Therapeutic Touch
Authors
Laura Pole, RN, MSN, OCNS, BCCT Senior Researcher
Read more Ms. Pole is an oncology clinical nurse specialist who has been providing integrative oncology clinical care, navigation, consultation and education services for more than 30 years. View profile.
Nancy Hepp, MS, BCCT Project Manager
Read more Ms. Hepp is a science researcher and communicator who has been writing and editing educational content on varied health topics for more than 20 years. View profile.
Last updated June 25, 2019.
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Key Points
- Therapeutic Touch® is a holistic therapy derived from ancient healing practices.
- TT incorporates the intentional and compassionate use of universal energy to promote balance and well-being.
- The Therapeutic Touch® International Association has established criteria and provides credentials for practitioners, mentors and teachers.
- One study shows positive effects of TT on bone cells.
- Although much of the research shows methodological problems, early clinical research in TT shows moderate effect on anxiety, stress-related conditions, pain and wound healing.
- TT poses no known safety concerns.
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Early in my practice as an oncology clinical nurse specialist, I became interested in complementary approaches to cancer. I participated in Therapeutic Touch® (TT) training and certification at our hospital. Then I studied further with Dr. Dolores Krieger, the nursing co-founder of Therapeutic Touch®. Staff nurses began referring patients and family members to me. Recipients reported feeling calmer and more peaceful. Most reported sleeping better after a treatment. Many reported significant pain relief.
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Karen was a 56-year-old operating room nurse with stage 3 ovarian cancer. My work with Karen began with conventional advanced practice nursing interventions, but after working together for some time, I told Karen about Therapeutic Touch®. She quickly agreed but said she was “skeptical.”
I first did TT with Karen in the hospital. She felt deeply calm and peaceful during and after TT. She slept better that night. I continued to treat her at her home. Her husband learned TT basics and did short sessions with Karen between my visits. This loving support brought them closer together.
One day Karen told me she had an allergic reaction to taxol (the chemotherapy of choice for her cancer). Her oncologist instructed the chemotherapy nurse to titrate the dose of a new second-line chemotherapy up each time, as long as Karen’s blood counts were good and she wasn’t having any dose-limiting side effects. A major potential complication of this regimen is suppression of red and white blood cell as well as platelet production. Karen was on this chemotherapy regimen for months. I continued to give her TT on a regular basis this whole time.
When Karen saw her oncologist after her chemotherapy was complete, she said his jaw dropped in disbelief when he saw the total cumulative dose that Karen was able to tolerate without ever requiring a transfusion or acquiring an infection. He apparently had never seen anything like this. Karen said she just smiled and thought to herself that the Therapeutic Touch® must have been the game changer. I can’t prove this, but Karen had no doubt in her mind that that’s what made the difference.
I needed to leave on vacation during the holidays. I told Karen that Dr. Krieger taught me how to administer TT remotely. Karen was open to trying it. I didn’t pre-arrange a time for the remote session. Halfway through my vacation I performed the distant TT for Karen and made note of the date and time. During my next visit, she asked me what I was doing at such and such time on such and such day. That was when I did the remote session! She said she suddenly felt very calm and sat down and concluded that I was doing TT for her. Then, she said she felt more energetic than she had in months and went down to clean out her basement to get ready for company. She said she had been meaning to do that for years, actually, but never had the energy to deal with it!
Karen the skeptic became a spokesperson for Therapeutic Touch®. She presented her “case” at several meetings of healthcare professionals. Telling others of her experience never ceased to touch her deeply. This matter-of-fact practical operating room nurse would often end her story with tears quietly running down her face. She had come to believe that some of the deepest truths are unexplainable and that love is so often present in the depth of healing.
Laura Pole
The Therapeutic Touch® International Association (TTIA) defines this energy therapy: “Therapeutic Touch® is a holistic, evidence-based therapy that incorporates the intentional and compassionate use of universal energy to promote balance and well-being."
