Effect of the Emotional Freedom Technique on Emotional Stability in Adolescent Prisoners

Introduction: The prevalence of children in Indonesian prisons in 2015 was as many as 2,207 children. The impact of detention on children can cause a psychological decline such as anger, anxiety, sadness, fear, disappointment, and other feelings that can cause changes in their emotional stability. The Therapy Emotional Freedom Technique (EFT) is one of the complementary therapies that can be administered to improve the emotional stability of adolescent prisoners. This study set out to determine the effect of emotional stability EFT against child prisoners in LPKA Class II Yogyakarta. Methods: This study design used a pre-experimental approach in a non-equivalent control group design. The researcher used purposive sampling to gain a sample of 32 respondents consisting of 16 respondents in the intervention group and 16 respondents in the control group. The research instrument used was Questionnaire Emotional Stability. The data analysis used an Independent t-test. Results: The results showed that there were differences in the average emotional stability between the intervention group and the control group with p = 0.000 (p <0.05). Conclusions: EFT therapy is highly recommended as one of the nursing interventions to increase emotional stability in adolescents.


INTRODUCTION
Adolescents are a valuable asset of the nation in realizing the progress of the country as a whole.It is said that because adolescents are the younger generation, that are the successors of the nation's ideals that are proven to be able to make changes (change agent) and solve problems i n a more creative, simple, and concise manner (Subiyakto, 2012).The involvement of adolescents in development is contained in the Regulation of the Minister of Women's Empowerment and Child Protection No. 03 of 2011 in Article 1, paragraph 2, which contains the policy on the participation of children in development.
Attention to adolescents has been attempted by the government, but t h e crime rates in adolescents is still high.Teenagers not only become the victims of criminal behavior, but they become adolescents who are the perpetrators of crime.The National Center for Juvenile Justice (NCJJ) 2014 said that law enforcement agencies in the United States caught 1.3 million adolescents under the age of 18 over the 2012 span.The majority of juvenile arrests were for theft ( 224,200 cases).In the arrest, as many as 4 out of 10 (42%) arrests included women, 29% involved 15 year-olds, and 61% of them were white teenagers (Sickmund, 2014).
In Indonesia, the prevalence of t he complaints focused on child crimes in 2014 according to the Indonesian Child Protection Commission (KPAI) (2016) found that there were 445 complaints with 67 cases where child were the perpetrators of violence.This increased in 2015 to 79 cases.Based on t he data from UNICEF (2015) in 2014, there were 3,488 children in Indonesian penitentiary institutions and this decreased in March 2015 to 2,207 children.The decline was due to the diversions (coaching of the child).The cause of teenagers being in prisons is caused by various criminal cases.Based on t h e Child Trends Data Bank (2015) study on juvenile inmates in the United States, they found that about 44 adolescents out of the 100,000 adolescent population experienced detention because they were the perpetrators of rape.Meanwhile, Cahyaningtyas (2013), in his research in Prison Class II Blitar, found that the most dominant crime was rape at 41.4% followed by theft and murder at 20.7%.The rest was evenly spread over maltreatment, drugs, and extortion.
Negative emotions should be anticipated or even prevented so then the children do not feel depressed, t hus resulting in a greater psychological impact from mental development disorders.The psychological impact of detention on the convicted child is based on a report from the American Academy of Pediatrics (2014), indicating that the prevalence of psychiatric disorders among adolescents in the penitentiary was high at an average of 16.5% (range: 6.2% -41.3 %).The research conducted by Rahmawati et.al (2015) also showed that the adolescent depression was often due to the high detention rate.The results showed that o ut of t he 46 juvenile inmates, as many as 28 people (60.9%) experienced depression.Adolescents should be trained early on to have good emotional stability.Emotional stability aims to improve the quality of one's life such as self-acceptance, selfconfidence, achievement and self-concept.
There are various ways to improve emotional stability through appropriate emotional management.Many of the emotional management methods that have been developed and t h a t a r e effective for controlling emotions in prisoners use the Emotional Freedom Technique (EFT).EFT is one of the complementary forms of therapy developed by Gary Craig in the mid-1990s, as one variant of a new science of psychology called Energy Psychology.This is in which the technique combines psychotherapy and acupuncture techniques with tapping methods o n parts of the body to improve the body's energy systems that affect the state of mind, emotions and behavior (Zainuddin, 2008).
The effectiveness of EFT has been demonstrated in t he research by Shari et al (2014).The study explained that as many as 30 teenagers who underwent the procedure of Percutaneous Coronary Intervention (PCI) suffered from anxiety.Out of the 30 teenagers, 15 adolescents were given EFT intervention for 15 minutes, while t he rest were not given any treatment.The result was a significant difference in the decrease in the intensity of anxiety after EFT was administered compared to those not being given any treatment.
Based on the preliminary study in June 2017 at t h e Institution of Special Guidance of Children Class II i n Yogyakarta, t h e recorded number of detainee counted 33 children.All children were of the male gender.The Standard of Child Protective Capacity exceeds capacity.When t he researcher interviewed three prisoners, all of them said t h a t they often felt sad and suddenly angry with themselves.They felt regret for the crimes that they had done, which makes them feel afraid t h a t t h e y will lose their future.

