CONTEXT: Spinal cord injury often results in chronic pain syndromes that conventional pain management is unable to resolve. Healing Touch (HT) is a biofield therapy that involves using the hands to promote healing and mediate the perception of pain by affecting the energy field of the person. The practice of HT is based on the premise that the energy field has the ability to provide valuable information about the person's physical, emotional, mental, and spiritual condition and can influence the dense matter of physical form. OBJECTIVE: This secondary analysis using case study reviews describes two different experiences of receiving a HT session for management of chronic neuropathic pain and its sequelae, utilizing energy field data and reports of participants and their HT practitioners. DESIGN: Qualitative case study approach was used. SETTING: Data were obtained from 42 HT sessions that took place within the homes of seven veterans with spinal cord injury. METHOD: Two cases involving the most common patterns of response were selected from seven cases to represent the participants' and practitioners' experiences. A descriptive qualitative approach informed the results. RESULTS: The findings indicate that a variety of experiences can exist in individuals with chronic pain due to spinal cord injury; experiences will also vary with their healing touch practitioners. There are commonalities in the perception of the practitioners in the damage to the energy field and energy centers, with individualized and consistent resolution of the field over time.

Wardell DW, Rintala D, Tan G. The University of Texas Houston, Health Science Center, School of Nursing, Houston, TX, USA. diane.wardell@uth.tmc.edu Explore (NY). 2008 May-Jun;4(3):187-95.

Reiki touch therapy is a complementary biofield energy therapy that involves the use of hands to help strengthen the body's ability to heal. There is growing interest among nurses to use Reiki in patient care and as a self-care treatment, however, with little supportive empirical research and evidence to substantiate these practices. The purpose of this integrative review is to begin the systematic process of evaluating the findings of published Reiki research. Selected investigations using Reiki for effects on stress, relaxation, depression, pain, and wound healing management, among others is reviewed and summarized. A summary of Reiki studies table illustrates the study descriptions and Reiki treatment protocols specified in the investigations. Synthesis of findings for clinical practice and implications for future research are explored.

Vitale A. Villanova University, 800 Lancaster Avenue, Villanova, PA 19085, USA. annern2@gmail.com Holist Nurs Pract. 2007 Jul-Aug;21(4):167-79; quiz 180-1.

BACKGROUND: Therapeutic touch (TT), a complementary therapy, has been shown to decrease stress, anxiety, and pain in adults and children, as well as improve mobility in patients with arthritis and fibromyalgia. However, less has been reported about the effectiveness of this therapy with infants, particularly preterm infants. OBJECTIVES: The aims of this research study were to explore the nature of the use of TT with preterm infants and describe a TT treatment process for this vulnerable population. DESIGN: Narrative inquiry and qualitative descriptive methods were used to discover knowledge about how TT is used with preterm infants. DATA COLLECTION: Telephone/in-person interviews and written narratives provided the data describing nurses' use of TT with preterm infants. PARTICIPANTS: The participants were registered nurses who practiced TT with preterm infants for varying years of experience. RESULTS: The participants described the responses of infants, 25 to 37 weeks postgestational age, whom they treated with TT. The infants' responses to TT included reduced heart and respiratory rates, enhanced ability to rest, improved coordination in sucking, swallowing, and breathing, and a greater ability to engage with the environment. The practitioners described the phases and elements of TT for preterm infants, which revealed unique patterns, for example, the treatment phase included the elements of smoothing and containing. CONCLUSION: The description that emerged from the practitioners' narratives of the TT treatment process for preterm infants provides preliminary data for the systematic use and evaluation of TT as an adjunct to facilitating preterm infants' physiological, behavioral, energy field development, and well-being.

Hanley MA. School of Nursing, Texas Tech University Health Sciences Center, Lubbock, TX. Explore (NY). 2008 Jul-Aug;4(4):249-58.

BACKGROUND: Energy medicine (EM) practitioners often claim to be able to perceive an energetic field associated with the body and to be able to use this skill to diagnose illness and guide treatment strategies. If a biofield associated with cells growing in culture is perceptible to EM practitioners, such an in vitro model would be a useful resource for investigating biofield perception that would provide some unique advantages over clinical models. OBJECTIVE: To evaluate whether EM practitioners can perceive the presence of cultured human cells without visual cues. DESIGN: Three randomized double-blinded pilot studies were used to evaluate the ability of participants to distinguish a flask containing cancer cells growing in culture medium from a flask containing either culture medium or sterile water. Each study consisted of six independent experiments: three with EM practitioners and three with non-practitioners. The number of independent trials for each experiment was estimated by statistical power analyses of the design. Practitioners' feedback from the first two studies was used to revise the protocol for the subsequent studies, with the intent to eliminate potential problems in making this distinction. Labeled flasks ("cells" and "no-cells") were added to serve as references for comparison in the second study and the number of experimental trials was reduced in the third study. SUBJECTS: Eight experienced EM practitioners and nine non-practitioners (laboratory personnel with no EM training). SETTING: A basic science laboratory and office at an academic medical center. OUTCOME MEASURES: In the first 2 studies, we determined the number of correct determinations in a series of 34 trials. In the third study, we determined the number of correct determinations in a series of 10 trials. RESULTS: All participants performed at the level expected by chance. CONCLUSION: While preliminary and inconclusive, these pilot studies found no evidence that EM practitioners can perceive a biofield associated with cancer cells growing in culture. Copyright Mary Ann Liebert, Inc.

