Therapeutic Touch is a type of hand-mediated “energy healing” technique.
Although results from two randomized controlled trials and one small preliminary trial suggest that therapeutic touch may have positive effects on pain and fatigue there is currently no strong evidence that it is an effective modality for supportive cancer care. Only few trials per outcome are available and all trials have methodological limitations. One trial of therapeutic touch for chemotherapy-related nausea and vomiting suggest non-specific effects while one case-control study reports no positive effects on radiotherapy-induced dermatitis.
No serious safety concerns are known.
Citation
Helen Cooke, CAM Cancer Consortium. Therapeutic Touch [online document], August 25, 2020.
Document history
Latest update: September 2020
Next update due: September 2023
Description
Therapeutic Touch (TT) is based on the belief that “energy fields” (also known as chi, qi, ki or prana) surround and penetrate the human body. Therapeutic touch practitioners are taught that disease or disorder can be detected in the energy system and affected therapeutically by smoothing or relieving congested energy1. Energy or biofield practices are often considered controversial as they do not fit conceptually within scientific thinking.
Please also see our CAM-Cancer summaries on Qigong and Reiki.
Components
TT practitioners are trained to work with the alleged energy fields to facilitate healing and relaxation. Usually healers conceive energy as something they receive, or channel, from an external universal energy source and transfer through their hands to the patients.
Application and dosage
TT is an individualised intervention guided by clues gained from assessing an individual’s alleged energy field2. A TT session typically involves three phases. The initial phase involves a process whereby the practitioner adopts a meditative quiet state. The second phase is an assessment phase where the practitioner uses their hands to sense areas around the body that feel imbalanced. The practitioner then uses slow, symmetric movements of his/her hands over the energy field with the goal of ‘smoothing out’ or relieving energy congestion. Finally the practitioner evaluates the session. An intervention usually lasts between 10 and 20 minutes2. Several sessions may be recommended.
History/provider(s)
TT was developed by an American nurse Dr Dolores Krieger (Professor of Nursing at New York University) and her colleague Dora Kunz (a healer) in the 1970s as a procedure for the assessment and treatment of the human biofield. Krieger and Kunz based their theory of TT on the assertions of nurse theorist Martha Rogers. Rogers claimed that humans are surrounded by energy fields that extend from the skin’s surface3. The training was initially developed for nurses, but training is now also open to other health professionals. It has been estimated that 200,000 individuals have been trained to practise TT since the 1970s, about 60% of whom are nurses. It is not known how many nurses are currently practising TT1.
Claims of efficacy/ alleged indication
It has been proposed that TT can be effective in decreasing anxiety, decreasing stress, evoking a relaxation response, decreasing pain and promoting wound healing4. People with cancer who receive TT have described it as a fulfilling and multidimensional experience that facilitated personal growth5.
Mechanism(s) of action
The underlying assumption of TT is based on the belief that energy fields (also known as chi, qi, ki or prana) surround and penetrate the human body and that when a person is ill or stressed the usual balanced flow of energy is interrupted and can become congested. This energy field is considered to extend a few inches beyond the skin’s surface2. Energy healers have different beliefs about how and why the assumed energy healing works6. An in-vitro study of TT was shown to significantly increase human osteoblast DNA synthesis, differentiation and mineralisation and decrease the differentiation and mineralisation in a human osteosarcoma-derived cell7. Biofield practices are often considered controversial as they do not fit conceptually within scientific thinking.
Prevalence of use
A European Survey of cancer patients reported that 2.1% of respondents used some form of energy therapy after their cancer diagnosis and 2% of respondents were using some form of energy therapy before their diagnosis8. The exact prevalence of the use of TT for cancer patients is unknown.
Legal issues
The Therapeutic Touch International Association offers a credentialing programme in the US4. Therapeutic touch practitioners are not regulated healthcare professionals in most countries
Cost(s) and expenditures
Some TT practitioners do not charge for treatments, others charge around €40 - €60 per session.
Three randomized controlled trials (one reported as 9-11,12,13), one small non-randomized controlled trial14 and one open-label case-control study15 are available. These trials have been included in various combinations in seven literature reviews1-3,6,16-18, sometimes in combination with qualitative studies. Although some trials suggest that Therapeutic Touch (TT) may reduce pain, fatigue and improve general well-being the evidence is not consistent and all individual studies have methodological limitations (also highlighted by the reviews).
Controlled clinical trials
A randomized clinical trial (RCT) evaluated the effect of TT on pain-related parameters of in 90 male patients with cancer9. The intervention consisted of TT in 7 sessions for a 4-week period, placebo TT (hands were placed around the body as a gesture, with distance from the body, and were moved without a certain order) or standard care. Several parameters on pain scales were assessed: general activity, mood, walking ability, relations with other people and sleep. At the end of the TT sessions, significant differences were observed between the three groups (p= 0.001). The differences were significant between the TT and placebo TT groups as well as between the TT and untreated control groups but not between the placebo TT and control group.
A further RCT examined the effects of TT onpain and fatigueof cancer patients (n=90) undergoing chemotherapy10. Patients received TT (30 min, once a day for 5 days), placebo (“mimic”) TT or standard care. The authors reported significant decreases in both VAS-measured pain and in the Rhoten Fatigue Scale for TT groups compared to placebo TT or standard care. The placebo group indicated a trend in decreasing pain and fatigue scores compared with the usual care group.
A single-blind RCT (Matourypour 2015, Matourypour 2016, Vanaki 2016) assessed the effects of TT (once for 20 min on the aura/human energy field focusing on solar chakra) compared to placebo TT (pretending to perform TT) and control (no treatment) on chemotherapy-induced nausea and vomiting in women with breast cancer11-13. Although statistically significant differences between the no treatment control group and the TT group and between the no treatment control group and the placebo TT group were reported, no difference between the real and placebo TT groups was noted suggesting non-specific effects of TT.
