The Effect of Emotional Freedom Technique on Parents' Anxiety Level: Newborn Hearing Screening

Emotional Freedom Technique for Parental Anxiety Regarding Newborn Hearing Screening

Newborn hearing screening (NHS) is a standard procedure that often triggers acute anxiety in parents. While Emotional Freedom Technique (EFT) has demonstrated efficacy in reducing psychological distress across various clinical settings, its specific application to maternal anxiety during the neonatal screening period remains under-researched. This study addresses this gap by investigating the impact of a targeted EFT intervention on anxiety levels in mothers awaiting their newborns' first hearing tests.

The primary objective is to determine if a brief, 15-minute EFT session reduces maternal anxiety more effectively than a standard waiting period. Participants were randomly assigned to either an intervention group, where they perform a structured acupoint tapping sequence, or a control group that received no active intervention. Anxiety was assessed using validated scales immediately before and after the 15-minute period to capture acute changes in distress. Due to clinical environment conditions and hospital accompaniment patterns, the study was completed with a final sample of 70 mothers.

Study Overview

• Status: Completed
• Conditions: Anxiety; Parental Anxiety; Maternal Anxiety
• Intervention / Treatment: Behavioral: Emotional Freedom Technique; Other: No intervention

Detailed Description

Study Design and Randomization: This prospective, controlled experimental study utilized a pretest-posttest design to evaluate the effects of the Emotional Freedom Technique (EFT) on maternal anxiety. A total of 72 eligible mothers were recruited from the Newborn Hearing Screening (NHS) Units of two public hospitals. Participants were assigned to either the EFT intervention group (n=36) or a non-intervention control group (n=34) using stratified block randomization based on hospital site and baseline state anxiety levels.

Procedural Standardization and Participant Management: To maintain internal validity and ensure the stability of pre-procedural anxiety measurements, specific situational controls were implemented. Participants were excluded if acute situational triggers-such as neonatal crying or breastfeeding-occurred immediately before or during the intervention period. In accordance with this criterion, two participants were excluded from the study due to persistent neonatal crying during the session. To minimize external distractions and allow the participant to focus entirely on the protocol, relatives provided care for the neonates during the 30-35 minute study duration.

Intervention Protocols:

• EFT Group: Participants received a 15-minute guided session led by a certified practitioner. The session began with the "Karate Chop" point setup, where the participant repeated a specific acceptance sentence three times. This was followed by sequential tapping (approximately seven times per point) on twelve designated acupoints: the beginning of the eyebrow, side of the eye, under the eye, under the nose, the chin, collarbone, under the armpit, thumb, index finger, middle finger, little finger, and the Karate Chop point. Multiple tapping rounds were completed within the 15-minute timeframe.
• Control Group: Participants underwent identical pre-test assessments but remained in a designated waiting area for 15 minutes without any active intervention, guidance, or therapeutic contact.

Data Collection and Measurement: Baseline assessments (Pre-tests) included a Parental Information Form, the Subjective Units of Distress Scale (SUDS), and the State-Trait Anxiety Inventory (STAI). Post-test assessments (SUDS and STAI) were administered to both groups immediately following the 15-minute intervention or waiting period. The STAI evaluated both situational (state) and general (trait) anxiety on a scale ranging from 20 to 80, while the SUDS provided a subjective distress rating from 0 to 10.

• Study Type: Interventional
• Enrollment (Actual): 72
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Turkey (Türkiye)
  • Bolu, Turkey (Türkiye), 14030
    • Bolu Abant Izzet Baysal University, Izzet Baysal Training and Research Hospital, Newborn Hearing Screening Center
  • Bolu, Turkey (Türkiye), 14030
    • Bolu Izzet Baysal State Hospital, Newborn Hearing Screening Center

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: Yes

Description

Inclusion Criteria:

• Mothers of neonates who are undergoing the newborn hearing screening (NHS) for the first time.
• Ability to communicate effectively in the native language without language barriers.
• No prior experience or training in applying the Emotional Freedom Technique (EFT).
• Voluntary agreement to participate in the study and completion of the informed consent form.

