesis]
    3. If you must stop before resolution, use grounding and containment, and do not leave the client in a highly activated state. [synthesis]
    4. Ask the client to notice changes before the next session. [synthesis]
  • Example language (illustrative): "Try to bring the memory back as strongly as you can. What's there now? … If anything stirs up this week, jot it down, and we'll take it next time."
  • Watch for:
    • Overnight resurfacing of the memory.
    • Clients who attribute the change to something other than the work; TFT calls this the "apex problem". [uncertain: not verified] Gently review the before-and-after ratings with them. [synthesis]

4.15 Between-session self-tapping

  • Purpose / when: To extend gains and build self-regulation once the client can tap reliably. Multiple sessions help clients learn the tapping. [source: Irgens et al. 2017]
  • Steps:
    1. Agree a specific, moderate trigger to practise on.
    2. Give a written cue card in your own words listing the algorithm the client has learned in session.
    3. Ask the client to rate SUD before and after, and to stop and use grounding if distress escalates. [synthesis]
  • Example language (illustrative): "Use the sequence we practised on the lift anxiety before your trip, not on the old trauma. Note your before and after numbers. If it goes up rather than down, stop and do the grounding."
  • Watch for:
    • Using tapping to avoid situations rather than face them.
    • Using it on high-intensity memories alone.
    • Compulsive use. [synthesis]

4.16 Trauma-safety steps

  • Purpose / when: Whenever TFT targets trauma memories.
  • From the sources:
    • Recalling distressing experiences is the known risk. [source: ISRCTN15345050]
    • Adverse experiences are logged on a form. [source: ISRCTN15345050]
    • Serious mental illness was excluded in lay-counsellor delivery. [source: ISRCTN15345050]
    • The therapist may tap for a highly aroused client (with consent). [source: Irgens et al. 2017]
    • Focusing on trauma can temporarily increase distress. [source: GoodTherapy]
  • Steps:
    1. Preparation. Stabilisation and grounding skills first, a stop signal, and psychoeducation.
    2. Screening. Screen for dissociation, current danger, substance use and suicidality.
    3. Titration. Start with the least distressing aspect, use a brief attunement rather than full immersion, keep eyes open, and keep one foot in the room. Take frequent SUD checks and stop if the SUD rises sharply.
    4. Dissociation. Watch for glazed eyes, flat speech or loss of time. Stop tapping, orient to the present and re-ground before resuming at a lower intensity.
    5. Closure. End with containment, and check in by phone or at the next session. [synthesis: steps 1–5]
  • Example language (illustrative): "Just touch the edge of the memory, enough to rate it, not to relive it. If you raise your hand, we stop and come back to the room."
  • Watch for:
    • Abreaction or flashbacks.
    • A falling SUD that reflects numbing rather than resolution.
    • Disclosures needing safeguarding action. [synthesis]

4.17 Lay-counsellor and humanitarian delivery (supervising clinicians)

  • Purpose / when: Where TFT is delivered by trained community members after mass trauma, as in TFT Foundation-funded projects. [source: ISRCTN15345050; Connolly & Sakai]
  • What sources describe:
    • Rwanda. A randomised wait-list trial treated 145 adult survivors of the 1994 genocide with TFT, measured trauma symptoms with the Trauma Symptom Inventory and a PTSD symptom scale, and reported gains maintained at two-year follow-up. [source: Connolly & Sakai 2011, abstract] Who delivered the treatment, the number of sessions and the algorithms used are [uncertain: not given in the abstract].
    • Iraq. Non-professional women were trained; materials were translated into English, Arabic and Kurdish; the lead investigator's team supervised; counsellors logged SUD and minutes per session; and an adverse-experience form was used. [source: ISRCTN15345050]
  • Steps for the supervising clinician:
    1. Set a clear referral pathway for severe cases.
    2. Hold regular supervision.
    3. Adapt the method culturally, including touch norms and translation.
    4. Log adverse events.
    5. Make sure consent is voluntary and not tied to aid. [synthesis: steps 1–5]
  • Example language (illustrative): "If someone becomes very distressed, can't come back to the present, or speaks of wanting to die, stop the tapping and call me straight away."
  • Watch for:
    • Lay counsellors' vicarious trauma.
    • Participants feeling obliged to report improvement. [synthesis]

4.18 Integrating TFT into an ongoing psychotherapy

  • Purpose / when: To use TFT for a defined target inside a broader treatment. The trial authors describe TFT as imaginal exposure combined with acupoint tapping, developed to enhance CBT. [source: Irgens et al. 2017]
  • Steps:
    1. Formulate first.
    2. Agree the target and the success criterion.
    3. Use TFT for the target.
    4. Process the meaning and any changes in talking therapy.
    5. Combine with in-vivo exposure and behavioural work where relevant, for example in agoraphobia. [synthesis]
  • Example language (illustrative): "Now the panic feeling is lower, let's plan to actually try the bus trip this week and see what happens."
  • Watch for:
    • TFT replacing necessary work on relationships, safety or behaviour.
    • Brief symptom relief that masks an ongoing risk. [synthesis]

4.19 Other named TFT procedures

TFT trainings are reported to include further named procedures and concepts, such as "collarbone breathing" and "individual energy toxins". [uncertain: not verified] They are not described here. Learn them only from approved training materials.

