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)

• 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 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 effects³Frank 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.
• Lower state anxiety before surgery among women with breast cancer treated with TT and dialogue compared to quiet time and dialogue in a small RCT⁴Samarel 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.

• 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 effects⁵Aghabati 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.

• 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 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 effects⁶Matourypour 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 RCT⁷Vanaki 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.

• 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 effects⁸Tabatabaee 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 RCT⁹Aghabati 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 difference in pain among women with mammographically detected, nonpalpable breast lesions undergoing biopsy treated with TT compared to sham TT in a small RCT¹⁰Frank 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.

• 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 trial¹¹Giasson 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.

• Less reported confusion among healthy women 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 effects¹²Lafreniere 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.

Modest evidence of less pain among people treated with TT

• Moderately less pain among a general population with TT compared to controls in a review of RCTsrandomized 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 effects and 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 trials¹³So PS, Jiang Y, Qin Y. Touch therapies for pain relief in adults. Cochrane Database of Systematic Reviews. 2008 Oct 8;(4):CD006535.
• 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 RCT¹⁴Mueller 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 trial¹⁵Coakley AB, Duffy ME. The effect of therapeutic touch on postoperative patients. Journal of Holistic Nursing. 2010 Sep;28(3):193-200.

Preliminary evidence of less anxiety, less fatigue, more vigor, less sleep disruption, and less reported tension or markers of stress among people treated with TT

• Less anxiety and greater comfort among elders in nursing homes treated with TT compared to controls in small controlled trials¹⁶Alp 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 trial¹⁷Lafreniere 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 fatigue and daytime sleepiness among students of nursing and midwifery with TT compared to sham TT or no intervention in a small RCT¹⁸Vural Doğru B, Utli H, Şenuzun Aykar F. Effect of therapeutic touch on daytime sleepiness, stress and fatigue among students of nursing and midwifery: a randomized sham-controlled trial. Complementary Therapies in Clinical Practice. 2021 May;43:101322.
• More vigor among healthy women with TT and soft music compared to no intervention in a small RCT¹⁹Lafreniere 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.
• Better sleep quality, among students of nursing and midwifery treated with TT compared to sham TT or no intervention in a small RCT²⁰Vural Doğru B, Utli H, Şenuzun Aykar F. Effect of therapeutic touch on daytime sleepiness, stress and fatigue among students of nursing and midwifery: a randomized sham-controlled trial. Complementary Therapies in Clinical Practice. 2021 May;43:101322.
• Less reported tension among healthy women with TT and soft music compared to no intervention in a small RCT²¹Lafreniere 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.
• Lower cortisol levels—a marker of stress—after vascular surgery among people treated with TT compared to standard care in a small controlled trial²²Coakley AB, Duffy ME. The effect of therapeutic touch on postoperative patients. Journal of Holistic Nursing. 2010 Sep;28(3):193-200.

Insufficient evidence 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-RCTs²³O’Mathúna DP. Therapeutic touch for healing acute wounds. Cochrane Database Syst Rev. 2016 Aug 23;(8):CD002766.