Therapeutic Touch®

Our assessments of evidence for each medical benefit fall into one of these categories:

• Strong evidence: consistent, significant effects in several large (or at least one very large) well designed clinical studies or at least two meta-analysesa statistical analysis that combines the results of two or more research studies; the results of smaller research studies addressing the same or similar questions can be analyzed as though they are one bigger, more powerful study of clinical studies of moderate or better quality (or one large meta-analysis) finding similar results
• Good evidence: significant effects in one large or several mid-sized and well-designed clinical studies ( randomized controlled trialsa study design in which people are randomly assigned to either an experimental group or a control group to compare the outcomes from different treatments; an RCT is considered a strong design for determining a therapy’s effects with an appropriate placebo or other strong comparison control or observational studies that control for confounds)
• Modest evidence: significant effects in at least three small but well-designed randomized controlled trials (RCTs), or one or more well-designed, mid-sized clinical studies of reasonably good quality (RCTs or observationala type of study in which individuals are observed or certain outcomes are measured, but no attempt is made to affect the outcome (for example, no treatment is given); an example is a study that records people’s diets, but doesn’t try to alter their diets, and looks for patterns of disease or other outcomes related to different foods studies), or several small studies aggregated into a meta-analysis
• Preliminary evidence: significant effects in small or poorly designed clinical studies OR conflicting results in adequate studies but a preponderance of evidence of an effect
• Weak evidence: one or more case studies, supported by animal evidence OR small treatment effects of limited clinical significance OR studies with no controls OR weak trends of effects
• Insufficient evidence: preclinical evidence only OR clinical studies with such poor or unclear methodology that no conclusion can be drawn OR conflicting findings across clinical studies with no preponderance of evidence in one direction; conflicting evidence occurs when studies find conflicting effects (positive effect vs no effect or negative effect) with the same treatment and the same general study population (same cancer type, for example)

Learn more about how we research and rate therapies and practices in How We Rate Therapies ›

No evidence of an effectoverall, one or more studies did not demonstrate that a treatment or intervention led to an expected outcome; this does not always mean that there is no effect in clinical practice, but that the studies may have been underpowered (too few participants) or poorly designed. Larger, well-designed studies provide more confidence in making assessments. on anxiety among people with breast cancer treated with TT

• No evidence of an effect on anxiety or fearfulness among women with mammographically detected, nonpalpable breast lesions requiring biopsy treated with TT compared to sham TT in a small RCTrandomized controlled trial, a study design in which people are randomly assigned to either an experimental group or a control group to compare the outcomes from different treatments; an RCT is considered a strong design for determining a therapy’s effects⁴Frank LS, Frank JL et al. Does therapeutic touch ease the discomfort or distress of patients undergoing stereotactic core breast biopsy? A randomized clinical trial. Pain Medicine. 2007 Jul-Aug;8(5):419-24.

No evidence of an effectoverall, one or more studies did not demonstrate that a treatment or intervention led to an expected outcome; this does not always mean that there is no effect in clinical practice, but that the studies may have been underpowered (too few participants) or poorly designed. Larger, well-designed studies provide more confidence in making assessments. on overall mood during radiotherapy among women with breast cancer treated with Therapeutic Touch

• No evidence of an effect on overall mood during adjuvanttreatment applied after initial treatment for cancer, especially to suppress secondary tumor formation radiotherapy after conservative surgery among women with stage 1–2 breast cancer treated with Therapeutic Touch 3 times a week following radiation therapy compared to controls in a small controlled triala study design in which people are assigned to either an experimental group or a control group to compare the outcomes from different treatment; assignment is not random, and so this is not as strong a study design as a randomized controlled trial, but still stronger than an uncontrolled trial⁵Younus J, Lock M 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. Complementary Therapies in Medicine. 2015 Aug;23(4):612-6.

Preliminary evidencesignificant effects in small or poorly designed clinical studies OR conflicting results in adequate studies but a preponderance of evidence of an effect (this is the CancerChoices definition; other researchers and studies may define this differently) of less fatigue during chemotherapy among women with cancer treated with TT

• Less fatigue during chemotherapy among women with cancer treated with TT for 5 days compared to either placebo or no intervention; also less fatigue among those treated with placebo compared to no intervention starting with the second day in a small RCTrandomized controlled trial, a study design in which people are randomly assigned to either an experimental group or a control group to compare the outcomes from different treatments; an RCT is considered a strong design for determining a therapy’s effects⁶Aghabati 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. 2010 Sep;7(3):375-81.