Preliminary data are available from a small non-randomised controlled trial (n=20) in persons with terminal cancer in palliative care14. Participants received three non-contact TT treatments (n = 10), participants in the control group (n = 10) participated in three rest periods. The authors report improved well-being assessed using the a visual analogue scale measuring pain, nausea, depression, anxiety, shortness of breath, activity, appetite, relaxation, and inner peace. The methodological quality of the study was however rated as very low.
A case-control, open-label pilot study evaluated the feasibility of TT in preventing radiotherapy dermatitis in women with breast cancer (n= 49)15. Although the intervention was considered feasible, there was no difference between cohorts for the overall EORTC cosmetic score and there was no significant difference in before and after study levels in quality of life, mood and fatigue. The control cohort who did not receive TT (n=32) were recruited after the study. The cohort had the same inclusion/exclusion criteria and followed the same study schedule as the experimental cohort but did not receive TT.
Adverse events
Therapeutic Touch has not been associated with any safety concerns. No adverse events were reported in the studies included in this summary.
Contraindications
No contraindications are on record.
Interactions
No interactions are on record.
Warnings
No warnings are on record.
- Pierce B. The use of biofield therapies in cancer care. Clin J Oncol Nurs 2007; 11(2):253-258
- Coakley AB, Barron AM. Energy therapies in oncology nursing. Semin Oncol Nurs 2012; 28(1):55-63. Accessed 15th of September 2020.
- Jackson E, Kelley M, McNeil P, Meyer E, Schlegel L, Eaton M. Does therapeutic touch help reduce pain and anxiety in patients with cancer? Clin J Oncol Nurs 2008; 12(1):113-120. Accessed 15th of September 2020.
- Therapeutic Touch website. Accessed 15th of September 2020.
- Kelly AE, Sullivan P, Fawcett J, Samarel N. Therapeutic touch, quiet time, and dialogue: perceptions of women with breast cancer. Oncol Nurs Forum 2004; 31(3):625-631. Accessed 15th of September 2020.
- Agdal R, von BH, Johannessen H. Energy healing for cancer: a critical review. Forsch Komplementmed 2011; 18(3):146-154. Accessed 15th of September 2020.
- Jhaveri A, Walsh SJ, Wang Y, McCarthy M, Gronowicz G. Therapeutic touch affects DNA synthesis and mineralization of human osteoblasts in culture. J Orthop Res 2008; 26(11):1541-1546. Accessed 15th of September 2020.
- Molassiotis A et al. Use of complementary and alternative medicine in cancer patients: a European survey. Annals of Oncology 2005; 16: 655-653. Accessed 15th of September 2020.
- Tabatabaee A, Tafreshi MZ, Rassouli M, Aledavood SA, AlaviMajd H, Farahmand SK. Effect of therapeutic touch on pain related parameters in patients with cancer: a randomized clinical trial. Mater Sociomed 2016;28:220-3. Accessed 15th of September 2020.
- Aghabati N, Mohammadi E, Pour Esmaiel Z. The effect of therapeutic touch on pain and fatigue of cancer patients undergoing chemotherapy. Evid Based Complement Alternat Med 2010;7:375-81. Accessed 15th of September 2020.
- Matourypour P, Zare Z, Mehrzad V, Musarezaie A, Dehghan M, Vanaki Z. An investigation of the effects of therapeutic touch plan on acute chemotherapy-induced nausea in women with breast cancer in Isfahan, Iran, 2012-2013. J Educ Health Promot. 2015 Aug 6;4:61. eCollection 2015. Accessed 15th of September 2020.
- Matourypour P, Vanaki Z, Zare Z, Mehrzad V, Dehghan M, Ranjbaran M. Investigating the effect of therapeutic touch on the intensity of acute chemotherapy-induced vomiting in breast cancer women under chemotherapy. Iran J Nurs Midwifery Res. 2016 May-Jun;21(3):255-60. Accessed 15th of September 2020.
- Vanaki Z, Matourypour P, Gholami R, Zare Z, Mehrzad V, Dehghan M. Theraeutic touch for nausea in breast cancer patients receiving chemotherapy: Composing a treatment. Complement Ther Clin Pract 2016;22:64-8. Accessed 15th of September 2020.
- Giasson M, Bouchard L. Effect of therapeutic touch on the wellbeing of persons with terminal cancer. J Holist Nurs. 1998;16:383–98. Accessed 15th of September 2020.
- Younus J, Lock M, Vujovic O, Yu E, Malec J, D'Souza D, et al. A case-control, mono-center, open-label, pilot study to evaluate the feasibility of therapeutic touch in preventing radiation dermatitis in women with breast cancer receiving adjuvant radiation therapy. Complement Ther Med 2015;23(4):612-6. Accessed 15th of September 2020.
- Tabatabaee A, Tafreshi MZ, Rassouli M, Aledavood SA, AlaviMajd H, Farahmand SK. Effect of Therapeutic Touch in Patients with Cancer: a Literature Review. Medical Archives (Sarajevo, Bosnia and Herzegovina). 2016;70(2):142-7. Accessed 15th of September 2020.
- Gonella S, Garrino L, Dimonte V. Biofield therapies and cancer-related symptoms: a review. Clinical Journal Oncology Nursing. 2014;18(5):568-76. Epub 2014/09/26. Accessed 15th of September 2020.
- Jain S, Mills PJ. Biofield therapies: helpful or full of hype? A best evidence synthesis. Int J Behav Med 2010; 17(1):1-16. Accessed 15th of September 2020.
