MD, PhD, MAE, FMedSci, FRSB, FRCP, FRCPEd.

Therapeutic touch (TT) is a form of paranormal or energy healing developed by Dora Kunz (1904-1999), a psychic and alternative practitioner, in collaboration with Dolores Krieger, a professor of nursing. TT is popular and practised predominantly by US nurses; it is currently being taught in more than 80 colleges and universities in the U.S., and in more than seventy countries. According to one TT-organisation, TT is a holistic, evidence-based therapy that incorporates the intentional and compassionate use of universal energy to promote balance and well-being. It is a consciously directed process of energy exchange during which the practitioner uses the hands as a focus to facilitate the process.

The question is: does TT work beyond a placebo effect?

This review synthesized recent (January 2009–June 2020) investigations on the effectiveness and safety of therapeutic touch  (TT) as a therapy in clinical health applications. A rapid evidence assessment (REA) approach was used to review recent TT research adopting PRISMA 2009 guidelines. CINAHL, PubMed, MEDLINE, Cochrane databases, Web of Science, PsychINFO, and Google Scholar were screened between January 2009-March 2020 for studies exploring TT therapies as an intervention. The main outcome measures were for pain, anxiety, sleep, nausea, and functional improvement.

Twenty-one studies covering a range of clinical issues were identified, including 15 randomized controlled trials, four quasi-experimental studies, one chart review study, and one mixed-methods study including 1,302 patients. Eighteen of the studies reported positive outcomes. Only four exhibited a low risk of bias. All others had serious methodological flaws, bias issues, were statistically underpowered, and scored as low-quality studies. Over 70% of the included studies scored the lowest score possible on the GSRS weight of evidence scale. No high-quality evidence was found for any of the benefits claimed.

The authors drew the following conclusions:

After 45 years of study, scientific evidence of the value of TT as a complementary intervention in the management of any condition still remains immature and inconclusive:

  • Given the mixed result, lack of replication, overall research quality and significant issues of bias identified, there currently exists no good quality evidence that supports the implementation of TT as an evidence‐based clinical intervention in any context.
  • Research over the past decade exhibits the same issues as earlier work, with highly diverse poor quality unreplicated studies mainly published in alternative health media.
  • As the nature of human biofield energy remains undemonstrated, and that no quality scientific work has established any clinically significant effect, more plausible explanations of the reported benefits are from wishful thinking and use of an elaborate theatrical placebo.

TT turns out to be a prime example of a so-called alternative medicine (SCAM) that enthusiastic amateurs, who wanted to prove TT’s effectiveness, have submitted to multiple trials. Thus the literature is littered with positive but unreliable studies. This phenomenon can create the impression – particularly to TT fans – that the treatment works.

This course of events shows in an exemplary fashion that research is not always something that creates progress. In fact, poor research often has the opposite effect. Eventually, a proper scientific analysis is required to put the record straight (the findings of which enthusiasts are unlikely to accept).

In view of all this, and considering the utter implausibility of TT, it seems an unethical waste of resources to continue researching the subject. Similarly, continuing to use TT in clinical settings is unethical and potentially dangerous.

11 Responses to Therapeutic Touch: “no quality scientific work has established any clinically significant effect”

  • Obligatory.

    Takeaway line:

    Perhaps the most important takeaway from this story is the democratic nature of the scientific method. A young child was able to devise an experiment that allowed her to test a given claim. This is precisely why any belief system that does not permit for such objective scrutiny should be viewed with much suspicion if not derision.

    Science works to disprove its own claims. SCAM works to confirm its own claims.

    Does this mean science knows something that SCAM does not?

  • Edzard says:
    “Similarly, continuing to use TT in clinical settings is unethical and potentially dangerous”.

    **Potentially dangerous,

    If you make a claim in a comment, support it with evidence.
    Can you support this claim with convincing incidents that have happened with TT?

