The Tapping Evidence Base
Stress & Cortisol

Clinical emotional freedom techniques for psychological and physiological stress reduction: A systematic review and network meta-analysis

Stapleton, P., van Elst, A. · Explore (NY) · 2026

Meta-analysis 👥 1051 participants ⚖️ vs. Network meta-analysis vs control and active interventions (CBT, guided imagery, music, breathing, TAU) 📈 SMD -2.39 (large) Moderate rigor ✓ Source-checked 📍 Australia
In plain English. Researchers pooled 17 randomized trials of Tapping for stress and compared it against other approaches in one statistical network. Tapping showed a large drop in self-reported stress and a modest but real improvement in biological stress markers like cortisol. Caveat: the underlying trials are mostly small with bias concerns.

What they found

SMD = -2.39
a large effect · 95% CI 95% CI -3.18 to -1.59 · on psychological stress, Clinical EFT vs control (frequentist network meta-analysis
small moderate large
0 0.5 0.8 2.5
Researchers pooled 17 randomized trials of Tapping for stress and compared it against other approaches in one statistical network.

First NMA to pool Clinical EFT effects across psychological AND biological stress outcomes: large significant reduction in psychological stress vs control (SMD -2.39, 95% CI -3.18 to -1.59) and small-to-moderate reduction in physiological stress (SMD -0.48, 95% CI -0.85 to -0.12). CBT, guided imagery and music were also significant; TAU and breathing imprecise. No significant network inconsistency; most included studies had some concerns or high risk of bias.

How the study worked

Who took part Adults in RCTs of Clinical EFT for stress (17 RCTs; psychological stress 14 studies n=1051, physiological stress 6 studies n=399) (n=1051)
What they did This meta-analysis statistically pooled the results of many earlier studies to estimate an overall effect.
Compared with Network meta-analysis vs control and active interventions (CBT, guided imagery, music, breathing, TAU)
Measured with Psychological stress (self-report), Physiological stress (incl. cortisol)

💡 Where this could help

The first EFT stress synthesis to pool self-report and biological outcomes in one network, giving a defensible headline for the stress/cortisol story.

🔬 What to study next

Higher-quality trials that report both self-report and cortisol in the same sample; most pooled studies carried some or high risk of bias.

The full record

DesignMeta-analysis
Participants1051 people
PopulationAdults in RCTs of Clinical EFT for stress (17 RCTs; psychological stress 14 studies n=1051, physiological stress 6 studies n=399)
Comparison groupNetwork meta-analysis vs control and active interventions (CBT, guided imagery, music, breathing, TAU)
Effect sizeSMD = -2.39 (95% CI 95% CI -3.18 to -1.59) — on psychological stress, Clinical EFT vs control (frequentist network meta-analysis, 14 RCTs, n=1051); physiological stress SMD -0.48 (95% CI -0.85 to -0.12), 6 RCTs, n=399
Outcome measuresPsychological stress (self-report), Physiological stress (incl. cortisol)
JournalExplore (NY)
Year2026
CountryAustralia
LanguageEnglish
MethodEFT / Tapping
Publication typeReview or meta-analysis
Verification✓ Confirmed against the primary source

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Cite this study

APA

Stapleton, P., & van Elst, A. (2026). Clinical emotional freedom techniques for psychological and physiological stress reduction: A systematic review and network meta-analysis. Explore (NY). https://doi.org/10.1016/j.explore.2026.103474

This record is part of the Tapping Evidence Base — an openly-sourced, fully-referenced directory of the research on EFT/Tapping. Explore more studies on Stress & Cortisol

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THE TAPPING EVIDENCE BASE Stress & Cortisol SMD -2.39 large effect WHAT THEY FOUND First NMA to pool Clinical EFT effectsacross psychological AND biological stressoutcomes: large significant… Meta-analysis · 1051 participants Stapleton · 2026 · evidence.thetappingsolution.com