acupuncture points provide the basis for significant improvement in psychological problems. However, the theory and mechanisms underlying the supposed effectiveness of EFT have "no evidentiary support" "in the entire history of the sciences of biology, anatomy, physiology, neurology, physics, or psychology." Researchers have described the theoretical model for EFT as "frankly bizarre" and "pseudoscientific." One review noted that one of the highest quality studies found no evidence that the location of tapping points made any difference, and attributed effects to well-known psychological mechanisms, including distraction and breathing therapy. An article in the Skeptical Inquirer argued that there is no plausible mechanism to explain how the specifics of EFT could add to its effectiveness, and they have been described as unfalsifiable and therefore pseudoscientific. Evidence has not been found for the existence of meridians. Research quality EFT has no useful effect as a therapy beyond the placebo effect or any known-effective psychological techniques that may be used with the purported "energy" technique, but proponents of EFT have published material claiming otherwise. Their work, however, is flawed and hence unreliable: high-quality research has never confirmed that EFT is effective. A 2009 review found "methodological flaws" in research studies that had reported "small successes" for EFT and the related Tapas Acupressure Technique. The review concluded that positive results may be "attributable to well-known cognitive and behavioral techniques that are included with the energy manipulation. Psychologists and researchers should be wary of using such techniques, and make efforts to inform the public about the ill effects of therapies that advertise miraculous claims." A 2016 systematic review found that EFT was effective in reducing anxiety compared to controls, but also called for more research to establish the relative efficacy to that of established treatments. Reception A Delphi poll of an expert panel of psychologists rated EFT on a scale describing how discredited EFT has been in the field of psychology. On average, this panel found EFT had a score of 3.8 on a scale from 1.0 to 5.0, with 3.0 meaning "possibly discredited" and a 4.0 meaning "probably discredited." A book examining pseudoscientific practices in psychology characterized EFT as one of a number of "fringe psychotherapeutic practices," and a psychiatry handbook states EFT has "all the hallmarks of pseudoscience." EFT, along with its predecessor, Thought Field Therapy, has been dismissed with warnings to avoid their use by publications such as The Skeptic's Dictionary and Quackwatch.