    • anyone who thinks TT is effective and thus uses it to treat a serious condition brings him/herself in danger.
      simple logic which needs no experimental evidence [bungee jumping without attaching the elastic is dangerous; no evidence needed]

  • TT is –never– used to treat a serious condition; -everybody- knows that.
    Main purpose is stress and fear reduction..
    Why so many hospitals and hospices work with TT and see this is as an
    useful complementary treatment ?

    https://pubmed.ncbi.nlm.nih.gov/9849260/

    • “never” is certainly the wrong word in this context [and I did write POTENTIALLY]
      why do so many hospitals… ? [2 fallacies in one: appeal to authority and appeal to popularity]]

    • “-everybody- knows that”

      LOL. Alties do “know” lots of things.

      “Main purpose is stress and fear reduction..”

      A nice cup of tea, a shoulder rub, and a chat would do that. So why the need for pseudomedical deception?

      Heck, even a prayer meet would be better; at least it’s honest that it’s religion.

  • All the high academics in all these institutions of higher learning offering such courses, are brought low, ethically and academically, by the 1998 published work of nine-year-old Emily Rosa.

  • I did search the Emily Rosa experiment and I have the opinion that it isn’t a high quality, or maybe a valid, experiment. What I’m writing here is an opinion and I don’t claim that it is correct. Your view of the matter would be greatly appreciated:

    1. According to Science-based Medicine Lecture 9: Pitfalls in Research by Harriet Hall, MD ( https://www.youtube.com/watch?v=hei-RDwANaI ) a group should have at least 50 subjects (Bausell’s Quick Checklist) so that the study can have more reliable results. This study was conducted in two parts. The group of the first part had 15 subjects and the group of the second had 7 people of the first part plus 6 people more.

    –> Is it a really small amount of participants for a study to be considered valid?

    2. The study was conducted in two parts. For the first part “the participants were informed that the study would be published as Emily Rosa’s 4th grade science fair project and gave their consent to be tested”. The study was held “at their homes or offices at different days for a period of several months”. This first part, as I have understood so far, was not video recorded. There should, in my opinion, have been a camera near-by, so that the healers could later verify and see what happened ‘behind the veil’ of what they could see when doing the experiment. In any way, this makes it difficult for us, too, to be able to see the whole process.

    –> Is there a way to prove that the hands of the person whose aura had to be scanned were truly in the 8-10 cm distance from the palms of the healers? Is there a way to prove that (all of) these 1st part experiments were truly conducted?

    3. “The decision to submit the results in a scientific journal was made several months later after people who heard about the results encouraged publication”.

    –> Were the healers from the first part informed about this decision? Did they all agree with it?

    4. The study can be found in many online sources. For example: https://jamanetwork.com/journals/jama/fullarticle/187390 . “Participants in the 2nd series were informed that the test would be videotaped for possible broadcast and gave their consent”.

    –> Is there any way for us to be able to see, apart from the published study, also the 1-day experiment, the one that was video-taped?

    5. The first part of the research was conducted, if I have understood properly, not as a first part of a scientific study, but as a stand-alone school-type experiment. I think it was later, when the formal experiment was conducted in a more strictly controlled way, that the school-type experiement was called a “part 1 study”.

    –> Should both of these parts, that were publised as part one and part two in a prestigeous journal, be considered of equal scientific value?

    6. The study concludes that “Their failure to substantiate TT’s most fundamental claim is unrefuted evidence that the claims of TT are groundless and that further professional use is unjustified.” This conclusion would, in my opinion, be valid only if we already, even before the experiments, knew with certainty that the TT energy field doesn’t exist. Otherwise, we would have to take into consideration that these 21 participants were not so good healers, or that some other cause could be the reason for the seeming failure, etc. In any way, only one study, even if the study is properly conducted, with more than 50 participants, etc, even then only one study isn’t enough to reach a certain conclusion that a drug, a practice, etc, works or doesn’t work. We can all have our own beliefs, that the TT field exists or that it doesn’t exist, but, scientifically speaking, conducting such an experiment implies by definition that we don’t yet know if TT is a valid theory or not.

    With most respect

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