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current research in psychology 5 1 64 72 2014 issn 1949 0178 2014 science publication doi 10 3844 crpsp 2014 64 72 published online 5 1 2014 http www thescipub ...

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               Current Research in Psychology 5 (1): 64-72, 2014 
               ISSN: 1949-0178 
               ©2014 Science Publication 
               doi:10.3844/crpsp.2014.64.72 Published Online 5 (1) 2014 (http://www.thescipub.com/crp.toc) 
                 THE IMPACT OF EFT AND MATRIX REIMPRINTING ON THE 
                  CIVILIAN SURVIVORS OF WAR IN BOSNIA: A PILOT STUDY 
                                                        Boath, E., T. Stewart and C. Rolling 
                
                              Staffordshire University, BG58 Brindley Building, Leek Rd, Stoke-on-Trent, ST4 2DE, England, UK 
                      
                     Received 2014-06-20; Revised 2014-07-09; Accepted 2014-07-16 
                                                                     ABSTRACT 
                     A pilot study was carried out to establish the feasibility and effectiveness of Matrix Reimprinting (MR) in 
                     treating post traumatic stress symptoms in civilian survivors of the war in Bosnia. Two Healing Hands 
                     Network Centres in Bosnia in Sarajevo and Hadzici. Clients accessing the Healing Hands Network in 
                     Bosnia were invited to participate in the pilot study of MR. At the start and end of their treatment, clients 
                     were asked to complete a modified version of the PTSD Checklist-Civilian Checklist (PCL-C; Blanchard et al., 
                     1996) at baseline, immediately after the two week MR intervention and then at 4 weeks follow-up. Eighteen 
                     clients were included MR pilot study. There was a significant reduction in the mean scores from baseline to 
                     immediately post intervention (p = 0.009) and again at the 4 week follow-up (p = 0.005). The size of the 
                     immediate effect was sustained at follow-up (p = 0.65). The qualitative analysis (via. an evaluation form at four 
                     weeks  follow-up)  identified  the  following  four  themes:  Theme  1:  Physical  and  psychological  changes 
                     Theme 2: The strength to move on and to self-care Theme 3: Rapport with the MR Practitioners Theme 4: 
                     Recommending it for others. Despite the limited sample size, significant improvements were shown. The 
                     qualitative and quantitative results support the potential of MR as an effective treatment for post traumatic 
                     stress symptoms. Further controlled studies are required. 
                      
                     Keywords: Matrix Reimprinting, EFT, PTSD, Bosnia, Trauma 
                               1. INTRODUCTION                                   that  26.3%  of  Bosnian  refugees  in  Croatia  suffered 
                                                                                 PTSD and 45% of those were still affected after 3 years. 
                   Post    Traumatic    Stress    Disorder    (PTSD)      is        In addition to the impact on war (Babic et al., 2010; 
               apsychological disorder that can develop after exposure to        Koso and Hansen, 2006; Kuljic et al., 2004), research 
               one or more traumatic events that threatened or caused            suggests that 90% of the casualties of war are civilians 
               severe physical harm (NICE, 2005a). Symptoms of PTSD              (Alexander  2010).  Thousands  of  citizens  experienced 
               are  varied  and  include:  Re-experiencing  symptoms  via        and/or  witnessed  highly  traumatic  events,  during  and 
               flashbacks,  nightmares  or  distressing  intrusive  images;      following  the  war  (Hodgetts  et  al.,  2003).  Addressing 
               avoidance of people, situations or circumstances that act         psychological trauma following war is therefore critical, 
               as  reminders  of  the  traumatic  events;  hyperarousal          however  the  resulting  social  and  political  upheaval 
               including  hypervigilance,  exaggerated  startle  responses,      combined with lack of resources means that remarkably 
               irritability,  difficulty  concentrating  and  sleep  problems;   few  receive  mental  health  services  (Connolly  et  al., 
               emotional  numbing  and  feeling  detached  from  other           2013). This has resulted in long-term emotional issues 
               people  (NICE,  2005a)  Galea  et  al.  (2005)  suggest  that     and  mental  health  problems  within  the  civilian 
               PTSD can persist for years if untreated.                          population  (Hodgetts  et  al.,  2003).  While  there  have 
                   It has been reported that 39.2% of Bosnian refugees           been many interventions to support civilian survivors of 
               in  Croatia  suffered  from  depression  and  26.3%  from         this war (Butollo, 2000; Kruse et al., 2009; Layne et al., 
               PTSD (Mollica et al., 1999). Oruc et al. (2008) reported          2008),  research  has  shown  that  the  recovery  rates 
               © 2014 Boath, E., T. Stewart and C. Rolling. This open access article is distributed under a Creative Commons Attribution (CC-BY) 3.0 license which 
               permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. DOI: 10.3844/crpsp.2014.64.72 
                                               Boath, E. et al. / Current Research in Psychology 5 (1): 64-72, 2014 
                among patients treated in specialized centres for war-            Disorder  (PTSD)  (Connolly  et  al.,  2013;  Church  and 
                related  PTSD  is  poor  and  symptom  improvements               Feinstein,  2010;  2012;  Boath  et  al.,  2012;  Stein  and 
                small (Priebe et al., 2010).                                      Brooks,  2011;  Church  et  al.,  2013;  2012b;  2009; 
                   Extensive  research  has  been  carried  out  in  an           Karatzias et al., 2011; Stewart et al., 2013). 
