Tapas Acupressure Technique

Origins as the developer describes them

The developer's website states that the Tapas Acupressure Technique (TAT) was developed in 1993 by Tapas Fleming, a licensed acupuncturist in California. In her own account, Fleming says the idea arrived as a thought about a single acupuncture point after a nap in her office, and that she began adding it to her treatment of allergy patients, working from acupressure and acupuncture methods she attributes to another California practitioner. These are the developer's statements about her own work, and no independent historical source for the origin was found.

Fleming describes adding further points over the following months, one suggested by a patient who reported that a tai chi teacher used it, and a hand position at the back of the head linked to her thinking about the visual center of the brain. She also describes bodily or cellular memory, including memory passed down through ancestors, as a conclusion drawn from clinical experience rather than formal study. These are beliefs held by the developer, and the trials reviewed on this page did not test them.

Placement within energy psychology

Published trial authors place TAT in energy psychology, a family of mind-body interventions that involve tapping or holding specific acupressure points while using mental imagery, alongside Thought Field Therapy and EFT (Emotional Freedom Techniques). Machipedia covers that family on its Energy Psychology page. The authors note that these approaches can draw on traditional Chinese medicine, in which free flow of Qi along meridians is held to be essential to health, and that blocked Qi is the mechanism the technique's developer and many TAT practitioners propose.

A 2008 review in the journal Psychotherapy called energy psychology exceedingly controversial, noting that it relies on unfamiliar procedures adapted from non-Western cultures and posits unverified mechanisms of action. The same review's author argued that the evidence, while preliminary, had reached the minimum threshold for designation as evidence-based for some uses. Other authors disputed that view, as described under Criticism and Limitations.

Name and trademark

The name carries the developer's first name, and TAT is presented with a registered-trademark symbol on the developer's website. A 2007 trial abstract likewise describes the name as a registered trademark of Tapas Fleming, a licensed acupuncturist. The abbreviation TAT is the form used throughout the published trials and by the developer's certification program.

Trial authors describe the method as combining self-applied light pressure on specific acupressure points with a prescribed sequence of mental steps. It is therefore a multimodal method and differs from Acupressure used alone, which Machipedia describes on its own page, and from Acupuncture, which uses needles on the same kind of point system.

Relationship to EFT and Thought Field Therapy

The 2012 trial report groups TAT with Thought Field Therapy and EFT (Emotional Freedom Techniques) as popular energy psychology techniques, and defines the family as tapping or holding acupressure points combined with mental imagery. On that definition, TAT is distinguished chiefly by holding points rather than tapping on them, and by its own prescribed mental sequence, although the sources reviewed do not compare the three methods directly.

Critical and supportive reviewers also discuss EFT and TAT together, because both were cited in the same 2008 review and the responses to it. Evidence from trials of EFT or Thought Field Therapy should not be carried over to TAT, and the reverse also holds, since the trials identified here tested TAT only for weight-loss maintenance.

General format

In general terms, a person using TAT holds a small number of points on the face and head with the hands while attending to a problem or area of concern, following a set sequence of silent or spoken statements. This page does not describe the steps. In the largest trial, the full protocol took about 20 to 30 minutes, and a shortened version of 2 to 5 minutes was also taught for use through the day.

The developer's website describes learning to hold acupressure points and use focused thoughts, practiced individually or in groups. Trial authors note the intervention is multimodal, including imagery, affirmations and other components, so any effect could in principle come from one component rather than the acupressure.

Training and certification as the developer's school states it

The developer's website offers a page for finding certified TAT professionals and says that working with one gives guidance and support. In the 2012 trial, certification as then described required 60 hours of workshop attendance, home study of print and audiovisual materials, documentation of 50 sessions on self, 50 on clients and 15 on fellow trainees, and a final evaluation of two sessions by a certified TAT trainer.

These requirements come from the developer's own certification program as reported by trial authors, and the current program may differ. No statutory regulation of TAT practice or independent training standard was found in the sources reviewed.

Uses the developer and practitioners describe

The developer's website states that TAT reduces stress and anxiety, builds emotional resilience, helps with processing emotional trauma, and can improve physical health conditions linked to emotional stress. Fleming's own account describes its first use as part of her treatment of allergy patients. The website also carries client and practitioner testimonials, which are not evidence of effect and are not used as sources here.