No evidence of an effectoverall, one or more studies did not demonstrate that a treatment or intervention led to an expected outcome; this does not always mean that there is no effect in clinical practice, but that the studies may have been underpowered (too few participants) or poorly designed. Larger, well-designed studies provide more confidence in making assessments. on fatigue during adjuvant radiotherapy after conservative surgery among women with breast cancer treated with TT

• No evidence of an effect on fatigue during adjuvanttreatment applied after initial treatment for cancer, especially to suppress secondary tumor formation radiotherapy after conservative surgery among women with stage 1–2 breast cancer treated with Therapeutic Touch 3 times a week following radiation therapy compared to controls in a small controlled triala study design in which people are assigned to either an experimental group or a control group to compare the outcomes from different treatment; assignment is not random, and so this is not as strong a study design as a randomized controlled trial, but still stronger than an uncontrolled trial⁷Younus J, Lock M 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. Complementary Therapies in Medicine. 2015 Aug;23(4):612-6.

Modest evidencesignificant effects in at least three small but well-designed randomized controlled trials (RCTs), or one or more well-designed, mid-sized clinical studies of reasonably good quality (RCTs or observational studies), or several small studies aggregated into a meta-analysis (this is the CancerChoices definition; other researchers and studies may define this differently) of less nausea and vomiting during chemotherapy among women with breast cancer treated with TT

• Lower intensity of vomiting 24 hours after chemotherapy among women with breast cancer either with or without metastasis (except metastasis to central nervous and digestive systems) treated with a single 20-minute session of Therapeutic Touch before chemotherapy compared to controls (routine treatment) and a weak trendan apparent change due to a therapy, close to but not achieving full statistical significance (this is the CancerChoices definition; other researchers and studies may define this differently toward less intensity compared to sham TT in a mid-sized RCTrandomized controlled trial, a study design in which people are randomly assigned to either an experimental group or a control group to compare the outcomes from different treatments; an RCT is considered a strong design for determining a therapy’s effects⁸Matourypour P, Vanaki Z et al. Investigating the effect of therapeutic touch on the intensity of acute chemotherapy-induced vomiting in breast cancer women under chemotherapy. Iranian Journal of Nursing and Midwifery Research. 2016 May-Jun;21(3):255-60.
• Delayed onset and shorter duration of acute chemotherapy-induced nausea among women with breast cancer treated with TT compared to placebo or no treatment; those treated with placebo also showed less occurrence of nausea compared to no treatment in a mid-sized RCT⁹Matourypour 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.
• Lower duration, frequency, and intensity of nausea during chemotherapy among women with breast cancer treated with TT compared to placebo or no intervention in a small RCT¹⁰Vanaki Z, Matourypour P et al. Therapeutic touch for nausea in breast cancer patients receiving chemotherapy: composing a treatment. Complementary Therapies in Clinical Practice. 2016 Feb;22:64-8.

Preliminary (conflicting) evidencesignificant effects in small or poorly designed clinical studies OR conflicting results in adequate studies but a preponderance of evidence of an effect (this is the CancerChoices definition; other researchers and studies may define this differently) of less pain among people with cancer treated with TT

• Lower pain scores among men referred to oncology care treated with TT compared to either sham TT or usual care; sham TT also showed benefit compared to usual care in a small RCTrandomized controlled trial, a study design in which people are randomly assigned to either an experimental group or a control group to compare the outcomes from different treatments; an RCT is considered a strong design for determining a therapy’s effects¹¹Tabatabaee 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.
• Less interference from pain to general activity, mood, walking ability, relations to other people, or sleep among men with cancer-related pain treated with 7 Therapeutic Touch sessions during a 4-week period with at least 3 days between sessions compared to either sham TT or controls (routine care) in a small RCT¹²Tabatabaee 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.
• Less pain during chemotherapy among women with cancer treated with TT for 5 days with TT compared to either placebo or no intervention;  less pain among those treated with placebo compared to no intervention starting with the second day in a small RCT¹³Aghabati 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. 2010 Sep;7(3):375-81.
• No evidence of an effectoverall, one or more studies did not demonstrate that a treatment or intervention led to an expected outcome; this does not always mean that there is no effect in clinical practice, but that the studies may have been underpowered (too few participants) or poorly designed. Larger, well-designed studies provide more confidence in making assessments. on pain among women with mammographically detected, nonpalpable breast lesions undergoing biopsy treated with TT compared to sham TT in a small RCT¹⁴Frank LS, Frank JL et al. Does therapeutic touch ease the discomfort or distress of patients undergoing stereotactic core breast biopsy? A randomized clinical trial. Pain Medicine. 2007 Jul-Aug;8(5):419-24.