                attempt  to  identify  the  most  effective  treatment  for           Much research has been carried out on the civilian 
                PTSD (Cowap et al., 2014) and recent meta-analytic                survivors  of  the  war  in  Bosnia  (Mollica  et  al.,  1999; 
                reviews suggest that exposure therapy, CBT and Eye                Oruc et al. (2008). Although research has demonstrated 
                Movement Desensitization and Reprocessing (EMDR)                  the  effectiveness  of  TFT  in  treating  PTSD  in  refugees 
                to be efficacious treatment approaches (Benedek et al.,           (Folkes, 2002) and civilian survivors of the genocide in 
                2009;  Bradley  et  al,  2005;  IM,  2006;  2007;  NICE,          Rwanda (Sakai et al., 2010; Connolly and Sakai, 2011), to 
                2005a;  Seidler  and  Wagner,  2006).  However,  the              date no study has reported on the effects of MR on post 
                debate  surrounding  most  effective  PTSD  treatment             traumatic stress symptoms in civilian survivors of war. 
                continues  and  while  some  researchers  have  argued                Hobfoll et al. (2007) emphasise that EFT, TFT and 
                towards the superiority of treatments such as exposure            other  self  help  tools  can  increase  subjects’  self-
                therapy  (Nemeroff  et  al.,  2006),  some  state  the            efficacy and enhance recovery. Clients being treated 
                argument that no one treatment is superior to another             with MR are first taught EFT and can then use EFT as 
                (Lee  et  al.,  2006).  In  spite  of  the  current  debate,      part of and between MR sessions. Although EFT can 
                trauma-focused      treatment     remains     the   current       be easily taught and self-administered, clients are not 
                recommendation  as  the  primary  PTSD  treatment                 advised to use MR by themselves for extreme issues 
                protocol (APA, 2000; NICE, 2005b).                                (Dawson and Allenby, 2010). 
                   Matrix  Reimprinting  (MR)  is  a  newly  developed                Research  suggesting  that  EFT  is  an  efficient  and 
                psychological technique that can to improve health and            effective  intervention  for  a  range  of  psychological 
                wellbeing  by  allowing  clients  to  access  and  transform      disorders  has  grown  exponentially  over  the  past  decade 
                painful  memories about traumatic events (Dawson and              and three systematic reviews have been recently published 
                Allenby, 2010). MR evolved from Emotional Freedom                 (Feinstein  2008;  Boath  et  al.,  2012;  Feinstein,  2012). 
