The Effect of Psychotherapy on Stress Biochemistry: An RCT of Psychotherapy and Emotional Freedom Techniques (EFT)
Condition: Stress; Depression; Anxiety
MeSH terms: Depression
Study type: Interventional

Summary: 
      The purpose of this study is to determine whether there is a change in levels of cortisol, a
      key stress hormone, during the course of a psychotherapy session. The two forms of
      psychotherapy compared are Cognitive Behavioral Therapy (CBT) and Emotional Freedom
      Techniques (EFT). A no treatment control group provides a baseline measure. The change in
      cortisol level is compared between the start and end of a one hour session.
    

Detailed description: 
      Cortisol is a crucial physiological marker for stress. Stress produces elevated cortisol
      levels for as long as the body can supply the precursors. Elevated cortisol levels are
      associated with physical conditions such as impaired immune system function, cardiovascular
      disease, stroke, and accelerated aging. Elevated cortisol levels are also implicated in many
      psychological conditions. If the adrenal glands, which produce cortisol, are stimulated by
      the physical or psychological environment to produce stress hormones, they shunt production
      away from making DHEA, which is vital for cell regeneration.

      The current pilot study examines the change in cortisol levels that result from a one hour
      psychotherapy session. It measures salivary cortisol, which indicates the levels of cortisol
      readily available to the body. This measure is relatively stable, and is not susceptible to
      large swings in the relatively brief period of a one hour psychotherapy session. Excluded are
      subjects with major depressive disorder, posttraumatic stress syndrome, and chronic diseases
      which have been shown to affect cortisol levels. Cortisol assessments will also take place in
      the afternoon or evening, to control for low waking cortisol which may be present in some
      normal subjects.

      It is hypothesized that if psychotherapy is successful at treating trauma, cortisol levels
      will decline between the beginning of the hour and the end of the hour. The structure of the
      session is that the client discusses their emotional trauma in the first half of the session,
      and is treated with either cognitive behavioral therapy (CBT) or emotional freedom techniques
      (EFT) in the second half of the session. A no treatment control group provides baseline data.
      Half an hour is sufficient time for cortisol reuptake, and if therapy is successful at
      reducing physiological markers of stress, the client might demonstrate lower levels of
      cortisol at the conclusion of the psychotherapy session. Subjects who spontaneously have
      recall of a new significant trauma during the treatment portion of the session will also be
      excluded, since such recall can result in a cortisol spike. The study also evaluates a range
      of psychological conditions before and after the session using the SA-45. This brief
      questionnaire has subscales for anxiety, depression, phobias, hostility and other
      characteristics; these can be compared to cortisol levels to determine any correlations
      between psychological and physiological change.
    

Intervention name(s): Psychotherapy: Emotional Freedom Techniques (EFT); Cognitive Behavioral Therapy (CBT)
Intervention type(s): Behavioral; Behavioral
Intervention description(s): A form of therapy that includes cognitive reframing with somatic reinforcement through touch or tapping of specified points on the body; A form of therapy that focuses on negative cognitions of problems, and reframing them in positive terms, but without somatic reinforcement.
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Triple (Participant, Care Provider, Outcomes Assessor)
Primary purpose: Treatment
Keywords: cortisol; hydrocortisone; psychotherapy; Emotional Freedom Techniques (EFT); Cognitive Behavioral Therapy (CBT); depression; anxiety