J Altern Complement Med. 2004 Jun;10(3) Yount G, Smith S, Avanozian V, West J, Moore D, Freinkel A. California Pacific Medical Center Research Institute, San Francisco, CA 94115, USA. yountg@sutterhealth.org

OBJECTIVES: Biofield energy healing involves controversial concepts, and although numerous controlled trials have evaluated the effects, little attention has been paid to the phenomenon from the perspective of the therapists themselves. DESIGN: Qualitative research. SETTINGS/LOCATION: Large Midwest metropolitan area. Interviews were generally conducted in the therapists' place of business. SUBJECTS: Experienced biofield energy therapists from several different disciplines. INTERVENTIONS: In-depth semistructured interviews, tape-recorded, transcribed verbatim, videotapes of demonstrations. OUTCOME MEASURES: We used a grounded theory approach to uncover relevant dimensions and themes related to the process of biofield energy healing. RESULTS: Major overall themes related to the "nature of energy" and the "healer-client relationship." Seven dimensions of the nature of energy include sources of energy, entities with energy, human energy anatomy, descriptions of energy, movement of energy, action of energy, and perception of energy. The dimensions build on one another to describe an energetic world view. The other major theme, the healer-client relationship, contains the central concept of healing facilitation as the goal of the experience. Compatibility and collaboration are critical to that process, as are creating a sense of trust and adhering to ethical standards. Communication underpins the whole process. CONCLUSIONS: The biofield energy therapists share a common energetic world view, wherein they must surrender to a universal energy while simultaneously creating a therapeutic alliance with the client who is also an active agent in healing process. This understanding has the potential to alter our assumptions about research design in biofield energy healing.

J Altern Complement Med. 2004 Dec;10(6) Warber SL, Cornelio D, Straughn J, Kile G. University of Michigan, Michigan Integrative Medicine, 715 East Huron Street, Ann Arbor, MI 48104-1555, USA. swarber@umich.edu

OBJECTIVE: To evaluate a battery of biofield awareness tasks that address bioelectromagnetic and consciousness related mechanisms of action, and examine individual differences in integrative biofield awareness (IBA). METHODS: Six (6) biofield awareness tasks were designed: 2 involved the experimenter placing his or her hands near the subject, 2 involved intense staring with associated eye movements approximately 3' from the subject, and 2 involved gentle intention with virtually no movement. Each task required a binary response from the subject. There were 10 trials per task for a total of 60 trials; blocks of 6 trials contained one of each task. Subjects were 165 undergraduate psychology students at the University of Arizona Tucson, AZ. Subjects were also assessed on their awareness of their own biofields, and they filled out various questionnaires, including estimates of how well they thought they would do and their openness to spiritual beliefs and experiences. RESULTS: Percent IBA accuracy for the entire sample (n = 165) was 57.7 +/- 10.3% and was significantly above chance (50%) performance (t = 9.58, p < 0.0000001). Each of the 6 tasks was individually significant. Subjects significantly (t = -2.72; p < 0.007) underestimated their IBA performance below chance (mean, 46.1 +/- 18.4%). However, higher estimates predicted higher IBA (r = 0.26, n = 164, p < 0.0008). Measures of subjects' self-awareness of their own biofields, as well as belief in, and experience of, extrasensory perception (ESP) also predicted higher IBA. CONCLUSIONS: The findings support claims of energy healers that biofield awareness can be modulated both bioelectromagnetically (locally) and via conscious intent (distally), and that individual differences in biofield awareness are related to self-awareness and sensitivity to others.

J Altern Complement Med. 2005 Feb;11(1) Nelson LA, Schwartz GE. Department of Psychology, University of Arizona, Tucson, AZ 85721-0068, USA.

OBJECTIVES: To explore the biofield aspect of cancer care; to identify the benefits of energetic approaches in cancer care; and to examine one approach through a case study. DATA SOURCES: Current research and national reports on biofield approaches in complementary therapies. CONCLUSION: Caring for the biofield is important in assisting the patient with cancer to enhance vitality, reduce pain, fatigue, and other side effects as a result of cancer treatments. IMPLICATIONS FOR NURSING PRACTICE: Cancer care must be holistic to provide maximal healing opportunities for patients. Consideration of the biofield is an important aspect of this care.

Semin Oncol Nurs. 2005 Aug;21(3) Hibdon SS. Student Health and Wellness Center, University of North Texas, Denton, TX, USA. Hibdon@dsa.admin.unt.edu

Reiki touch therapy is a complementary biofield energy therapy that involves the use of hands to help strengthen the body's ability to heal. There is growing interest among nurses to use Reiki in patient care and as a self-care treatment, however, with little supportive empirical research and evidence to substantiate these practices. The purpose of this integrative review is to begin the systematic process of evaluating the findings of published Reiki research. Selected investigations using Reiki for effects on stress, relaxation, depression, pain, and wound healing management, among others is reviewed and summarized. A summary of Reiki studies table illustrates the study descriptions and Reiki treatment protocols specified in the investigations. Synthesis of findings for clinical practice and implications for future research are explored.

Holist Nurs Pract. 2007 Jul-Aug;21(4) Vitale A. Villanova University, 800 Lancaster Avenue, Villanova, PA 19085, USA. annern2@gmail.com

CONTEXT: Spinal cord injury often results in chronic pain syndromes that conventional pain management is unable to resolve. Healing Touch (HT) is a biofield therapy that involves using the hands to promote healing and mediate the perception of pain by affecting the energy field of the person. The practice of HT is based on the premise that the energy field has the ability to provide valuable information about the person's physical, emotional, mental, and spiritual condition and can influence the dense matter of physical form. OBJECTIVE: This secondary analysis using case study reviews describes two different experiences of receiving a HT session for management of chronic neuropathic pain and its sequelae, utilizing energy field data and reports of participants and their HT practitioners. DESIGN: Qualitative case study approach was used. SETTING: Data were obtained from 42 HT sessions that took place within the homes of seven veterans with spinal cord injury. METHOD: Two cases involving the most common patterns of response were selected from seven cases to represent the participants' and practitioners' experiences. A descriptive qualitative approach informed the results. RESULTS: The findings indicate that a variety of experiences can exist in individuals with chronic pain due to spinal cord injury; experiences will also vary with their healing touch practitioners. There are commonalities in the perception of the practitioners in the damage to the energy field and energy centers, with individualized and consistent resolution of the field over time.

Explore (NY). 2008 May-Jun;4(3):187-95. Wardell DW, Rintala D, Tan G. The University of Texas Houston, Health Science Center, School of Nursing, Houston, TX, USA. diane.wardell@uth.tmc.edu

by Anne H. Spencer. Ph.D.