5. Handling problems

The only problem-handling guidance in the sources is the new-focus question, aspect work, the reversal correction, the therapist tapping for an aroused client, and the adverse-event logging. All other responses below are synthesis. [source: Irgens et al. 2017; Pasahow 2009; ISRCTN15345050]

  • No SUD change after several rounds (stuck).
    • Check that the client is still attuned: are they actually holding the image? [source: Irgens et al. 2017]
    • Ask what is worst about the feeling now, and treat that. [source: Irgens et al. 2017]
    • At Dx level, test and correct psychological reversal. [source: Pasahow 2009]
    • If it is still stuck, step out of tapping and explore ambivalence, fear of change, or what the symptom protects. [synthesis]
  • SUD rises.
    • Stop tapping, ground and orient, and lower the intensity: a smaller aspect, a briefer attunement.
    • Consider whether a more distressing memory has surfaced, and whether stabilisation work is needed first. [synthesis]
  • Overwhelm, flashback or dissociation.
    • Halt the procedure. Use orienting: name objects in the room, feel your feet, and keep the eyes open.
    • Do not push on to "zero".
    • Resume another day at lower intensity, or switch to stabilisation.
    • Log it as an adverse event, as trial protocols do. [source: ISRCTN15345050] [synthesis]
  • Scepticism or embarrassment ("this is silly").
    • Acknowledge it.
    • Offer TFT's explanation and the exposure-based one, and make it an experiment judged by the client's own ratings.
    • Respect a decision not to use it; TFT is optional within the therapy. [synthesis]
  • Client strongly attached to the energy explanation, or to rapid-cure claims.
    • Explore the client's beliefs respectfully, without dismissing them.
    • Keep expectations realistic: some problems need several sessions, as the sources note. [source: Irgens et al. 2017]
    • Do not promise instant cures. Correct any belief that TFT treats physical disease, and route physical symptoms to the doctor. [synthesis]
  • Over-reliance or compulsive tapping.
    • Review the function of the tapping: is it relief, avoidance, or a ritual?
    • Pair it with exposure and behavioural experiments.
    • Limit home use to agreed targets. [synthesis]
  • Non-adherence to home practice.
    • Find out what got in the way: shame, forgetting, or fear of stirring things up.
    • Simplify to one short sequence on a mild trigger.
    • Practise it in session until the client is fluent. [source: Irgens et al. 2017, on learning across sessions] [synthesis]
  • The client discounts the change ("it would have gone anyway").
    • Review the recorded before-and-after SUD ratings together, without arguing.
    • Make the client's own attribution the focus of curiosity.
    • TFT's own term for this pattern ("apex problem") is [uncertain: not verified]. [synthesis]
  • Touch-related discomfort or a rupture after therapist tapping or muscle testing.
    • Stop at once and acknowledge it.
    • Repair openly: "I'm glad you told me."
    • Return to hands-off self-tapping, and document it.
    • Touch is only ever with explicit consent before and during, the right to stop, and never sexual.
    • Follow your professional body's chaperone and documentation guidance. [synthesis]
  • Rupture over disappointment ("it didn't work like they said").
    • Validate the disappointment.
    • Separate the client's worth from the method's results.
    • Revisit the formulation, and offer evidence-based alternatives for the problem, such as trauma-focused CBT or EMDR for PTSD, or CBT with exposure for anxiety disorders. [synthesis]
  • Risk disclosures during tapping (suicidality, abuse, current danger).
    • Stop the procedure.
    • Follow standard risk assessment, safety planning and safeguarding procedures.
    • TFT is not a substitute for risk management. [synthesis]
  • Commercial pressure.
    • Clients or colleagues may promote expensive advanced levels, remote VT sessions or self-help products.
    • Do not sell TFT trainings or products to your clients, and declare any interest.
    • Help clients weigh cost against evidence before they buy. [source: Wikipedia, on the VT fee — uncertain: secondary, unverified] [synthesis]
  • Fidelity drift.
    • With no standardised adherence measure [source: Irgens et al. 2017], use peer review of recorded sessions (with consent) and supervision by a certified TFT practitioner. [synthesis]
  • Children and young people.
    • Obtain parental consent and the child's own assent.
    • Use self-tapping only, or a parent-led alternative to therapist touch.
    • Keep sessions short, and follow child safeguarding procedures. [synthesis]

Sources

Sources consulted:

Books and papers cited as reported in the sources above [uncertain: secondary citations]:

  • Callahan, R. J., & Trubo, R. (2001). Tapping the Healer Within: Using Thought Field Therapy to Instantly Conquer Your Fears, Anxieties, and Emotional Distress. Chicago: Contemporary Books. [as cited in Irgens et al. 2017]
  • Callahan, R. J., & Callahan, J. (2000). Cited for the "thought field" concept (p. 143). [as cited on Wikipedia; uncertain: full title not verified]
  • Pignotti, M. (2005). Thought Field Therapy Voice Technology vs. Random Meridian Point Sequences: A Single-blind Controlled Experiment. [title as cited in The Skeptic (Panayi 2020); journal details uncertain]
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