Therapeutic Touch

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.

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:

1. Centers in their intention
2. Assesses the recipient’s energy field by holding hands a few inches from the body while moving them from head to foot
3. Administers the intervention to mobilize the person’s energy field, continually balancing or rebalancing that field
4. 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.³

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:⁸

• 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:

• 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.”⁹
• 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.¹⁰
• 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.¹¹

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.”¹²

Anxiety

Fatigue and Sleep Quality

• Less fatigue and daytime sleepiness, and greater sleep quality, among students of nursing and midwifery with TT compared to sham TT or no intervention in a small RCT¹³

Nausea and Vomiting

• Delayed onset and shorter duration of acute chemotherapy-induced nausea with Therapeutic Touch compared to placebo and no treatment among women with breast cancer in a mid-sized RCT¹⁴

Pain

• Moderately less pain in a review of RCTs and controlled trials¹⁵
• Lower pain scores among people with back pain diagnosis on hospital admission with Therapeutic Touch added to standard treatment compared to standard treatment alone in a small RCT¹⁶
• Lower pain scores among men referred to oncology care with TT compared to both sham TT and usual care; sham TT also showed benefit compared to usual care in a small RCT¹⁷

Studies not specific to cancer:

• Less anxiety and greater comfort among elders in nursing homes in small controlled trials¹⁸