Therapeutic Touch


Therapeutic Touch (TT) is a type of hand-mediated “energy healing” technique. It has been proposed that TT can support people with cancer in managing physical and emotional symptoms including anxiety, stress, pain and fatigue.


The most recent, well-conducted systematic review (SR) including six randomised controlled trials (RCTs) on TT for cancer treatment toxicities reports the following findings. 

Pain: TT may reduce pain, but evidence is currently inconclusive due to methodological limitations. These findings are based on one SR including 4 RCTs.

Fatigue: TT may reduce fatigue, but evidence is inconclusive due to methodological limitations, based on findings from one RCT (n=90).
Chemotherapy-induced nausea and vomiting (CINV): TT may reduce CINV, but evidence is inconclusive due to methodological limitations, based on findings from one RCT (n=108).

Chemotherapy-induced nausea and vomiting (CINV): TT may reduce CINV, but evidence is inconclusive due to methodological limitations, based on findings from one RCT (n=108).

Anxiety: evidence is conflicting, only one of two available RCTs (n=82, n=35) reports significant effects.

Mood: No differences reported in one RCT (n=35). 

Quality of life: TT improved QoL compared with bed rest in one small RCT (n=20), but the study has   methodological limitations. 


No serious safety concerns are known, but information on side effects is very limited.


Ava Lorenc, CAM Cancer Collaboration. Therapeutic Touch [online document], February 2024.

Document history

Summary updated in March 2024 by Ava Lorenc. Assessed as up to date in September 2020 and January 2019 by Barbara Wider; updated in January 2017 and January 2015 by Helen Cooke. First published in September 2012 authored by Helen Cooke. Next update due in March 2027.


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 energy (Pierce 2007). 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.


TT was developed by American nurse Dr Dolores Krieger, Professor of Nursing at New York University and healer Dora Kunz 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 surface (Jackson 2008). 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 TT (Pierce 2007) and the exact prevalence of the use of TT for cancer patients is also unknown.


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.

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 healing. (TTIA 2024a). People with cancer who receive TT report that it helps them manage physical and emotional symptoms including pain and fatigue (Cadet 2022) and have described it as a fulfilling and multidimensional experience that facilitated personal growth (Kelly 2004).

Application and dosage

TT is an individualised intervention guided by clues gained from assessing an individual’s alleged energy field (Coakley 2012). 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 minutes (Coakley 2012). Several sessions may be recommended.

Mechanisms 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 surface (Coakley 2012). Energy healers have different beliefs about how and why the assumed energy healing works (Agdal 2011), with some suggestion it is a belief-based intervention (Garrett 2021).

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 cell (Jhaveri 2008). Biofield practices are often considered controversial as they do not fit conceptually within scientific thinking.

Legal issues 

The Therapeutic Touch International Association offers a credentialing programme in the US (TTIA 2024b). Therapeutic touch practitioners are not regulated healthcare professionals in most countries.

One systematic review (SR) published in 2023 included eight publications reporting six randomised controlled trials (RCTs) on therapeutic touch for cancer treatment toxicities (Hauptmann 2023). The SR is well conducted, with comprehensive searches and robust screening processes. However, it is unclear why meta-analysis was not conducted. For all outcomes, the SR authors conclude that there is no evidence of acceptable quality showing effectiveness as high-quality RCTs showed no effect while low-quality studies did.

Previous narrative reviews generally come to more positive conclusions, but they did not assess study quality/risk of bias or use systematic methods to identify and synthesise studies, so their findings are not reliable (Agdal 2011; Coakley 2012; Gonella 2014; Jackson 2008; Pierce 2007; Tabatabaee 2016).  

Supportive and palliative care 

Description of included trials 


The SR included 4 RCTs investigating pain: two in breast cancer n=82 and n=35, various cancers n=90, and female cancer patients n=90 (Hauptmann 2023). Two studies found no effect, two found significant effects, however, the SR authors conclude that there is no evidence of acceptable quality showing effectiveness.  


The SR included one RCT (n=90) which investigated fatigue, finding significant results compared to routine care/sham. However, they conclude that there is no evidence of acceptable quality showing effectiveness (Hauptmann 2023).

Chemotherapy-induces nausea and vomiting (CINV)

The SR included one RCT (n=108; reported in three papers) that investigated nausea (Hauptmann 2023). Short-term effects were found, however, the SR authors conclude that due to poor methodological quality of included RCT there is no evidence of effectiveness. 


The SR included two RCTs (n=82, n=35) which studied the effect of therapeutic touch on anxiety in patients with breast cancer/suspected breast cancer, only one of which found a significant effect (Hauptmann 2023). 


One of the above RCTs (n=35) also investigated mood, finding no differences. 

Quality of life

The SR included one small RCT (n=20) which investigated QoL, in terminal cancer patients, finding a significant effect compared to rest, but evidence is inconclusive due to study limitations (Hauptmann 2023). 


Adverse events

Therapeutic Touch has not been associated with any safety concerns. None of the studies included in the SR provided information on adverse events (Hauptmann 2023).


No contraindications are on record.


No interactions are on record.


No warnings are on record.

Agdal R, Helmbjorg J von B, Johannessen H. Energy healing for cancer: a critical review. Forsch Komplementmed 2011; 18(3):146-154. 

Cadet T, Davis C, Wilson P, and Elks J. The Experiences of Touch Therapies in Symptom Management of Rural and Regional Cancer Patients in Australia. Int J Ther Massage Bodywork, 2022; 15: 66-71.

Coakley AB, Barron AM. Energy therapies in oncology nursing. Semin Oncol Nurs 2012; 28(1):55-63. 

Garrett B, and Riou M. A rapid evidence assessment of recent therapeutic touch research, Nursing Open, 2021; 8: 2318-30.

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. 

Hauptmann, M., Kutschan S, Hübner J, Dörfler J. Bioenergy therapies as a complementary treatment: a systematic review to evaluate the efficacy of bioenergy therapies in relieving treatment toxicities in patients with cancer. J Cancer Res Clin Oncol, 2023; 149: 2607-19.

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. 

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.

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. 

Pierce B. The use of biofield therapies in cancer care. Clin J Oncol Nurs 2007; 11(2):253-258

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. 

TTIA 2023a, Therapeutic Touch® International Association website,  Accessed 23rd January 2024.

TTIA 2023b, Credentialing, Accessed 23rd January 2024.



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