You have healing power! This is a truism that everyone can honor if they will let the energy flow. Mother's rub their babies back and the little child falls into a peaceful sleep. Nurses stroke infants in Intensive Care and they rest easily. Daddies kiss skinned knees and they are all better. Sisters hold the dying and they slip into heavenly bliss. Therapists touch clients and relaxation occurs. What is this "Mystical Power?"

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Our objective was to assess the effect of Therapeutic Touch (TT) on the proliferation of normal human cells in culture compared to sham and no treatment. Several proliferation techniques were used to confirm the results, and the effect of multiple 10-minute TT treatments was studied. Design: Fibroblasts, tendon cells (tenocytes), and bone cells (osteoblasts) were treated with TT, sham, or untreated for 2 weeks, and then assessed for [(3)H]-thymidine incorporation into the DNA, and immunocytochemical staining for proliferating cell nuclear antigen (PCNA). The number of PCNA-stained cells was also quantified. For 1 and 2 weeks, varying numbers of 10-minute TT treatments were administered to each cell type to determine whether there was a dose-dependent effect. Results: TT administered twice a week for 2 weeks significantly stimulated proliferation of fibroblasts, tenocytes, and osteoblasts in culture (p = 0.04, 0.01, and 0.01, respectively) compared to untreated control. These data were confirmed by PCNA immunocytochemistry. In the same experiments, sham healer treatment was not significantly different from the untreated cultures in any group, and was significantly less than TT treatment in fibroblast and tenocyte cultures. In 1-week studies involving the administration of multiple 10-minute TT treatments, four and five applications significantly increased [(3)H]-thymidine incorporation in fibroblasts and tenocytes, respectively, but not in osteoblasts. With different doses of TT for 2 weeks, two 10-minute TT treatments per week significantly stimulated proliferation in all cell types. Osteoblasts also responded to four treatments per week with a significant increase in proliferation. Additional TT treatments (five per week for 2 weeks) were not effective in eliciting increased proliferation compared to control in any cell type. Conclusions: A specific pattern of TT treatment produced a significant increase in proliferation of fibro-blasts, osteoblasts, and tenocytes in culture. Therefore, TT may affect normal cells by stimulating cell proliferation.

J Altern Complement Med. 2008 Mar 27 Gronowicz GA, Jhaveri A, Clarke LW, Aronow MS, Smith TH. Department of Surgery, University of Connecticut Health Center, Farmington, CT.

Therapeutic Touch (TT) is a complementary healing modality used by health care providers to reduce anxiety, accelerate relaxation, decrease pain, and enhance immunity. Research studies report outcomes of TT treatments, but few describe the specific process. This qualitative research study was conducted to describe the nature of the core process of TT in adults and full term infants as practiced by five professional nurses, each treating one adult and one infant. Analysis of data obtained from interviews and focused participant observations was conducted. Findings provide empirical data to depict an overall process divided into three phases: (a) preparation, (b) treatment, and (c) termination, that adheres to the standard process as described by Krieger. It expands on the description of each phase, including two new subcomponents, orienting and disengagement, not previously seen in the literature. Lastly, the study describes the modification of the TT process with infants compared to adults.

J Holist Nurs. 2008 Mar;26(1):17-24. Coppa D. University of Rhode Island.

Limited effective strategies exist to alleviate or treat disruptive behaviors in people with Alzheimer's disease. Fifty-one residents of a long-term care facility with Alzheimer's disease were randomly assigned to one of three intervention groups. A multiple time series, blinded, experimental design was used to compare the effectiveness of therapeutic touch, simulated therapeutic touch, and usual care on disruptive behavior. Three forms of disruptive behavior comprised the dependent variables: physical aggression, physical nonaggression, and verbal agitation. Physical nonaggressive behaviors decreased significantly in those residents who received therapeutic touch compared with those who received the simulated version and the usual care. No significant differences in physically aggressive and verbally agitated behaviors were observed across the three study groups. The study provided preliminary evidence for the potential for therapeutic touch in dealing with agitated behaviors by people with dementia. Researchers and practitioners must consider a broad array of strategies to deal with these behaviors.

West J Nurs Res. 2008 Feb 13 Hawranik P, Johnston P, Deatrich J. University of Manitoba.

Rogers's Science of Unitary Human Beings framed this study of pandimensional pattern changes in healers and healees paired for an 8-week series of Therapeutic Touch (TT) sessions. Comparison of healee patterns before and after 141 TT sessions supported the hypotheses that healees would manifest decreased pulse and blood pressure, and reduced pain and stress (p < .05). Duration of TT sessions was not preset but determined by healers according to energy cues. TT time was not related to pattern changes, consistent with the clinical practice of TT and the atemporal nature of Rogers's conceptual framework. Healers and healees showed parallel changes after the TT series. Participants manifested greater spirituality (p <.05). Although increases in three of the four dimensions of power were significant (p <.05), changes in power measured as a whole were not. Contrary to expectations, manifestations of diversity were decreased in healers and healees.

J Holist Nurs. 2007 Dec;25(4):217-25; discussion 226-7. Smith DW, Broida JP. University of Southern Maine College of Nursing and Health Professions, USA.

This paper analyses the demarcation problem from the perspective of four philosophers: Popper, Kuhn, Lakatos and Feyerabend. To Popper, pseudoscience uses induction to generate theories, and only performs experiments to seek to verify them. To Popper, falsifiability is what determines the scientific status of a theory. Taking a historical approach, Kuhn observed that scientists did not follow Popper's rule, and might ignore falsifying data, unless overwhelming. To Kuhn, puzzle-solving within a paradigm is science. Lakatos attempted to resolve this debate, by suggesting history shows that science occurs in research programmes, competing according to how progressive they are. The leading idea of a programme could evolve, driven by its heuristic to make predictions that can be supported by evidence. Feyerabend claimed that Lakatos was selective in his examples, and the whole history of science shows there is no universal rule of scientific method, and imposing one on the scientific community impedes progress. These positions are used in turn, to examine the scientific status of therapeutic touch theory. The paper concludes that imposing a single rule of method can impede progress, in the face of multiple epistemologies, and the choice of scientific approach should be a pragmatic one based on the aims of the programme.