Preliminary evidencesignificant effects in small or poorly designed clinical studies OR conflicting results in adequate studies but a preponderance of evidence of an effect (this is the CancerChoices definition; other researchers and studies may define this differently) of greater well-being among people with terminal cancer treated with TT

• Greater sensation of well-being among people with terminal cancer in palliative carerelieving pain or suffering without dealing with the cause of the condition; palliative care is specialized medical care that focuses on providing patients relief from pain and other symptoms of a serious illness treated with TT compared to no intervention in a small controlled triala study design in which people are assigned to either an experimental group or a control group to compare the outcomes from different treatment; assignment is not random, and so this is not as strong a study design as a randomized controlled trial, but still stronger than an uncontrolled trial¹⁵Giasson M, Bouchard L. Effect of therapeutic touch on the well-being of persons with terminal cancer. Journal of Holistic Nursing. 1998 Sep;16(3):383-98.

No evidence of an effectoverall, one or more studies did not demonstrate that a treatment or intervention led to an expected outcome; this does not always mean that there is no effect in clinical practice, but that the studies may have been underpowered (too few participants) or poorly designed. Larger, well-designed studies provide more confidence in making assessments. on quality of life during adjuvanttreatment applied after initial treatment for cancer, especially to suppress secondary tumor formation radiotherapy after surgery among women with breast cancer treated with Therapeutic Touch

• No evidence of an effect on quality of life during adjuvant radiotherapy after conservative surgery among women with stage 1–2 breast cancer treated with Therapeutic Touch 3 times a week following radiation therapy compared to controls in a small controlled trial¹⁶Younus J, Lock M 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. Complementary Therapies in Medicine. 2015 Aug;23(4):612-6.

No evidence of an effectoverall, one or more studies did not demonstrate that a treatment or intervention led to an expected outcome; this does not always mean that there is no effect in clinical practice, but that the studies may have been underpowered (too few participants) or poorly designed. Larger, well-designed studies provide more confidence in making assessments. on radiation dermatitis or cosmetic outcomes during adjuvanttreatment applied after initial treatment for cancer, especially to suppress secondary tumor formation radiotherapy after surgery among women with breast cancer treated with Therapeutic Touch

• No evidence of an effect on grade of radiation dermatitis, time to develop worst grade, or cosmetic outcomes during adjuvant radiotherapy after conservative surgery among women with stage 1–2 breast cancer treated with Therapeutic Touch 3 times a week following radiation therapy compared to controls in a small controlled triala study design in which people are assigned to either an experimental group or a control group to compare the outcomes from different treatment; assignment is not random, and so this is not as strong a study design as a randomized controlled trial, but still stronger than an uncontrolled trial¹⁷Younus J, Lock M 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. Complementary Therapies in Medicine. 2015 Aug;23(4):612-6.

Therapeutic Touch and soft music: preliminary evidencesignificant effects in small or poorly designed clinical studies OR conflicting results in adequate studies but a preponderance of evidence of an effect (this is the CancerChoices definition; other researchers and studies may define this differently) of less reported confusion among women treated with TT and soft music

• Less reported confusion and tension and more vigor among healthy women treated with TT and soft music compared to no intervention in a small RCTrandomized controlled trial, a study design in which people are randomly assigned to either an experimental group or a control group to compare the outcomes from different treatments; an RCT is considered a strong design for determining a therapy’s effects¹⁸Lafreniere KD, Mutus B et al. Effects of therapeutic touch on biochemical and mood indicators in women. Journal of Alternative and Complementary Medicine. 1999 Aug;5(4):367-70.