The association also describes Therapeutic Touch® as "a contemporary interpretation of several ancient healing practices…an intentionally directed process of energy exchange during which the practitioner uses the hands as a focus to facilitate the rebalancing of another’s energy field in support of healing."
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The therapy was developed and researched by nurses, and most of its practitioners are nurses, although many non-nurses have been trained. It is a discipline that requires practice, and the Therapeutic Touch® International Association has established criteria and provides credentials for practitioners, mentors and teachers.
In this practice, basically a noncontact intervention, the TT practitioner administers the therapy through the hands. Treatments last about 10 to 20 minutes, and the recipient, who is fully clothed, sits in a chair or lies on a treatment table. The practitioner completes these steps:
- Centers in their intention
- Assesses the recipient’s energy field by holding hands a few inches from the body while moving them from head to foot
- Administers the intervention to mobilize the person’s energy field, continually balancing or rebalancing that field
- Puts closure on the session with an evaluation and final assessment
Some people who prefer not to be physically touched and/or prefer a “touch” intervention where they can be fully clothed may find TT appealing.
Therapeutic Touch® practitioners find the therapy useful for these effects:
- Facilitating relaxation and feelings of well-being
- Restoring balance by mobilizing a person’s own healing energies
- Enhancing the body’s effect on healing processes
- Relieving stress
- Supporting immune function, wound healing and bone repair
- Decreasing side effects of cancer treatment.
People’s responses to treatment are individualized, and some may require repeated sessions.
Clinical Practice Guidelines
2009 evidence-based clinical practice guidelines for integrative oncology conclude that therapies based on a philosophy of bioenergy fields are safe and may provide some benefit for reducing stress and enhancing quality of life. Only limited evidence is available regarding their efficacy for symptom management, including reducing pain and fatigue. The Society for Integrative Oncology gives a strong recommendation for these therapies:
- For reducing anxiety: grade 1B (strong recommendation, moderate-quality evidence)
- For pain, fatigue, and other symptom management: grade 1C (strong recommendation, low or very low quality evidence)
Treating the Cancer
Working against cancer growth or spread, improving survival, or working with other treatments or therapies to improve their anticancer action
Lab and Animal Studies
In a lab study, results of a highly controlled single-blind in vitro randomized controlled trial of TT on human osteoblasts (HOB) and on an osteosarcoma-derived cell line (SaOs2) led researchers to observe that TT "appears to increase human osteoblast DNA synthesis, differentiation and mineralization, and decrease differentiation and mineralization in a human osteosarcoma-derived cell line" compared to controls. In other words, TT promoted bone formation in normal cells and decreased formation in bone-cancer cells.
Early clinical research in TT shows moderate effect on anxiety, stress-related conditions, pain and wound healing.
Managing Side Effects and Promoting Wellness
Managing or relieving side effects or symptoms, reducing treatment toxicity, supporting quality of life or promoting general well-being
Clinical Evidence
“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.” In this context, early clinical research in TT shows moderate effect on anxiety, stress-related conditions, pain and wound healing.
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Natural Medicines database indicates that evidence shows TT as possibly being effective for general anxiety and anxiety related to chemotherapy in people with cancer. The database also lists TT as possibly effective for decreasing pain and depression and improving sleep in people with chronic pain, as well as reducing stress and inducing relaxation in non-cancer populations. Natural Medicines mentions that although some preliminary research shows TT’s usefulness in the following, evidence is not yet sufficient to rate its effectiveness:
- Pain related to breast biopsy
- Cancer-related pain
- Cancer-related quality of life
- Preoperative anxiety and sedation in women having breast cancer surgery
CAM-Cancer provides a summary of clinical trial studies on Therapeutic Touch® in cancer care. From a limited number of small trials, Therapeutic Touch® had the following effects:
- In a randomized controlled trial of 90 men with cancer, the effects of Therapeutic Touch® on pain-related parameters was compared to placebo and control. The authors concluded: “TT had a positive impact on the positive management of pain related parameters in cancer patients. Therefore, TT is suggested to be used by healthcare providers as a complementary method for managing pain and its parameters.”