Int J Nurs Pract. 2007 Dec;13(6):324-30. Newbold D, Roberts J. Florence Nightingale School of Nursing and Midwifery at King's College London, London, UK. david.newbold@kcl.ac.uk

PURPOSE: The purpose of this randomized pilot was to determine feasibility of testing Reiki, a complementary therapy intervention, for women undergoing breast biopsy (BB). BACKGROUND: Increasingly women face the possibility of BB, the definitive test for breast cancer. Psychological distress associated with BB includes anxiety and depression. Reiki was proposed as an intervention to decrease anxiety and promote relaxation. METHOD: Thirty-two women scheduled for BB were randomized to Reiki intervention versus conventional care control. Anxiety and depression were evaluated using self-report questionnaires. FINDINGS: Analysis found no significant mean differences between groups over time. Comparably low baseline anxiety levels (possible selection bias) decreased naturally with time allowing little room for observing treatment effect. CONCLUSIONS: Reiki, when administered in the naturalistic setting of a complementary therapy office, did not suggest evidence of efficacy. An intervention offered within the bounds of the conventional care setting may be more feasible for addressing BB distress.

J Holist Nurs. 2007 Dec;25(4):238-48; discussion 249-51. Potter PJ. University of Washington School of Nursing.

Given the current necessity of retaining qualified nurses, a self-care program consisting of Yoga, Tai Chi, Meditation classes, and Reiki healing sessions was designed for a university-based hospital. The effectiveness of these interventions was evaluated using self-care journals and analyzed using a Heideggerian phenomenological approach. Outcomes of the self-care classes described by nurses included: (a) noticing sensations of warmth, tingling, and pulsation which were relaxing, (b) becoming aware of an enhanced problem solving ability, and (c) noticing an increased ability to focus on patient needs. Hospitals willing to invest in self-care options for nurses can anticipate patient and work related benefits.

Issues Ment Health Nurs. 2007 Oct;28(10):1141-55. Raingruber B, Robinson C. University of California-Davis Medical Center, 2315 Stockton Boulevard, Sacramento, CA 95817, USA. Bonnie.raingruber@ucdmc.ucdavis.edu

To explore the hypothesis that nontouch therapy such as therapeutic touch (TT) reduces stress to a clinically important degree and is safe to use in preterm infants. DESIGN: A pilot randomized, double-blind, controlled trial. SUBJECTS: Two groups of 10 infants were enrolled and randomly assigned to treatment or nontreatment groups. Gestational age was less than 29 weeks. Demographic descriptions of the 2 groups were statistically similar. METHODS: The observer and staff were blinded to assignment; the TT practitioner was blinded to observed measurements. Each infant received either TT or no therapeutic touch (NTT) for 5 minutes on 3 consecutive days at the same time of day, behind a curtain. Heart period variability (HPV) was measured 5 minutes before, during, and after the treatment phase. RESULTS: Examination of the parameters of oxygen saturation and episodes of apnea demonstrated no increase in adverse events in TT group compared with NTT group. Repeated-measures multivariate analysis of variance on HPV revealed differences in the interaction of group assignment with low-frequency, high-frequency, and low-to-high- frequency ratio interaction (F2,143 = 8.076, P = .000) and for group, day, and low-frequency, high-frequency, and low-to-high-frequency ratio (F2,288 = 3.146, P = .015), and in the posttreatment time period (F1,16 = 6.259, P = .024), reflective of greater parasympathetic activity in TT group. CONCLUSION: In this pilot trial, HPV showed an increase for the TT group compared with the NTT group. The study reveals no adverse effects of TT in preterm infants.

Adv Neonatal Care. 2008 Dec;8(6):315-33. Whitley JA, Rich BL. Neonatal Nurseries, McMaster Children's Hospital, Hamilton Health Sciences, Hamilton, Ontario, Canada.

The purpose of this study was to determine if Reiki energy therapy, level I, was taught as a self-care practice to healthcare providers, would their caring perceptions change? Methodological triangulation technique, including a self-report caring scale and interviews, was used, demonstrating positive changes in perceptions of participants' caring behaviors.

Brathovde A.

Monmouth Medical Center, Long Branch, NJ 07740, USA. abrathovde@sbhcs.com

Holist Nurs Pract. 2006 Mar-Apr;20(2):95-101.

Tactile touch is a complementary therapy that is rarely undertaken in intensive care units (ICUs) in Sweden. This study was a part of a larger project that examines whether tactile touch can relieve the suffering of patients in the ICU. The aim of this study was to describe nurses' lived experience of preparation before giving tactile touch in an ICU. Four assistant nurses and one registered nurse, each with diplomas in tactile touch working at three different ICUs in Sweden, participated in the study. A phenomenological approach was chosen to achieve experience-based and person-centred descriptions. Data were collected through interviews and analysed following Giorgi's method. The main finding was that before providing tactile touch, the nurses needed to add the new role as touch therapists, to their professional one. The essential aspect being the transition from nurse to touch therapist. Findings included a general structure, with four constituents; a sense of inner balance, an unconditional respect for the patients' integrity, a relationship with the patient characterised by reciprocal trust, and a supportive environment. Furthermore, the study underlines the difficulties to integrate a complementary caring act, such as tactile touch, in a highly technological environment.

Henricson M, Berglund AL, Segesten K.

University College of BorÂs, School of Health Science, Allegatan, SE-501 90 BorÂs, Sweden. maria.henricson@hb.se

Intensive Crit Care Nurs. 2006 Aug;22(4):239-45. Epub 2006 Mar 15.