MATERIALS AND METHODS
This research used a quantitative research a p p r o a c h using a preexperimental design.The approach (type) of the research used was a nonequivalent control group design (control group and experimental group).This study was conducted by grouping t h e sample members into the experimental and control groups (Notoatmodjo, 2015).The treatment group in this research were the respondents who had been using EFT to regulate emotional stability and and the control group were the respondents who did not do an intervention.Both groups were pretested and post-tested.The pre Test was done before the EFT and t h e post-test was done after the EFT.EFT was also administered to the control group one day later after the post-test.
Sampling in this research was done through the purposive sampling technique, thus account for all juvenile inmates in LPKA Class II in Yogyakarta.The characteristics of the study sample included the inclusion and exclusion criteria.The inclusion criteria of the intervention and control group were that they were willing to be a research respondent, that they were communicative and co-operative, that they had full awareness, and that they were of the male sex.
The exclusion criteria included inmates who were mentally ill, a nd t h e prisoners w h o w e r e receiving other pharmacological and non-pharmacological therapies to decrease their emotional instability.Next. the age of the respondent and the duration of their sentence was noted.The data collection tool used to measure emotional stability in this research was a questionnaire. This

RESULTS
The results of this study provided data on the characteristics of the respondents including age, t h e duration of their sentence, t h e univariate analysis results, and the influence of the Emotional Freedom Technique (EFT) on emotional stability, age and t h e duration of sentence with their emotional stability presented based on the results of bivariate analysis.
Based on the analysis results, we obtained t h a t the average length of the term of the adolescent's stay was 4.72 months, with a median 4 months (95% CI: 3.82 -5.62) with a standard deviation of 2.495.The lowest sentence was 1 month and the duration of the longest sentence was 11 months.It can be concluded that 95% believed that the average duration of a juvenile convict's sentence in LPKA Class II i n Yogyakarta in July 2017 was between 3.82 months and 5.62 months.
Based on Table 2 above, the results show that the p-value of t h e adolescent's age associated with emotional stability was p = 0,139.This equals p> 0.05, so it can be concluded that there is no relationship between t h e ag e o f t he adolescents with their teen emotional stability score.Furthermore, the p-value of the duration of the sentence is related to emotional stability, which is p = 0.861.The conclusion is that there is no correlation between the duration of the juvenile's sentence and the emotional stability score of the juvenile inmates (p> 0.05).The results of the research on the average score of the adolescent's emotional stability in LPKA Class II in Yogyakarta before getting EFT therapy was 64.06 with a standard deviation of 10.129.After the adolescents got EFT therapy, the result was 82.13 with a standard deviation of 12.010.Based on the results, there is a difference of value of the average score of emotional stability score, which was 18.7 .T h e statistic test result was p-value = 0,000.This means that at alpha 5% with a 95% confidence degree, there was a significant difference between the average emotional stability in LPKA Class II i n Yogyakarta before and after getting EFT therapy (p <0.05).
Table 4 explains that the results of the research concerning the average emotional stability score of the control group in LPKA Class II i n Yogyakarta in the pretest was 65,00 with a standard deviation of 8.702.The post-test of t h e control group was 65.63 with a standard deviation of 5.898.Based on these results, there is an the average value in the emotional stability score of 0.63 and t h e statistical test results obtained a p-value = 0.751.This means that at alpha 5% with a 95% confidence level, there is no significant difference between the mean of emotional stability in LPKA Class II i n Yogyakarta before and after getting EFT therapy (p> 0.05).
Based on Table 4.5, the results showed that the average score of emotional stability in LPKA Class II in Yogyakarta in t h e post-test of the intervention group was 82.13 with a standard deviation of 9.382.In the control group, this was 66.19 with a standard deviation of 12.010.This indicates that there is difference in the value of t h e mean score of emotional stability between t h e intervention group and control group equal to 15.94.The statistical test results obtained a p-value = 0.000.It can thus be concluded that there is a significant difference in the average of emotional stability in LPKA Class II in Yogyakarta, which shows that there is an influence from EFT on t h e emotional stability of juvenile inmates in LPKA Class II Yogyakarta (p <0.05).