Exclusion Criteria:

• Known history of diagnosed psychiatric disorders or epilepsy.
• Situations where the neonate is crying or being breastfed immediately prior to the intervention or during the assessment.
• The scheduled hearing screening procedure is initiated before the 30-35-minute study protocol is completed.
• Occurrence of any acute situational triggers or environmental distractions that may interfere with the stability of anxiety measurements.

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Supportive Care
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: None (Open Label)

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Emotional Freedom Technique Group; 15-minute guided acupoint tapping session	Behavioral: Emotional Freedom Technique; 15-minute guided acupoint tapping session
Other: Control Group; 15-minute waiting period without active guidance	Other: No intervention; 15-minute waiting period without active guidance

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
State Anxiety Inventory (STAI-S) Score	The STAI-S measures the current state of anxiety. Scores range from 20 to 80, where higher scores indicate greater levels of anxiety.	Baseline (Pre-test) and 15 minutes after the baseline (Post-test)

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Subjective Units of Distress Scale (SUDS)	A self-assessment scale for distress/anxiety. Scores range from 0 (no distress) to 10 (extreme distress).	Baseline (Pre-test) and 15 minutes after the baseline (Post-test).
State-Trait Anxiety Inventory - Trait (STAI-T) Score	The STAI-T is a self-report scale used to measure an individual's general tendency to experience anxiety. The scale consists of 20 items, with scores ranging from 20 to 80. Higher scores reflect a higher level of trait anxiety.	Baseline (Pre-test) and 15 minutes after the baseline (Post-test).

Collaborators and Investigators

• Sponsor: Abant Izzet Baysal University
• Investigators: Principal Investigator: Sümeyra Alan, PhD, Bolu Abant İzzet Baysal Üniversitesi

Publications and helpful links

General Publications

• Clond M. Emotional Freedom Techniques for Anxiety: A Systematic Review With Meta-analysis. J Nerv Ment Dis. 2016 May;204(5):388-95. doi: 10.1097/NMD.0000000000000483.
• Kim, D., Bae, H., & Chon Park, Y. (2008). Validity of the Subjective Units of Disturbance Scale in EMDR. Journal of EMDR Practice and Research, 2, 57 - 62.
• Oner N, Le Compte A. State-Trait Anxiety Inventory: Handbook. 2nd ed. Istanbul: Bogazici University Press; 1998.
• Wolpe J. Subjective Units of Distress Scale (SUDS). APA PsycTests. 1969.

Study record dates

Study Major Dates

• Study Start (Actual): March 31, 2026
• Primary Completion (Actual): June 24, 2026
• Study Completion (Actual): June 24, 2026

Study Registration Dates

• First Submitted: February 12, 2026
• First Submitted That Met QC Criteria: February 12, 2026
• First Posted (Actual): February 19, 2026

Study Record Updates

• Last Update Posted (Actual): July 30, 2026
• Last Update Submitted That Met QC Criteria: July 29, 2026
• Last Verified: July 1, 2026

More Information

Terms related to this study

• Keywords: Acupressure; Complementary Therapies; Emotional Freedom Technique; Newborn Hearing Screening; Neonatal Screening; EFT; Tapping; Parental Health; Anxiety, Procedure-Related
• Additional Relevant MeSH Terms: Mental Disorders; Anxiety Disorders
• Other Study ID Numbers: AIBU-SBF-SA-01

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: YES
• IPD Plan Description: Individual participant data that underlie the results reported in this study, after de-identification (text, tables, figures, and appendices), will be shared with researchers who provide a methodologically sound proposal. The primary objective is to allow for secondary analyses that align with the original research goals. All data sharing will be conducted in strict accordance with the participant confidentiality protections outlined in the Informed Consent Form. A formal Data Use Agreement (DUA) must be signed before any data transfer occurs.
• IPD Sharing Time Frame: Data will be made available beginning 6 months after the publication of the primary results and will remain accessible for a period of 3 years.
• IPD Sharing Access Criteria: Data access requests should be submitted via email to [sumeyraalan@ibu.edu.tr]. Proposals will be reviewed for scientific merit. Requestors must demonstrate that they have obtained necessary institutional ethical approvals and must agree to use the data only for the purposes specified in their approved proposal.
• IPD Sharing Supporting Information Type: STUDY_PROTOCOL; SAP

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No