Complementary and alternative medicine (CAM) has become much in vogue, and CAM practitioners have increased in tandem with this. The trend of using CAM for treating epilepsy does not differ from that in other medical conditions, with nearly one half of patients using CAM. In this article we review the major complementary and alternative medicines used for treatment of epilepsy. They include mind-body medicines such as reiki and yoga; biologic-based medicine such as herbal remedies, dietary supplements, and homeopathy; and manipulative-based medicine such as chiropractic. In the available literature, there is a sense of the merit of these therapies in epilepsy, but there is a paucity of research in these areas. Individualized therapies such as homeopathy and reiki cannot be compared with medicines in a conventional pharmaceutical model. Hence, many studies are inconclusive. In a science of double-blind, randomized controlled trials, appropriate designs and outcome measurements need to be tailored to CAM. This article explains the principles of the major CAM therapies in epilepsy, and discusses peer-reviewed literature where available. More effort needs to be put into future trials, with the assistance of qualified CAM professionals to ensure conformation to their therapeutic principles.

Ricotti V, Delanty N.

Curr Neurol Neurosci Rep. 2006 Jul;6(4):347-53.

After the diagnosis of cancer in a child is made, many families complement conventional medical care with lifestyle changes including diet, exercise, environment, and mind-body therapies. Biomechanical, bioenergetic, and other therapies are also sometimes sought. These include massage, chiropractic, acupuncture/acupressure, therapeutic touch, Reiki, homeopathy, and prayer. Some of these complementary therapies have well-established roles in cancer therapy for children, whereas others are controversial and require more research.

McLean TW, Kemper KJ.

Department of Pediatrics, Wake Forest University School of Medicine, Winston-Salem, NC 27157, USA. tmclean@wfubmc.edu

J Soc Integr Oncol. 2006 Fall;4(4):187-93.

GOALS OF WORK: Therapeutic touch (TT) is a complementary and alternative medicine (CAM) treatment modeled on the ancient practice of "laying on of hands" that has been developed into a contemporary supportive care intervention. Evidence-based support for TT is emerging with increasingly more sophisticated studies; however, flaws in early research contributed to a perception that TT is poor science. Yet TT is a safe CAM treatment that is highly valued by patients and can be integrated into conventional settings. Having offered TT as a supportive care intervention within a provincial cancer agency for 20 years, we have grappled with the issues of evidence and of satisfying both patient demands and administrative needs. Our TT practice evolved in response to changing needs and our experience may be useful to those who are contemplating offering a CAM treatment within a conventional setting. OBJECTIVES: The objectives are to describe TT practice within a conventional cancer agency and to identify the important issues and success factors of this program and, secondly, to discuss TT research and our approach to the issues. MAIN RESULTS AND CONCLUSIONS: TT is a safe and beneficial intervention for cancer patients that can be integrated within a conventional setting, providing that the program evolves with changing patient and organizational needs. Lessons gleaned include (1) positioning TT within the context of research and evidence-based practice, (2) developing and adhering to standards of practice and professionalism, and (3) maintaining a nonpartisan attitude and communicating a plausible rationale.

Support Care Cancer. 2007 Jul 3 Stephen JE, Mackenzie G, Sample S, Macdonald J.

Faculty of Health Sciences, Simon Fraser University, East Academic Annex #1000, 8888 University Drive, Burnaby, British Colombia, V5A 1S6, Canada.

The nervous breakdown of a 22-year-old, young woman was caused by severe sexual abuse in childhood, which was repressed over many years. During therapy, the patient accumulated resources to start the painful integration of these old traumas. Using holistic existential therapy in accordance with the life mission theory and the holistic process theory of healing, she finally was able to confront her old traumas and heal her existence. She seemingly recovered completely (including regaining full emotional range) through holistic existential therapy, individually and in a group. The therapy took 18 months and more than 100 hours of intensive therapy. In the beginning of the therapy, the issues were her physical and mental health; in the middle of the therapy, the central issue was her purpose of life and her love life; and at the conclusion of the therapy, the issue was gender and sexuality. The strategy was to build up her strength for several months, mobilizing hidden resources and motivation for living, before the old traumas could be confronted and integrated. The therapy was based on quality of life philosophy, on the life mission theory, the theory of ego, the theory of talent, the theory of the evil side of man, the theory of human character, and the holistic process theory of healing. The clinical procedures included conversation, philosophical training, group therapeutic tools, extended use of therapeutic touch, holistic pelvic examination, and acceptance through touch was used to integrate the early traumas bound to the pelvis and scar tissue in the sexual organs. She was processed according to 10 levels of the advanced toolbox for holistic medicine and the general plan for clinical holistic psychiatry. The emotional steps she went through are well described by the scale of existential responsibility. The case story of Anna is an example of how even the most severely ill patient can recover fully with the support of holistic medical treatment, making her feel, understand, and let go of her negative beliefs and life-denying decisions.

ScientificWorldJournal. 2006 Feb 2;6:1965-76. Related Articles, Links

Ventegodt S, Clausen B, Merrick J.

The Quality of Life Research Center, Copenhagen K, Denmark. ventegodt@livskvalitet.org

Research on touch therapies is still in the early stages of development. Studies of Therapeutic Touch, Healing Touch, and Reiki are quite promising; however, at this point, they can only suggest that these healing modalities have efficacy in reducing anxiety; improving muscle relaxation; aiding in stress reduction, relaxation, and sense of well-being; promoting wound healing; and reducing pain. The multidimensional aspects of healing inherent in patient care continue to be expanded and facilitated by our understanding and application of energy therapies.

Nurs Clin North Am. 2007 Jun;42(2):243-59.

Engebretson J, Wardell DW.

Department of Target Populations, School of Nursing, University of Texas Health Science Center-Houston, 6901 Bertner Avenue, Room 764, Houston, TX 77030, USA.

The growing popularity and use of therapeutic touch (TT) is an issue that has generated controversy and concern within the medical community. While anecdotal and traditional scientific evidence suggest that TT would be an advantageous addition for clinics and hospitals to include in their armamentarium of complementary interventions within the realm of traditional medicine, TT has not become widely available in the U.S. One reason for the lack of availability may be the dearth of conclusive scientific support for TT's efficacy and, therefore, its inclusion in clinic and hospital treatment planning would give it the appearance of legitimate practice, which it may not yet deserve. Whether or not deserved, if TT were added to hospital and clinic treatment protocols without substantial scientific support, it would be thought to have the implicit support of the scientific community, at which point the question of its efficacy would be moot in the minds of many people; thus patients would utilize it, because they believe it works rather than because it works. Since TT has not yet been scientifically proven as per Western standards, leaders of the health care community are likely wary of lending support to TT at this time. If TT can be found to be a scientifically sound therapeutic technique, then it will be more readily accepted in the health care community. This paper reviews TT.