                Techniques (EFT; Craig, 2011). EFT is a gentle therapy            Although there are a growing number of MR practitioners 
                that  can  be  used  for  a  variety  of  emotional  issues,      (around  2,500  worldwide)  and  anecdotal  evidence 
                including  PSTD  (Craig  PTSD  book;  Feinstein,  2010;           demonstrating the effectiveness of MR for a wide range of 
                Church,  2010;  Church  et  al.,  2012a;  2013).  In  EFT,        issues including: Trauma, fibromyalgia, allergies, phobias, 
                subjects gently tap with their fingertips on acupressure          pain  management,  depression,  anxiety  and,  stress 
                points (mainly on the head and hands) and relate this to          reduction,  a  literature  search  of  nursing,  medical  and 
                the voicing of specific statements (Craig, 2011). MR is           psychological  electronic  databases  using  the  key  terms 
                an  energy  psychology  technique  which  incorporates            ‘matrix reimprinting’ revealed only one published clinical 
                EFT, imagined parts/inner child work, referred to in MR           studies of MR to date (Stewart et al., 2013).  
                as Energy Consciousness Holograms (ECHOs) and also                    A systematic review of EFT for PTSD is currently 
                integrates  recent  understanding  from  quantum  and             underway by two of the authors, who have identified 
                epigenetic science (Church, 2013). Using MR, the client           nine  published  papers  focused  on  EFT  for  PTSD 
                works with the ECHO to release the stress or trauma in a          (Cowap et al., 2014). Five of these focus of combat trauma 
                dissociated manner by imagining themselves talking to             (Church  et  al,  2009;  Church,  2010;  2013;  Gurret  et  al., 
                and supporting the ECHO. The client can then support              2012; Hartung and Stein, 2012). However no published 
                the  ECHO using EFT to relive or revise the traumatic             papers focussed on EFT for civilian survivors of war. 
                event.  A  new  and  positive  picture  is  then  created  and        Healing Hands Network is a British based Charitable 
                highlighted, which is used to reprogram the mind with             Organisation established in 1996 to help survivors of the 
                the new information, indicating that the trauma is over 
                (Dawson and Allenby, 2010).                                       siege in Sarajevo, Bosnia and Herzegovina (HHN, 2013). 
                   MR is claimed to be particularly suitable to help              They provide therapy treatments to people living  with 
                clients  overcome  serious  health  and  emotional                mental,  physical  and  emotional  effects  of  war  and 
                challenges,  including  conflict  and  war  trauma                disaster in and around Sarajevo. Clients are referred by 
                (Dawson and Allenby 2010; Stewart et al., 2013).                  local   organisations  including  the  Association  of 
                   There is a growing body of literature that suggests            Concentration  Camp Victims, the  Association of Civil 
                that energy psychology methods including EFT and MR               War Victims and the Centre for Torture Victims. This 
                are effective in the treatment of Post Traumatic Stress           pilot study aimed to assess whether Matrix Reimprinting 
                 
                    Science Publications                                      65                                                          CRP 
                                               Boath, E. et al. / Current Research in Psychology 5 (1): 64-72, 2014 
                would be an effective and acceptable treatment of PTSD            Demographic and occupational questions were added 
                in civilian survivors of the 1992-95 war in Bosnia.               to  the  questionnaire,  but  no  sensitive  questions 
                                                                                  regarding ethnic/religious background were included. 
                      2. MATERIALS AND METHODS                                    The  final  two  questions  asked  whether  or  not  the 
                   A  sample  of  18  adults  was  selected  by  the  two         respondents  witnessed  or  experienced  what  they 
                                                                                  considered to be a traumatic event during the conflict 
                Bosnian administrators of Healing Hands Network, with             and if  yes,  did  they  think  that  it  still  affected  them 
                the inclusion criteria that subjects were still experiencing      today. The questionnaire was translated into Bosnian-
                severe emotional distress from their experiences during           Serbo-Croat,  back-translated  into  English  and  pilot-
                the 1992-95 war in Bosnia. All 18 were existing clients           tested by health professionals in BiH. 
                of Healing Hands Network (HHN) and were identified                    Clients  were  assessed  using  the  PCL-CM  at  three 
                by HNN as being suitable for MR.                                  time  points,  at  baseline,  immediately  post  intervention 
                   The  participants  had  been  exposed  to  a  wide             and at four weeks post intervention. Clients were asked 
                spectrum of traumatic events during the war including:            to fill in an evaluation form to explore their views of MR 
                Beatings,  confiscation  or  destruction  of  personal            at  four  weeks  follow-up.  Responses  were  captured  in 
                property, war wounds, torture, rape, sexual humiliation           writing.  The  qualitative  data  were  analysed  using  a 
                and/or witnessing another person’s injury or murder.              framework approach (Ritchie and Spencer, 1994). The 
                   None  of  the  subjects  spoke  English  and  three            quantitative  data  were  entered  into  SPSS.  Data  were 
                interpreters   were    therefore   recruited.   All    three      screened  for  normality  using  the  Shapiro-Wilk  test. 
                interpreters  were introduced to the highly experienced,          PTSD scores were found to be normal and were analysed 
                qualified and certified MR volunteer practitioners who            using the paired t-test. Where P-values were <0.05, the 
                gave  them  an  introduction  to  EFT  and  Matrix                differences were considered statistically significant. 
