Application of Music Therapy and Psychological Cognitive Restructuring by Emotional Freedom Techniques (EFT)

Bando H, Yoshioka A, Bando M, Fukuda Y and Kitanishi T

Published on: 2025-11-10

Abstract

Authors and collaborators have been involved in music therapy, psychotherapy, art therapy, Ayurvedic medicine, bioresonance and others. Recent medical development has introduced the combination treatment of music therapy and Emotional Freedom Techniques (EFT). It can use psychological cognitive restructuring, self-acceptance and emotional verbal expression. A specific relationship has been observed between EFT and music therapy, in which common factors exist such as physical rhythm, safe contact with emotional recall, and the introduction of self-regulation. The combined treatment of these would be proposed, with some aims of reducing emotional stress, such as anxiety, depression, tension, restoring self-regulation, and promoting emotional expression.

Keywords

Music therapy; Psychotherapy; Emotional freedom techniques (EFT); Emotional expression; Cognitive behavioral therapy (CBT)

Commentary

Traditional, complementary, and integrative medicine (TCIM) has been developed in the world with its necessity, popularity and satisfaction [1]. Several kinds of treatments in TCIM have been applied and investigated in our practice group [2]. Authors and co-researchers have continued related research in the fields of TCIM, including music therapy, Ayurveda, psychological exam, bioresonance, and so on [3,4]. These activities have been presented in Integrative Medicine Japan (IMJ), shikoku division of IMJ, Japanese music therapy association (JMTA), and other medical and clinical societies [5,6].

We have been also involved in nerve stimulation of auriculotherapy approach based on the medical principle of transcutaneous auricular vagus nerve stimulation (taVNS) [7]. It has some relationship with Chinese acupuncture and the hundreds of acupressure points on the human body.?As related therapeutic procedure, Emotional Freedom Techniques (EFT) has attracted some attention in TCIM. It possibly gives clinical benefits for some psychological disorder such as depression [8]. Some reference reports and data will be described in this article.

Regarding our previous medical reports of in the Shikoku district of IMJ, some activities have been reported, including psychological evaluation of Tokyo University Egogram (TEG) [9], humanity philosophy for IM [10], music therapy session for intellectual disabilities [11], art therapy [12], and mental health care [13]. Among our clinical practice in IM and CAM, our medical and music therapy team had important experiences for the combined treatment of music session and Ayurvedic head massage using bioresonance measurement [14]. The method was to incorporate Ayurvedic head massage into our music therapy sessions. During the massage, we used oil to accompany the subject's preferred music rhythm. This can be described as music plus physical therapy. On the other hand, EFT involves lightly touching the skin while the patient (client) speaks words that affect their psychology. Comparing the two, the common point is the use of auditory and cutaneous stimulation. The differences are shown in Table 1.

Table 1: Comparison of Music Therapy/Ayurveda and Standard EFT Methods.

	Author's activity method Music therapy & Ayurveda	Standard protocol Usual EFT method
Stimulation for the skin	Oil massage by the hand palm based on Ayurveda method	Tapping the acupressure points lightly on the surface of the skin
Stimulation by listening	Listening the favorite music of the patient or client	Listening own voice of the patient for the future goal
Psychological stimulus	Usually not so stimulating but lightly relaxative effective	Expression of own strong feeling from bottom of the heart

A Systematic Review was performed for clinical effect and safety of EFT to anxiety disorders [8]. The method included 506 cases from 7 RCTs. Various protocol were found, and their control groups included non-treatment, cognitive behavioral therapy (CBT), breathing therapy, supportive interviews, and progressive muscle relaxation. In the compared reports of comparing to no intervention method, significantly reducing anxiety symptoms were found. When comparing to active controls, EFT treatment revealed superior or similar efficacy to muscle relaxation or breathing therapy, without significant difference to CBT research. From mentioned above, EFT is likely to be safe and useful intervention for reduction of anxiety and additional related psychological benefits. However, some discussions are present for heterogeneity of study protocol and methodological limitations. Future high-quality RCTs will be expected for confirm and explore the clinical efficacy of EFT.

As an energy psychology, EFT has attracted attention as treatment for posttraumatic stress disorder (PTSD). Meta-analysis for effect of EFT in reducing PTSD symptoms [15]. Totally 13 reports with 621 cases were involved. EFT improved PTSD significantly in comparison with the baseline (SMD -0.901), that showed more efficacy than control (SMD - 2.106). In addition, the scores of anxiety and depression showed significant reduction, and their effects persisted up to 3 months, anxiety and depression. EFT showed clinical effect for veteran’s subgroup in improvements of PTSD symptoms, anxiety and depression. Furthermore, its medical efficacy may be sustained for up to 3 months.