TT and dialogue: no evidence of an effectoverall, one or more studies did not demonstrate that a treatment or intervention led to an expected outcome; this does not always mean that there is no effect in clinical practice, but that the studies may have been underpowered (too few participants) or poorly designed. Larger, well-designed studies provide more confidence in making assessments. on mood before or after surgery or pain after surgery among women with breast cancer treated at home with Therapeutic Touch and dialogue

• No evidence of an effect on mood before or after surgery or pain after surgery among women with breast cancer treated at home with 10 minutes of Therapeutic Touch and 20 minutes of dialogue within 7 days before surgery compared to 10 minutes of quiet time and 20 minutes of dialogue in a small controlled triala study design in which people are assigned to either an experimental group or a control group to compare the outcomes from different treatment; assignment is not random, and so this is not as strong a study design as a randomized controlled trial, but still stronger than an uncontrolled trial¹⁹Samarel N, Fawcett J, Davis MM, Ryan FM. Effects of dialogue and therapeutic touch on preoperative and postoperative experiences of breast cancer surgery: an exploratory study. Oncology Nursing Forum. 1998 Sep;25(8):1369-76.

Preliminary evidence of lower state anxiety before surgery but no evidence of an effect after surgery among women with breast cancer treated at home with Therapeutic Touch and dialogue

• Lower state anxiety before surgery but no evidence of an effect after surgery among women with breast cancer treated at home with 10 minutes of Therapeutic Touch and 20 minutes of dialogue within 7 days before surgery compared to 10 minutes of quiet time and 20 minutes of dialogue in a small controlled trial²⁰Samarel N, Fawcett J, Davis MM, Ryan FM. Effects of dialogue and therapeutic touch on preoperative and postoperative experiences of breast cancer surgery: an exploratory study. Oncology Nursing Forum. 1998 Sep;25(8):1369-76.

Anxiety: preliminary evidencesignificant effects in small or poorly designed clinical studies OR conflicting results in adequate studies but a preponderance of evidence of an effect (this is the CancerChoices definition; other researchers and studies may define this differently) of less anxiety among people treated with TT

• Less anxiety and greater comfort among elders in nursing homes treated with TT compared to controls in 2 small controlled trialsa study design in which people are assigned to either an experimental group or a control group to compare the outcomes from different treatment; assignment is not random, and so this is not as strong a study design as a randomized controlled trial, but still stronger than an uncontrolled trial²¹Alp FY, Yucel SC. The effect of therapeutic touch on the comfort and anxiety of nursing home residents. Journal of Religion and Health. 2021 Jun;60(3):2037-2050; Yücel ŞÇ, Arslan GG, Bagci H. Effects of hand massage and therapeutic touch on comfort and anxiety living in a nursing home in Turkey: a randomized controlled trial. Journal of Religion and Health. 2020 Feb;59(1):351-364.
• Lower anxiety among healthy women treated with TT and soft music compared to baseline, while no reduction with no intervention in a small comparison trial²²Lafreniere KD, Mutus B et al. Effects of therapeutic touch on biochemical and mood indicators in women. Journal of Alternative and Complementary Medicine. 1999 Aug;5(4):367-70.
• Less anxiety among elderly people treated with 20 minutes of Therapeutic Touch for 3 consecutive days compared to either sham TT (mimic touch) or standard care in a small RCTrandomized controlled trial, a study design in which people are randomly assigned to either an experimental group or a control group to compare the outcomes from different treatments; an RCT is considered a strong design for determining a therapy’s effects²³Lin Y-S, Taylor AG. Effects of Therapeutic Touch in reducing pain and anxiety in an elderly population. Integrative Medicine 1998;1(4):155-162.
• Less anxiety among burn patients treated with Therapeutic Touch once a day for 5 days compared to sham TT in a small RCT²⁴Turner JG, Clark AJ, Gauthier DK, Williams M. The effect of therapeutic touch on pain and anxiety in burn patients. Journal of Advanced Nursing. 1998 Jul;28(1):10-20.