ScientificWorldJournal. 2006 Aug 25;6:2188-95. Huff MB, McClanahan KK, Omar HA.

Division of Adolescent Medicine, Department of Pediatrics, University of Kentucky, Lexington, KY, USA.

Fatigue is an extremely common side effect experienced during cancer treatment and recovery. Limited research has investigated strategies stemming from complementary and alternative medicine to reduce cancer-related fatigue. This research examined the effects of Reiki, a type of energy touch therapy, on fatigue, pain, anxiety, and overall quality of life. This study was a counterbalanced crossover trial of 2 conditions: (1) in the Reiki condition, participants received Reiki for 5 consecutive daily sessions, followed by a 1-week washout monitoring period of no treatments, then 2 additional Reiki sessions, and finally 2 weeks of no treatments, and (2) in the rest condition, participants rested for approximately 1 hour each day for 5 consecutive days, followed by a 1-week washout monitoring period of no scheduled resting and an additional week of no treatments. In both conditions, participants completed questionnaires investigating cancer-related fatigue (Functional Assessment of Cancer Therapy Fatigue subscale [FACT-F]) and overall quality of life (Functional Assessment of Cancer Therapy, General Version [FACT-G]) before and after all Reiki or resting sessions. They also completed a visual analog scale (Edmonton Symptom Assessment System [ESAS]) assessing daily tiredness, pain, and anxiety before and after each session of Reiki or rest. Sixteen patients (13 women) participated in the trial: 8 were randomized to each order of conditions (Reiki then rest; rest then Reiki). They were screened for fatigue on the ESAS tiredness item, and those scoring greater than 3 on the 0 to 10 scale were eligible for the study. They were diagnosed with a variety of cancers, most commonly colorectal (62.5%) cancer, and had a median age of 59 years. Fatigue on the FACT-F decreased within the Reiki condition (P=.05) over the course of all 7 treatments. In addition, participants in the Reiki condition experienced significant improvements in quality of life (FACT-G) compared to those in the resting condition (P <.05). On daily assessments (ESAS) in the Reiki condition, presession 1 versus postsession 5 scores indicated significant decreases in tiredness (P <.001), pain (P <.005), and anxiety (P<.01), which were not seen in the resting condition. Future research should further investigate the impact of Reiki using more highly controlled designs that include a sham Reiki condition and larger sample sizes.

Integr Cancer Ther. 2007 Mar;6(1):25-35.

Tsang KL, Carlson LE, Olson K.

Department of Psychology, University of Calgary, Alberta, Canada.

Touch is considered a core aspect of care provision and therapeutic relationships. Therapeutic touch allows nurses to facilitate healing and forge therapeutic relationships through touch or non-touch and maintain channels of communication often lost in dementia as the disease progresses. This article reports the findings of a research project to examine the effectiveness of therapeutic touch in dementia care.

Nurs Older People. 2006 Dec;18(11):27-30. Related Articles, Links

Doherty D, Wright S, Aveyard B, Sykes M.

Faculty of Health, Staffordshire University, Blackheath.

Healing Touch is a complementary therapy that can be used as a nursing intervention for patients in critical care settings. Use of healing touch may facilitate positive patient outcomes. However, further research is needed to adequately evaluate the effectiveness of healing touch in the critical care setting. The use of Healing Touch in critically ill patients is explored in this article.

Dimens Crit Care Nurs. 2007 Jan-Feb;26(1):9-14. Related Articles, Links

Eschiti VS.

College of Nursing, University of Oklahoma Health Sciences Center, PO Box 26901, Oklahoma City, OK 73190, USA. valerie-eschiti@ouhsc.edu

OBJECTIVES: This empirical study explored the efficacy of using Reiki treatment to improve memory and behavior deficiencies in patients with mild cognitive impairment or mild Alzheimer's disease. Reiki is an ancient hands-on healing technique reputedly developed in Tibet 2500 years ago. DESIGN: This study was a quasi-experimental study comparing pre- and post-test scores of the Annotated Mini-Mental State Examination (AMMSE) and Revised Memory and Behavior Problems Checklist (RMBPC) after four weekly treatments of Reiki to a control group. SETTINGS/LOCATION: The participants were treated at a facility provided by the Pleasant Point Health Center on the Passamaquoddy Indian Reservation. SUBJECTS: The sample included 24 participants scoring between 20 and 24 on the AMMSE. Demographic characteristics of the sample included an age range from 60 to 80, with 67% female, 46% American Indian, and the remainder white. INTERVENTIONS: Twelve participants were exposed to 4 weeks of weekly treatments of Reiki from two Reiki Master-level practitioners; 12 participants served as controls and received no treatment. OUTCOME MEASURES: The two groups were compared on pre- and post-treatment scores on the AMMSE and the Revised Memory and Behavior Problems Checklist (RMBPC). RESULTS: Results indicated statistically significant increases in mental functioning (as demonstrated by improved scores of the AMMSE) and memory and behavior problems (as measured by the RMBPC) after Reiki treatment. This research adds to a very sparse database from empirical studies on Reiki results. CONCLUSION: The results indicate that Reiki treatments show promise for improving certain behavior and memory problems in patients with mild cognitive impairment or mild Alzheimer's disease. Caregivers can administer Reiki at little or no cost, resulting in significant societal value by potentially reducing the needs for medication and hospitalization.

J Altern Complement Med. 2006 Nov;12(9):911-3. Related Articles, Links

Crawford SE, Leaver VW, Mahoney SD.