Concerning the treatment of EFT, related evidences have remained inconsistent. The meta-analysis was conducted for assessment of the overall effect of EFT [16]. Methods included 18 RCTs, and the analysis revealed the significant overall effect size for 1.268 for EFT, for reduction of depression. In the future, further investigation will clarify medical long-period efficacy and wider applications. In order to study clinical effect of combined treatment of acupuncture and music therapy, meta-analysis was performed for 11 papers with 698 patients [17]. They had post-stroke depression (PSD) from various etiologies. The research included the comparison of combined group and control group. As a result, combined treatment showed significant efficacy of reduction scores of Self-Rating Depression Scale (SDS) and Pittsburgh sleep quality index (PSQI). Then, it suggested clinical improvement of depression in PSD cases.

A specific relationship has been observed between EFT and music therapy. Both share common factors: physical rhythm (touch and rhythm), safe contact with emotional recall, and the introduction of self-regulation [18]. Specifically, i) musical rhythm and respiratory synchronization promote autonomic nervous system (ANS) stability, which has a synergistic effect with the short-term physiological changes (e.g., improved heart rate variability) produced by EFT tapping. ii) Music acts as a "prelude" to inducing safe emotional recall. Furthermore, combining it with EFT's localized tapping reduces excessive arousal and facilitates memory entry. iii) Music therapy uses improvised or sung phrases and words. These can be combined with EFT's setup sentences and reminder phrases, facilitating the patient's internal verbalization. Intervention studies combining EFT and music therapy have been reported [19]. As a result, both music therapy and EFT reduced the average score of nursing students before the OSCE (Objective Structured Clinical Exam) using the Situational Anxiety Scale (SAS). In this way, it is possible to design mutually complementary programs.

By the combination of both EFT and music therapy, a proposal manual for 30-min session is shown in Table 2. The purpose includes reducing emotional stress, such as anxiety, depression, tension, restoring self-regulation, and promoting emotional expression [20]. It also aims to integrate the somatosensory regulation of EFT through tapping with the emotional arousal and rhythmic stability of music therapy. This proposal recommends introductory music with a tempo of 60-70 bpm, a melody of adequate fluctuations, and a soft tone of piano, harp, or strings.

Table 2: The Proposal Session of the Combination of EFT and Music Therapy for 30 Minutes.

	Phase	time	Content	the purpose
1	Introduction & Environment Adjustment	5 min	Adjust lighting, seating position, and sound environment. Start breathing guidance and music (gentle tempo, 60-70 bpm).	Stabilizes the autonomic nervous system and creates a sense of security for the session
2	Emotional Awareness Phase	5 min	While listening to music, touch the patient's body with both palms to check the temperature, stiffness, and reaction to touch, and select the tempo of the music. Scale rating (0-10).	Identifying and promoting awareness of the emotions targeted by EFT
3	EFT Setup	5 min	While tapping on the hand sword point, chant a phrase 3 times such as "I feel this anxiety, but I still accept myself."	Introduction of self-acceptance and cognitive restructuring
4	EFT Tapping + Music Rhythm Synchronization	10 min	Tapping on key acupuncture points in time with the beat of the music, regulating your breathing and observing your physical minute sensations.	Integration of physical rhythm and emotional expression, restoration of autonomic nervous balance
5	Integration and Relaxation	3 min	Change to music of 4) above with a different tempo or instrument to encourage slower breathing and heart rate. Maintain silence for about 2 minutes.	Physiological stability and emotional integration
6	Feedback Scale Reassessment	2 min	Rate the change on the same scale (0-10) as when you started. Share your thoughts in a few words.	Learning to check effectiveness and self-monitor

Thus, the integrated session of EFT and music therapy is unique. Its structure encompasses three elements: i) physical rhythm, ii) safe emotional expression, and iii) cognitive restructuring in a short period of time. In medical settings, it is a safe method that serves as a bridge between medication and psychotherapy while increasing patients' sense of self-efficacy. In clinical settings, it has the advantage of easily producing a sense of relief, relaxation, and subjective reduction in anxiety in a short period. By continuing this, it plays a role in training emotion regulation.

In summary, recent trends in integrative medicine have focused on combining various treatments, such as music therapy and aromatherapy. This paper introduced the new ideas of combination of EFT and music therapy and offered several considerations. It would be our great pleasure if these descriptions contribute to the future development of integrative medicine and music therapy.

Conflict of interest: The authors declare no conflict of interest.

Funding: There was no funding received for this paper.

Global Journal of Arts and Social Sciences

Application of Music Therapy and Psychological Cognitive Restructuring by Emotional Freedom Techniques (EFT)

Abstract

Keywords

Commentary

References