Pain: modest evidencesignificant effects in at least three small but well-designed randomized controlled trials (RCTs), or one or more well-designed, mid-sized clinical studies of reasonably good quality (RCTs or observational studies), or several small studies aggregated into a meta-analysis (this is the CancerChoices definition; other researchers and studies may define this differently) of less pain among people treated with TT

• 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 RCT²⁵Mueller G, Palli C, Schumacher P. The effect of Therapeutic Touch on back pain in adults on a neurological unit: an experimental pilot study. Pain Management Nursing. 2019 Feb;20(1):75-81.
• Lower level of pain after vascular surgery among people recovering from with TT compared to standard care in a small controlled trial²⁶Coakley AB, Duffy ME. The effect of therapeutic touch on postoperative patients. Journal of Holistic Nursing. 2010 Sep;28(3):193-200.
• Less pain severity among people with osteoarthritis of the knee treated with Therapeutic Touch compared to either sham TT or no intervention in a small RCT²⁷Gordon A, Merenstein JH, D’Amico F, Hudgens D. The effects of therapeutic touch on patients with osteoarthritis of the knee. Journal of Family Practice. 1998 Oct;47(4):271-7.
• Less pain among elderly people treated with 20 minutes of Therapeutic Touch for 3 consecutive days compared to either sham TT (mimic touch) or standard care in a small RCT²⁸Lin Y-S, Taylor AG. Effects of Therapeutic Touch in reducing pain and anxiety in an elderly population. Integrative Medicine 1998;1(4):155-162.
• Less pain among burn patients treated with Therapeutic Touch once a day for 5 days compared to sham TT in a small RCT²⁹Turner JG, Clark AJ, Gauthier DK, Williams M. The effect of therapeutic touch on pain and anxiety in burn patients. Journal of Advanced Nursing. 1998 Jul;28(1):10-20.
• Less pain among people with tension headache pain treated with Therapeutic Touch compared to placebo (sham TT) in a small RCT³⁰Keller E, Bzdek VM. Effects of therapeutic touch on tension headache pain. Nursing Research. 1986 Mar-Apr;35(2):101-6.

Preliminary evidence of higher comfort scores after bone marrow transplant among people treated with Therapeutic Touch

• Higher comfort scores after bone marrow transplant among people treated with Therapeutic Touch every third day beginning the day chemotherapy began until discharge from the program compared to controls receiving a “friendly visit” in a small RCT³¹Smith MC, Reeder F, Daniel L, Baramee J, Hagman J. Outcomes of touch therapies during bone marrow transplant. Alternative Therapies in Health and Medicine. 2003 Jan-Feb;9(1):40-9.

Stress or tension: preliminary evidence of less emotional distress among people with osteoarthritis of the knee treated with Therapeutic Touch

• Less emotional (affective) distress among people with osteoarthritis of the knee treated with Therapeutic Touch compared to either sham TT or no intervention in a small RCT³²Gordon A, Merenstein JH, D’Amico F, Hudgens D. The effects of therapeutic touch on patients with osteoarthritis of the knee. Journal of Family Practice. 1998 Oct;47(4):271-7.

Wound healing: insufficient evidencepreclinical evidence only OR clinical studies with such poor or unclear methodology that no conclusion can be drawn OR conflicting findings across clinical studies with no preponderance of evidence in one direction; conflicting evidence occurs when studies find conflicting effects (positive effect vs no effect or negative effect) with the same treatment and the same general study population (same cancer type, for example) (this is the CancerChoices definition; other researchers and studies may define this differently) of better wound healing among people treated with TT

• Mixed results of better healing, worse healing, and no evidence of an effect across a review of 4 RCTs and quasi-RCTs³³O’Mathúna DP. Therapeutic touch for healing acute wounds. Cochrane Database Syst Rev. 2016 Aug 23;(8):CD002766.

Transplant complications: no evidence of an effectoverall, one or more studies did not demonstrate that a treatment or intervention led to an expected outcome; this does not always mean that there is no effect in clinical practice, but that the studies may have been underpowered (too few participants) or poorly designed. Larger, well-designed studies provide more confidence in making assessments. on time for engraftment or complications after bone marrow transplant among people treated with Therapeutic Touch

• No evidence of an effect on time for engraftment or complications after bone marrow transplant among people treated with Therapeutic Touch every third day beginning the day chemotherapy began until discharge from the program compared to controls receiving a “friendly visit” in a small RCT³⁴Smith MC, Reeder F, Daniel L, Baramee J, Hagman J. Outcomes of touch therapies during bone marrow transplant. Alternative Therapies in Health and Medicine. 2003 Jan-Feb;9(1):40-9.