Trial authors state that case reports and anecdotes suggest dramatic results across a range of medical conditions, and give this as one reason to test energy psychology techniques, while noting that their efficacy had not been adequately tested in randomized trials. Of the conditions listed above, the controlled trials identified for this page address only weight-loss maintenance.

Claims in the energy psychology literature

A 2008 review of energy psychology reported that practitioners describe outcomes as more rapid, powerful and precise than other exposure-based treatments, and concluded that one form met the American Psychological Association Division 12 criteria as probably efficacious for specific phobias and another for maintaining weight loss. Critics disputed the review's methods, and the claim of unusual speed has not been established by the trials covered here.

Pilot trial for weight-loss maintenance (2007)

A randomized pilot at a health maintenance organization compared TAT, qigong and a self-directed support group after a 12-week behavioral weight-loss program. The 2007 report states that 88 percent of randomized participants completed the study and that, at 24 weeks, the TAT group maintained 1.2 kg more weight loss than the support group (p = 0.09) and 2.8 kg more than the qigong group. The authors concluded that TAT warranted further research. Later authors describe this pilot as having 92 participants.

The LIFE trial (2012)

The larger LIFE trial randomized 285 adults, who had lost at least 4.5 kg in a six-month program, to TAT or facilitated social-support meetings, with 142 and 143 participants per arm and eight group sessions each. At 12 months, adjusted weight regain was 1.72 kg for TAT and 2.96 kg for support, a difference the authors report as not significant, and depression, stress, insomnia and quality of life also did not differ. A trial protocol paper described it as the largest randomized study of an energy psychology intervention to date.

An exploratory analysis found that among participants with the greatest initial weight loss, TAT was associated with less regain. The authors caution that this came from post hoc tests with small effect sizes and possible confounding, that participants were not blinded and expectancy was not measured, and that firm conclusions are precluded.

Adherence and other conditions

A secondary analysis reported that 66 percent of TAT participants attended at least 6 of 8 sessions and over 80 percent reported home practice on at least 2 days a week. Higher satisfaction was correlated with less weight regain, but frequency of practice was not significantly associated with weight, stress, insomnia, depression or quality of life.

A PubMed search on the technique's full name returned five records: the pilot, the trial protocol, the main trial, the adherence analysis and a critical review. No controlled trial of TAT for allergy symptoms, smoking, trauma or post-traumatic stress was identified in those searches, so the sources reviewed here do not support conclusions for those uses.

Methodological and mechanism critiques

A 2009 critique in Psychotherapy examined the research cited in the 2008 review for EFT and TAT, reported serious flaws in its methodology, and argued that small successes might be attributable to well-known cognitive and behavioral techniques included alongside the acupoint component. The critique urged psychologists to be wary of such techniques and to inform the public about the ill effects of therapies that advertise miraculous claims.

The reviewer who wrote the 2008 paper replied that the exchange reflected a paradigmatic clash within the professional community, and acknowledged that reports of the speed and power of energy psychology had not been explained using established clinical models. The proposed mechanism of blocked Qi along meridians has not been verified by the sources reviewed.

Certainty of the evidence

Taken together, the evidence is limited to one pilot and one larger randomized trial in a single health system in Oregon, mostly of older women, with no significant primary-outcome difference from a social-support comparison. The largest trial's own authors cannot separate acupressure from group attendance, imagery or affirmations. Certainty that TAT affects any condition is therefore low, and certainty of harm or no harm beyond those settings is also limited.

Adverse events reported in trials

The 2007 pilot reported no significant study-related adverse events, and the 2012 trial, which checked for adverse events at each visit, reported no unanticipated serious intervention-related events. Participants in the trials were adults in a health maintenance organization who were screened for eligibility.

The 2012 trial excluded people with a recent cardiovascular event, recent cancer treatment, inpatient psychiatric hospitalization, or pregnancy, so its findings do not describe those groups. No source reviewed documents harms specific to TAT, and absence of reported harm in these trials is not evidence that none occurs.

Care boundaries and trauma

The developer's website describes use for emotional trauma, but no controlled trial of TAT for trauma or post-traumatic stress was found. A critical review of energy psychology cautions that such methods may add little beyond established cognitive and behavioral components and advises wariness toward miraculous claims. TAT should not delay or replace medical or mental health care, and anyone with distressing trauma symptoms or a diagnosed condition may wish to discuss any added practice with a licensed clinician.