                Reimprinting at an introductory meeting prior to meeting 
                any of the participants.                                                               3. RESULTS 
                   The  intervention  was  carried  out  at  two  separate 
                venues, eight participants at each site. The first Group              A total of 18 civilian survivors of the war participated 
                (Group  A)  were  seen  at  the  HHN  headquarters  in            in the research. Four were men and 10 women, 4 were 
                Sarajevo and the second group (Group B) in the HHN                aged 30-40 years, 7 were 40-60 years and 3 were over 
                outreach post in Hadzici, 12 km from Sarajevo.                    60. Table 1 shows the difference in PCL-CM over time. 
                   Each participant was timetabled to receive four, one           One client did not complete the PCL-CM; the reason for 
                hour, one-to-one sessions spread over two weeks at their          this was not provided. 
                respective centre. Each person saw the same practitioner              The mean score on the PCL-CM at baseline (pre MR 
                and interpreter for each session.                                 intervention) was 82.71 (SD = 18.72) and immediately 
                   Each person was given translated written copies of             post the two week intervention, the mean scores reduced 
                the basic EFT protocol, including suggestions for using           to  53.77  (SD  =  27.20).  This  was  clinically  and 
                EFT  to  aid  sleep.  They  were  also  introduced  to  a         statistically significant (p = 0.009). The mean score on 
                breathing technique similar to Heart Math breathing, a            the PCL-CM at the 4 week follow-up was 53.38 (SD = 
                heart-focused breathing technique which can be helpful            24.58). This was a clinically and statistically significant 
                for  emotional  wellbeing  (IH,  2013).  The  clients  were 
                instructed  that  they  could  continue  to  use  EFT  on         reduction  from  the  baseline  scores  (p  =  0.005).  There 
                themselves any time they wished.                                  was however no significant change in scores between the 
                   At the end of the two weeks, both groups met and               post  intervention  and  4  week  follow-up  (p  =  0.65), 
                were  given  time  to  talk  with  each  other  about  their      suggesting  that  the  immediate  effects  of  MR  were 
                experiences  during  the  study  and  provide  written            sustained, representing both a clinically and statistically 
                feedback on MR.                                                   significant reduction from baseline. 
                   The outcome measure used was a version of the                   
                civilian  version  of  the  PTSD  Checklist  (PCL-C;              Table 1. Results of inferential analysis pre and post MR  
                Blanchard et al., 1996) which had been modified and                                          Mean (SD)                  N = 17 
                translated into Bosnian. The PCL-CM was selected for              Baseline                   82.71 (18.72)              13 
                its ability to screen for PTSD without asking about the           Post intervention          53.77 (27.20)              13 
                specific traumatic events that may have caused PTSD.              4 week follow-up           53.38 (SD = 24.58)         13 
                 
                    Science Publications                                      66                                                          CRP 
                                           Boath, E. et al. / Current Research in Psychology 5 (1): 64-72, 2014 
                  The qualitative data produced richr insight into the           “I have noticed a change and a positive one. I 
              client’s experience and outcomes of EFT and MR. No                feel very happy, satisfied, more brave and more 
              negative side effects were reported and all 14 clients who        positive overall towards life... (Mira) 
              completed the  evaluation  form  gave  positive  feedback     Theme 2: The Strength to Move on and to Self-
              about their experiences and these were characterised by       Care 
              four overarching themes:  
              Theme 1: Physical and psychological changes                      Participants reported that not only had MR had given 
              Theme 2: The strength to move on and to self-care             them the  strength  to  move  on  with  their  life,  learning 
              Theme 3: Rapport with the MR Practitioners                    EFT as a precursor to MR had provided them with a 
              Theme 4: Recommending MR for others                           strategy for self care: 
                  Quotes are presented to illustrate the themes; names           “The sessions gave me enough strength to move 
              have been changed to maintain confidentiality.                    on  with  my  life...While  I  was  coming  to  the 
              Theme 1: Physical and Psychological Changes                       therapies, my family has noticed that I was a lot 
                                                                                calmer. (Sava) 