DISCUSSION
The most common age was middle age (Anjaswarni, 2014).Age is one of the most important indicators when determining the maturity l e v e l of a person.Source: Analysis Data Primer (2017) Maturity here is not only physically, but also psychologically.The older a person's age, the more mature their thoughts, behavior, and mastery of their emotions will be (Hurlock, 2012).
Living in a penitentiary and away from a known person will make their psychological condition decline, especially for adolescents at the time w h e n adolescents are in transition.According to Sarwono (2015), teenagers characterize the transition period by searching for their identity, and the process of socialization and the support of t hei r family and peers is needed.Therefore, the process of the socialization approach is directed by the prison officers and t h e juvenile's supportive peers are needed.Therefore, any emotional pressure can be well controlled.Imprisonment is a life event that can cause stress, putting the individual at risk of depression (Reeder, Martin & Grifin, 2007in Hardiani, 2012).
Life inside LPKA is isolated from the outside environment, away from loved ones.This will cause psychological shock for teenagers, in addition to feelings of sadness, anxiety, anger and fear.This makes a juvenile prisoner vulnerable to mental health problems, especially those associated with the problem of emotional stability.
Most teenagers in jail have mental health problems such as depression, and have made suicide attempts.This problem is compounded by t h e adverse conditions experienced during imprisonment, where the adolescents have to adapt to the prison environment.During detention, adolescents experience isolation, boredom, intimidation, and stress (Ng et al., 2011).The adolescents should be supported by good moral reasoning (Desmita, 2007), self-study and socially responsible behavior (Haviguhurst, 1976) in Sobur, 2015).Teenagers who are in LPKA will experience the same situation, facilities and treatment as adults.Teenagers will feel depressed, a n d t h e i r independence is limited, away from their parents, family and closest friends, which means that the developmental tasks that teenagers should complete will be hampered.Child developmental tasks going i ncompleted results in unhappiness in adolescents, causing community rejection, and difficulty when trying to complete the task of developing into the next Stage of life (Havighurst, 1961in Yusuf, 2015).
The difficult conditions experienced by juvenile inmates causes t he teenagers to feel isolated, hollow, anxious and indecisive.Feelings of sadness, worry, fear and disappointment can make a prisoner difficult when i t c o m e s t o maintaining their emotional stability.In addition, activities that are routinely done every day wi l l make teenagers feel bored, a n d they w i l l tend not do their hobbies outdoors.The emotions of young adolescents entering LPKA tended to be due to the inability of t h e adolescents to adapt to the new environment, while t h e long-time adolescents in LPKA felt anxiety and fear in the face of their freedom.This causes most o f t h e m to feel the same emotional intensity though their length of time in detention was different.This study is in line with Helm's research (2014) and t h a t o f Mares (2016), which showed that there is no correlation between detention length and mental health in juveniles.
This research method refers to Zainudin (2008), who used Borrowing Benefits in the subject of t h e i r research.Furthermore, research on the effectiveness of EFT using the Borrowing Benefits method was done by Church, et al (2012) on 9 students who suffered f r o m severe depression with an average score of 23.44.The treatment group received four EFT sessions in groups for a period of 3 consecutive weeks.Each session lasted 90 minutes.After 3 weeks, the average depression score decreased to 6.08.This shows that the effect of EFT using the Borrowing Benefits method is very effective against depression.The effect of EFT has also been proven by Suh (2015) by examining the symptoms of anxiety and anger in adolescents in as many as 27 teenagers who have Hwabyung syndrome (HB) in Korea.Suh identified their starting capacity to reduce anxiety, anger, and emotional outbursts.Remeen then taught EFT for four weeks using the