Effect of the emotional freedom technique on perceived stress, quality of life, and cortisol salivary levels in tension-type headache sufferers: a randomized controlled trial

Explore (NY). 2013 Mar-Apr;9(2):91-9. doi: 10.1016/j.explore.2012.12.005.


Objective: To evaluate the short-term effects of the emotional freedom technique (EFT) on tension-type headache (TTH) sufferers.

Design: We used a parallel-group design, with participants randomly assigned to the emotional freedom intervention (n = 19) or a control arm (standard care n = 16).

Setting: The study was conducted at the outpatient Headache Clinic at the Korgialenio Benakio Hospital of Athens.

Participants: Thirty-five patients meeting criteria for frequent TTH according to International Headache Society guidelines were enrolled.

Intervention: Participants were instructed to use the EFT method twice a day for two months.

Outcome measures: Study measures included the Perceived Stress Scale, the Multidimensional Health Locus of Control Scale, and the Short-Form questionnaire-36. Salivary cortisol levels and the frequency and intensity of headache episodes were also assessed.

Results: Within the treatment arm, perceived stress, scores for all Short-Form questionnaire-36 subscales, and the frequency and intensity of the headache episodes were all significantly reduced. No differences in cortisol levels were found in any group before and after the intervention.

Conclusions: EFT was reported to benefit patients with TTH. This randomized controlled trial shows promising results for not only the frequency and severity of headaches but also other lifestyle parameters.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Activities of Daily Living*
  • Adult
  • Complementary Therapies*
  • Emotions*
  • Female
  • Humans
  • Hydrocortisone / metabolism*
  • Male
  • Middle Aged
  • Quality of Life*
  • Saliva / metabolism
  • Severity of Illness Index
  • Stress, Psychological*
  • Surveys and Questionnaires
  • Tension-Type Headache / metabolism
  • Tension-Type Headache / psychology
  • Tension-Type Headache / therapy*
  • Time Factors


  • Hydrocortisone