The following article is from the ACEP website in the Research – Selected Articles section.

CONDUCTING SINGLE SUBJECT RESEARCH TO EVALUATE THE EFFICACY OF ENERGY PSYCHOLOGY TECHNIQUES
Janet Farrel, Ph.D.

In order for Energy Psychology (EP) techniques to gain credibility in the scientific psychological community, it is imperative that we as clinicians conduct research that validates our use of these techniques. Experimental designs using random assignment of subjects to experimental and control groups are the gold standard for clinical research. However, most clinicians do not have the resources to conduct such group experiments. An alternative experimental method that is well suited to clinical setting is the Single Subject Design (SSD). Because the SSD does not have a control group, it attempts to rule out alternative explanations for client improvement by comparing the same subject to himself/herself over time. This is done by taking repeated measures of the target symptom(s) before and after the EP intervention is conducted.

In 1995, the American Psychological Association Division 12 Task Force on Promotion and Dissemination of Psychological Procedures published a list of empirically-validated treatments. To make the list of “well-established treatments”, two independent series of more than nine SSD experiments were required which demonstrated the efficacy of one treatment method compared with other methods. To make the list of “probably efficacious treatments”, a series of four or more single case design experiments which demonstrated efficacy were required (Chambless et al., 1966). This guideline established by the APA opened the door for single-subject designs done by clinicians in their own settings.

CHOOSING THE TARGET

It is recommended that you choose a specific DSM-IV diagnosis as your target, because 1) doing so will increase the significance of any results you might get; 2) your results can be combined in a series with those of other EP clinicians who are using the SSD design on the same diagnosis; and 3) well-validated test instruments are available for most DSM-IV diagnoses. Check with the Association for Comprehensive Energy Psychology (ACEP) Research Committee regarding recommendations for diagnoses you might want to target.

DATA COLLECTION

A) CHOOSING YOUR INSTRUMENTS/QUESTIONNAIRES

See ACEP Research Committee for recommended instruments for each diagnosis. These instruments should be some combination of questionnaires filled out by the client and instruments administered by the clinician. Family members, significant others, and/or a clinician other than the treating therapist may also fill out questionnaires regarding the client’s target symptoms.

Once pretest questionnaires are administered and scored, their results should be significant for the presence of the DSM-IV diagnosis you have chosen to study EP’s effectiveness. If the results are not significant, it makes little sense to continue the SSD with this particular subject.


B) REPEATED MEASURES/WHEN TO COLLECT THE DATA

Simply taking measures/questionnaires of the target symptoms before and after the EP therapy will not rule out alternative explanations for client improvement. Alternative explanations need to be controlled for.

      1) PASSAGE OF TIME – One alternative explanation is that the mere passage of time accounted for the decrease in symptoms. The way to control for this possibility in SSD’s is to take at least two and preferably three measures at one-week intervals before having any treatment sessions with the client. If there is little or no decrease in the symptoms from the first to the second or third test administrations, this lowers the possibility that subsequent improvements that occur during the therapeutic intervention are a result of the passage of time.

This series of pretests can be conducted by sending the client the self administered questionnaires and by collecting information for the clinician-administered test instruments over the telephone. If the pretests are done in this remote manner, it is important that the client fill out the questionnaires and that the clinician administer the over-the-phone measures at a consistent day, time and place. It is probably a good idea for the client to send in the self administered questionnaires by mail or e-mail immediately after they fill them out, to insure consistency of administration.

An alternative way of administering the pretests, but potentially inconvenient and bothersome for the client, is to have the client come into the office and fill out the questionnaires in your waiting room before ever having a therapy session. Of course, one of these pretests would be filled out in the waiting room prior to the first therapy session and would not be inconvenient to the client.

      2) THERAPEUTIC CONTACT – A second, more likely alternative explanation for the client’s improvement is therapeutic contact. In other words, other aspect(s) of the therapy account for the lion’s share of the improvement in the client’s symptoms. Our goal as EP clinician/researchers is to demonstrate that the EP techniques result in significant symptom improvement above and beyond the personal contact with an empathic and insightful therapist. The way to accomplish this is to have two or more therapy sessions with the client before beginning the EP techniques. The questionnaires should be administered before each of these therapy sessions. If there is little or no significant improvement in symptoms during the initial therapy sessions prior to initiating EP, then this client is a good candidate with which to conduct the SSD using the EP treatment.

      3) BEGINNING THE ENERGY PSYCHOLOGY TREATMENT – You are now ready to begin the EP intervention. Continue to collect the questionnaire data in the waiting room prior to each treatment session. Although you may typically alter and adapt your use of EP techniques to fit your own treatment style, try to use standard EP protocols as much as possible while conducting SSD (this will increase the validity and replicability of your findings).

Continue the EP treatments as long as you continue to see improvement in symptoms or until the symptoms have remitted and the client no longer meets the DSM-IV criteria for that disorder.

Once the treatment effect has been achieved, take followup measures (questionnaires) at one, three and six-month intervals. These can be filled out by the client at home and/or conducted by the therapist over the telephone.


C) REPORTING YOUR RESULTS:

SSD’s are not amenable to the statistical analyses used in group experimental designs. However, once you collect your SSD data, it can be combined with results from other EP clinicians and analyzed using group design techniques. ACEP Research Committee will deal with this, your task is to collect and submit the data. The most common way for SSD data to be reported is through the use of graphs and tables. Below are examples of graphs of SSD.

You should have a separate graph for each instrument you use, and within that graph you will have four vertical segments:

1) The pretest, non-contact weeks.

2) The therapeutic contact, no-EP-treatment weeks.

3) The EP-treatment phase.

4) The post-treatment or followup phase.


It goes without saying that once you begin the EP treatment portion of the SSD, you will need to report your results, regardless of whether they show EP treatment effectiveness. Don’t’ be discouraged if your results are not positive for the EP treatment you used; your results will be combined with those of other clinicians, and all results, whether seemingly ‘positive’ or ‘negative’, help advance our knowledge of EP therapies.

It is a good idea to contact the ACEP Research Committee for their input before you embark on your SSD and before you analyze your results. Once you have analyzed your results, contact the Research Committee regarding how and where to get them published.

Good luck, and thank you for participating in this noble cause.