- A separate randomized controlled trial studied TT’s effect on pain and fatigue in 90 cancer patients on chemotherapy. “The TT (significant) was more effective in decreasing pain and fatigue of the cancer patients undergoing chemotherapy than the usual care group, while the placebo group indicated a decreasing trend in pain and fatigue scores compared with the usual care group.”
- In a small non-randomized controlled trial of using TT in people with terminal cancer in palliative care, those receiving TT had improved well-being compared to those in the control group. This study had low methodological quality.
- A single-blind, randomized controlled trial assessed the effects of TT compared to placebo TT and control (no treatment) on chemotherapy-related nausea and vomiting in women with breast cancer. Statistically significant differences between the TT group and the control group were found. However, no differences were seen between the TT and the placebo TT group, suggesting that TT has non-specific effects.
According to the CAM-Cancer summary, “Based on the limited number of trials, it is not possible to draw conclusions about the effectiveness of Therapeutic Touch® for people with cancer.”
Based on the limited number of trials, it is not possible to draw conclusions about the effectiveness of Therapeutic Touch® for people with cancer.
CAM-Cancer
Cautions
Therapeutic Touch® poses no known safety concerns.
Note: BCCT has not conducted an independent review of research of Therapeutic Touch®. This summary draws primarily from the CAM-Cancer summary and other sources as noted.
- Therapeutic Touch International Association. Our Definition. Viewed July 17, 2018.
- Potter PJ. Energy therapies in advanced practice oncology: an evidence-informed practice approach. Journal of the Advanced Practitioner in Oncology, 2013 May-Jun; 4(3), 139–151.
- Potter PJ. Energy therapies in advanced practice oncology: an evidence-informed practice approach. Journal of the Advanced Practitioner in Oncology, 2013 May-Jun; 4(3), 139–151.
- Deng GE, Frenkel M et al. Evidence-based clinical practice guidelines for integrative oncology: complementary therapies and botanicals. Journal of the Society for Integrative Oncology. 2009 Summer;7(3):85-120.
- Jhaveri A, Walsh SJ, Wang Y, McCarthy M, Gronowicz G. Therapeutic Touch® affects DNA synthesis and mineralization of human osteoblasts in culture. Journal of Orthopaedic Research. 2008 Nov;26(11):1541-6.
- CAM-Cancer. Therapeutic Touch®. Viewed June 27, 2018.
- Peters RM. The effectiveness of Therapeutic Touch®: a meta-analytic review. Nursing Science Quarterly. 1999 Sep;12:52–61; Winstead-Fry P, Kijek J. An integrative review and meta-analysis of Therapeutic Touch® research. Alternative therapies in health and medicine. 1999 Jan;5:58–67.
- TRC Natural Medicines. Therapeutic Touch® (subscription required). Viewed June 26, 2018.
- Tabatabaee A, Tafreshi MZ et al. Effect of Therapeutic Touch® on pain related parameters in patients with cancer: a randomized clinical trial Materia Socio-Medica. 2016 Jun;28(3), 220–223.
- Aghabati N, Mohammadi E, Pour Esmaiel Z. The effect of Therapeutic Touch® on pain and fatigue of cancer patients undergoing chemotherapy. evidence-based complementary and alternative medicine. eCAM. 2010 Sep;7(3), 375–381.
- Giasson M, Bouchard L. Effect of Therapeutic Touch® on the wellbeing of persons with terminal cancer. Journal of Holistic Nursing. 1998 Sep;16:383–98.
- Matourypour P, Zare Z et al. An investigation of the effects of Therapeutic Touch® plan on acute chemotherapy-induced nausea in women with breast cancer in Isfahan, Iran, 2012-2013. Journal of Education and Health Promotion. 2015 Aug 6;4:61.
- CAM-Cancer: Therapeutic Touch®. Viewed June 26, 2018.
- CAM-Cancer: Therapeutic Touch®. Viewed June 26, 2018.
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