Passamaquoddy Tribe at Pleasant Point, Perry, ME, USA. phadrus@ptc-me.net

The purpose of this pilot study was to compare reports of pain and levels of state anxiety in 2 groups of women after abdominal hysterectomy. A quasi-experimental design was used in which the experimental group (n = 10) received traditional nursing care plus three 30-minute sessions of Reiki, while the control group (n = 12) received traditional nursing care. The results indicated that the experimental group reported less pain and requested fewer analgesics than the control group. Also, the experimental group reported less state anxiety than the control group on discharge at 72 hours postoperation. The authors recommend replication of this study with a similar population, such as women who require nonemergency cesarian section deliveries.

Holist Nurs Pract. 2006 Nov-Dec;20(6):263-72; quiz 273-4.

Vitale AT, O'Connor PC.

Community Medical Center, Toms River, NJ, USA. annern2@gmail.com

This pilot study assessed the role of Healing Touch (HT), an energy-based therapy, in modulating chronic neuropathic pain and the associated psychological distress from post spinal cord injury. Twelve veterans were assigned to either HT or guided progressive relaxation for six weekly home visits. The instruments selected showed sensitivity, although there was a large variation among the groups. There was a significant difference in the composite of interference on the Brief Pain Inventory (t = -2.71, p = .035). The mean score of the fatigue subscale of the Profile of Moods decreased (ns) in the HT group and in the subscale of confusion yet remained stable in the control group. The Diener Satisfaction With Life Scale showed increased well-being in the HT group and no change in the control group. Participants reported various experiences with HT sessions indicating that it may have benefit in the complex response to chronic pain.

J Holist Nurs. 2006 Dec;24(4):231-40; discussion 241-4.

Wardell DW, Rintala DH, Duan Z, Tan G.

University of Texas Houston Hhealthcare system, USA.

GOAL OF WORK: To determine whether the impact of "laying on of hands" on the well-being of patients with advanced cancer is more efficient when performed by a person with self-declared "healing powers" as compared to an actor mimicking the healer in close detail. MATERIALS AND METHODS: A total of 80 patients were registered to participate in a randomized, single-blind phase III trial to evaluate the difference in efficacy of "laying on of hands" by either a "healer" or an actor. Each group consisted of 40 patients, scheduled to receive treatment for 5 min, three times a week. The effect of treatment was measured using a "Well-Being scale", with the difference of the average score of the "Well-Being scale" on day 10 being defined as primary and that on day 5 as secondary endpoint. MAIN RESULTS: There was no significant difference in average score values between the "healer" and the actor with regard to the primary (p = 0.34) or the secondary endpoint (p = 0.94), but the comparison was limited due to major protocol violations by the "healer" who unblinded his status after the first run and quit the study. The study was completed by the actor as a descriptive, explorative study on the impact of "laying on of hands". A significant improvement in symptoms after treatment was found on day 5 (p < 0.001) and on day 10 (p = 0.0002). CONCLUSION: "Laying on of hands" resulted in a significant improvement of cancer- or cancer-therapy-associated symptoms. The magnitude of improvement obtained was similar whether on a self-declared-healer- or an actor-provided "treatment".

Support Care Cancer. 2007 Feb;15(2):143-51. Epub 2006 Oct 13. Related Articles, Links

Pohl G, Seemann H, Zojer N, Ochsner C, Luhan C, Schemper M, Ludwig H.

Department of Internal Medicine I, Center for Oncology and Hematology, Wilhelminenspital, Montleartstr 37, 1171, Vienna, Austria.

Tactile touch is a complementary therapy that is rarely undertaken in intensive care units (ICUs) in Sweden. This study was a part of a larger project that examines whether tactile touch can relieve the suffering of patients in the ICU. The aim of this study was to describe nurses' lived experience of preparation before giving tactile touch in an ICU. Four assistant nurses and one registered nurse, each with diplomas in tactile touch working at three different ICUs in Sweden, participated in the study. A phenomenological approach was chosen to achieve experience-based and person-centred descriptions. Data were collected through interviews and analysed following Giorgi's method. The main finding was that before providing tactile touch, the nurses needed to add the new role as touch therapists, to their professional one. The essential aspect being the transition from nurse to touch therapist. Findings included a general structure, with four constituents; a sense of inner balance, an unconditional respect for the patients' integrity, a relationship with the patient characterised by reciprocal trust, and a supportive environment. Furthermore, the study underlines the difficulties to integrate a complementary caring act, such as tactile touch, in a highly technological environment.

Intensive Crit Care Nurs. 2006 Aug;22(4):239-45. Epub 2006 Mar 15. Related Articles, Links

Henricson M, Berglund AL, Määttä S, Segesten K.

University College of Borås, School of Health Science, Allegatan, SE-501 90 Borås, Sweden. maria.henricson@hb.se

Reiki is a healing practice, rised in Japan in the mid XI'th century. The philosophy of this art of cure assumes that human health depends on the level and harmonious flow of the vital energy, called "ki". Therefore the main aim of this practice is to remove all energetic blockades in individual's body. Owing to that process the natural, in the practicioners' opinion, human's ability of healing by transfer the ki is restored. Certain steps of initiations increase practitioners skills. In the contemporary euroamerican culture, Reiki has begun to unfold since the beginning of 1970's. Expanding in those days New Age philosophy has supported its adaptation in our society. In Poland this method appeard in the late 1980's and is still rather unknown as a culture occurrence. Author's research, conducted among practicioners' from Olsztyn and Poznan, was to broaden the knowledge about the method and people, who are involved in it. The results show that Reiki is one of the holistic treatment's practices but it has also its unique character. For instance, it assumes the particular role of healer, who is a guide for his patient, helping him to understand and cure himself. According to the practitioners Reiki is the way of comprehensive development, identified with the drift towards holistic health.

Med Nowozytna. 2005;12(1-2):67-84. Related Articles, Links

Kosakowska A.