                  It  was  evident  from  the  data  that  MR  produced         “These treatments are very good and I know that 
              positive  changes.  All  reported  positive  changes  in          they will give me the strength to move on with my 
              psychologically  and  some  physically  and  that  these          life” (Zora) 
              changes had also been noted by family and friends as 
              illustrated by the following data extracts:                       “This therapy was very useful for me, I managed 
                   “I have noticed a change and a positive one. I               to relax and rest a lot.. (Mira) 
                   feel very happy, satisfied, more brave and more              “I managed to achieve so much within the past 
                   positive  overall  towards  life.  I  became  happier        ten days. Five days after the first session I felt 
                   and  more  communicative  with  my  friends...My             great  and  relaxed...“This  therapy  helped  me  a 
                   family has noticed this change in me as well my              lot. I am much calmer than before. I learnt how 
                                                                                to help myself when I am depressive because this 
                   friends who now say I appear to be more cheerful             therapy helps me to calm down and relax” (Izet) 
                   and more talkative… I feel a little better talking       Theme 3: Rapport with the MR Practitioners 
                   with my family and friends. I am even capable of 
                   speaking with people I don’t know-unlike before.            Rapport  can  be  described  as  a  sympathetic 
                   All sessions helped me to improve my psychological       relationship or understanding between the practitioner 
                   as well as physical health” (Lamia)                      and client, or a achieved when the client feels that the 
                   “Of course I have changed for the better. I feel a       therapist understands them and appreciates the value 
                   lot better and other people say that about me as         and complexity of their personal experience (Owens, 
                   well... (Josip)                                          2012; Yapko, 1995). Rapport is essential in building a 
                                                                            therapeutic  alliance  with  a  client  (Hartmann,  2002) 
                   My family noticed the improvements in my mood            and the participants noted the positivity and empathy 
                   and behaviour..(Branka)                                  of the two therapists: 
                    My daughter tells me that lately I am more calm             “I  would  like  to  express  my  gratefulness  and 
                   and  that  I  am  not  as  aggressive  as  before.”          thankfulness to X {MR/EFT therapist] X has made 
                   (Alenka)                                                     a huge positive turn in my life. She is very brave, a 
                   “Treatment has helped me a lot. Other people                 very  strong  person  and  a  joyful  person.  I  wish 
                   noticed  the  improvement.  I  feel  much  better            nothing  more  than  for  X  to  be  happy  and  to 
                   (Hasan)                                                      always have that smile on her face. I would like to 
                                                                                thank the whole crew. Thank you!” (Lamia) 
                   ...At  the  beginning I  felt  a  huge  burden  on  my       “We  have  worked  with  beautiful  therapists 
                   shoulders  and  my  mind  was  filled  with  grey            who  knew  how  to  help  us.  Both  of  the 
                   thoughts  but  after  only  one  session  my  mind           therapists  showed  us  a  lot  of  understanding 
                   cleared,  the  greyness  disappeared  and  I  felt           and they had so much positive energy that they 
                   stronger.” (Zana)                                            managed to transform onto us as well. I would 
               
                   Science Publications                                 67                                                      CRP 
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...Current research in psychology issn science publication doi crpsp published online http www thescipub com crp toc the impact of eft and matrix reimprinting on civilian survivors war bosnia a pilot study boath e t stewart c rolling staffordshire university bg brindley building leek rd stoke trent st de england uk received revised accepted abstract was carried out to establish feasibility effectiveness mr treating post traumatic stress symptoms two healing hands network centres sarajevo hadzici clients accessing were invited participate at start end their treatment asked complete modified version ptsd checklist pcl blanchard et al baseline immediately after week intervention then weeks follow up eighteen included there significant reduction mean scores from p again size immediate effect sustained qualitative analysis via an evaluation form four identified following themes theme physical psychological changes strength move self care rapport with practitioners recommending it for others de...

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