OBJECTIVE: To determine whether Reiki, a process of transmission of healing energy, can significantly reduce microvascular leakage caused by exposure to excessive noise using an animal model. RATIONALE: Reiki is beginning to be used in hospitals to accelerate recovery. Despite many anecdotes describing Reiki's success, few scientific studies are reported and none of those use animals. Animal models have the advantage over human subjects in that they provide well-controlled, easily interpretable experiments. The use of noise is relevant to hospital patients because of the excessive ambient noise in hospitals in the United Kingdom and United States. Loud noise can lead to several nonauditory disorders in humans and animals that impair recovery. In the rat, stress from noise damages the mesenteric microvasculature, leading to leakage of plasma into the surrounding tissue. DESIGN: One group of four rats simultaneously received daily noise and Reiki, while two other groups received "sham" Reiki or noise alone. A fourth group did not receive noise or additional treatment. The experiment was performed three times to test for reproducibility. OUTCOME MEASURES: Average number and area of microvascular leaks to fluorescent albumin per unit length of venule. RESULTS: In all three experiments, Reiki significantly reduced the outcome measures compared to the other noise groups (sham Reiki and noise alone) (p < 0.01). CONCLUSIONS: Application of Reiki significantly reduces noise-induced microvascular leakage in an animal model. Whether or not these effects are caused by Reiki itself, or the relaxing effect of the Reiki practitioner, this procedure could be useful for minimizing effects of environmental stress on research animals and hospital patients.

J Altern Complement Med. 2006 Jan-Feb;12(1):15-22. Related Articles, Links

Baldwin AL, Schwartz GE.

Department of Physiology, College of Medicine, University of Arizona, Tucson, AZ 85724-5051, USA. abaldwin@u.arizona.edu

OBJECTIVE: To measure effects of Reiki treatments on growth of heat-shocked bacteria, and to determine the influence of healing context and practitioner well-being. METHODS: Overnight cultures of Escherichia coli K12 in fresh medium were used. Culture samples were paired with controls to minimize any ordering effects. Samples were heat-shocked prior to Reiki treatment, which was performed by Reiki practitioners for up to 15 minutes, with untreated controls. Plate-count assay using an automated colony counter determined the number of viable bacteria. Fourteen Reiki practitioners each completed 3 runs (n = 42 runs) without healing context, and another 2 runs (n = 28 runs) in which they first treated a pain patient for 30 minutes (healing context). Well-being questionnaires were administered to practitioners pre-post all sessions. RESULTS: No overall difference was found between the Reiki and control plates in the nonhealing context. In the healing context, the Reiki treated cultures overall exhibited significantly more bacteria than controls (p < 0.05). Practitioner social (p < 0.013) and emotional well-being (p < 0.021) correlated with Reiki treatment outcome on bacterial cultures in the nonhealing context. Practitioner social (p < 0.031), physical (p < 0.030), and emotional (p < 0.026) well-being correlated with Reiki treatment outcome on the bacterial cultures in the healing context. For practitioners starting with diminished well-being, control counts were likely to be higher than Reiki-treated bacterial counts. For practitioners starting with a higher level of well-being, Reiki counts were likely to be higher than control counts. CONCLUSIONS: Reiki improved growth of heat-shocked bacterial cultures in a healing context. The initial level of well-being of the Reiki practitioners correlates with the outcome of Reiki on bacterial culture growth and is key to the results obtained.

J Altern Complement Med. 2006 Jan-Feb;12(1):7-13. Related Articles, Links

Rubik B, Brooks AJ, Schwartz GE.

Institute for Frontier Science, Oakland, CA 94611, USA. brubik@earthlink.net

A pilot study was conducted to investigate the effects of Healing Touch (HT) on agitation in persons with dementia. Because of the restricted availability of patients, the main purpose of the study was to investigate the effectiveness of HT on dementia patients who demonstrated similar high levels of agitation as measured by the Cohen-Mansfield Agitation Inventory. Results indicated that agitation levels were significantly lowered and that HT is worthy of further study.

Geriatr Nurs. 2006 Jan-Feb;27(1):34-40. Related Articles, Links

Wang KL, Hermann C.

Northern Arizona Healthcare System, Department of Veterans Affairs, Prescott, USA.

BACKGROUND: Therapeutic Touch (TT) is a widely used complementary therapy. This study investigated the effects of TT on hemoglobin and hematocrit level in students who were basically healthy. METHOD: The volunteers with a hemoglobin level less than 12 grams per deciliter (g/dl) were randomly assigned to three groups of TT, mimic therapeutic touch (MT), and control. Blood samples were collected before the first treatment and again a week after the last one and measurements were taken. RESULTS: TT increased the level of hemoglobin (.99 .13 g/dl) and hematocrit (2.82 .43%) significantly. MT also increased the level of hemoglobin (.55 .11 g/dl) and hematocrit (2.75 .44%) significantly. No significant changes were found in the control group. TT increased hemoglobin more effectively than MT (p< .05). CONCLUSIONS: Significant changes of both variables in TT and MTgroups suggest that more careful precision might be needed while selecting individuals as sham therapists in further experiments.

J Holist Nurs. 2006 Mar;24(1):49-50.

Movaffaghi Z, Hasanpoor M, Farsi M, Hooshmand P, Abrishami F.

Mashad University of Medical Sciences.

The aims of this study were (1) to explore the experience of touch between parents and children with autism before, during, and after a Training and Support Programme (TSP), and (2) to develop a model of the process of touch therapy for this group of parents and children. Fourteen parents and their children agreed to take part in the study. Five of these parents withdrew. Reasons for withdrawal included personal circumstances and ill health. Data were collected by semi-structured interviews with parents before attending the TSP and Home Record Sheets completed by parents during the TSP. Results indicate that before the TSP touch was experienced as out of parents' control. During the TSP, the experience of touch appeared to change. A key benefit gained by parents was the feeling of closeness to children. The key benefits gained by children were perceived by the parents as improved sleep patterns, children were more relaxed after receiving the massage and appeared more amenable to touch. Of interest was children's request for massage at home. At 16-week follow-up both parents and children continue to enjoy giving and receiving touch therapy, respectively.

Complement Ther Clin Pract. 2005 Aug;11(3):182-9.

Cullen LA, Barlow JH, Cushway D.

School of Health and Social Science, Interdisciplinary Research Centre in Health, Coventry University, Priory Street, Coventry CV1 5FB, UK. l.powell@coventry.ac.uk