Effects of Healing Touch in Clinical Practice: A Systematic Review of Randomized Clinical Trials

Effects of Healing Touch in Clinical Practice: A Systematic Review of Randomized Clinical Trials

Energy-based healing practices have been part of various cultures throughout history. Use of these complementary therapies, referred to as biofield therapies, is gaining popularity in the U.S. The theory behind energy-based healing practices is that humans have an energetic dimension necessary for sustaining life. A healthy person's energy field is symmetrical and balanced, allowing optimal energy flow. Imbalances in the energy field might result in pathological physical and psychological symptoms.

Scientific study of the biological mechanisms, effectiveness and safety of biofield therapists is limited. However, this month's Massage Therapy Foundation research column reviews an interesting, systematic, evidence-based approach study of the biofield therapy Healing Touch that was conducted at the University of Virginia, Charlottesville, and recently published in the Journal of Holistic Nursing.

Healing Touch is a "hand-mediated" therapy involving the practitioner using his or her hands, either on or above the client's body, to restore, energize and equilibrate imbalances in the client's energy field, with the goal of health, well-being or to alleviate specific conditions. Healing Touch originated in the nursing field in the late 1980s as a patient-centered modality in which the practitioner and client both participate in the healing process. Reported benefits include reducing stress, anxiety, pain and depression symptoms, while increasing relaxation and an overall sense of well-being.

This published systematic review evaluated data from randomized clinical trials (RCTs). The systematic review examined the clinical effectiveness of Healing Touch as supportive care for medical conditions. Electronic databases (MEDLINE, CINAHL, and ClinicalTrials.gov) were searched for peer-reviewed articles about Healing Touch. Of the 332 potentially relevant articles, five were included in the review (327 articles were excluded). The five articles selected, involved studies which used random assignment to the treatment condition. Some of the five articles were selected because they employed a blinded study design, which means the studies had data collectors or participants who did not know what type of treatment the participants received (e.g. treatment or control).

The five selected studies involve the use of imagery, stress-relaxation therapy, prayer, therapeutic massage, Healing Touch, mock Healing Touch and presence (as in the presence of someone with the participant, but who did not perform any type of treatment). The sample sizes ranged from 62 to 237 participants. The participants included both men and women who had a mean age between 50 and 65 years old. The studies included multiple conditions including cancer, coronary artery bypass surgery or surgery to enlarge coronary arteries blocked by plaque (percutaneous coronary intervention).

While one study had no significant results with Healing Touch alone, the other four studies show significant findings. One study showed that recipients had significant improvements in respiratory rate, heart rate, blood pressure, pain and mood disturbance after receiving Healing Touch. Two of the studies showed that recipients who received Healing Touch had a significant increase in overall functioning, satisfaction, emotional role functioning, mental health and health transition and a decrease in worry. And the fifth study showed that Healing Touch recipients had a significant decrease in anxiety and the length of their hospital stay.

More studies about the clinical effectiveness of Healing Touch for improving health-related quality of life are required, given the inconclusive findings and limitations of the studies reviewed. Limitations included one study which did not include a "usual care alone" group, i.e. a control group, which is a group of participants that received only the usual medical care and no biofield therapy or other type of therapies. Usual care alone groups are essential when making comparisons with the standard of care. One study used a standardized Healing Touch method involving a "modified" chakra connection, but the modification was not explained. This makes replicating the study difficult. In another study, music was played during Healing Touch treatments; in this case, theoretically the music could have been the reason recipients felt more relaxed. Also, a standard Healing Touch protocol was not used and recipients had different types of cancer. Both of these factors could have potentially contributed to some of the variability in the results. Further, one of the studies used Healing Touch involving different lengths of treatment without the use of a standard protocol, again making replication of the study difficult.

None of the studies justified the protocol or length of time chosen for the Healing Touch treatments. Additionally, because there are several levels of training, the experience of the Healing Touch practitioners should have been described.

Additionally, a limitation of systematic reviews is that studies with positive results are more often published than those with negative results which can lead to a bias toward the publication of studies that are more positive rather than representing all RCT findings.

Research in biofield therapies is difficult because there is a question about whether it can be analyzed using conventional scientific approaches, such as RCTs. Few clinical trials use adequate research methods, including the use of blinding and control treatments; which can result in exaggerated treatment effects. Sometimes trials do not have large enough sample sizes. Another issue is that biofield therapy practitioners are not always involved in developing research protocols and researchers might be unfamiliar with the language used in complementary therapies. Yet another potential problem is that many different types of subjective assessments can be used to determine treatment outcomes; this makes it difficult to compare studies. An approach using mixed-methods including both quantitative and qualitative data, might prove vital to understanding the effects of Healing Touch.

How exactly Healing Touch has an effect is currently unclear. The biofield has only recently begun to be measured. Future research in biofield therapies such as Healing Touch should continue to improve in rigor and detail, as well as investigate whether the effects of these therapies are comparable to the effects of other complementary modalities such as massage therapy.

In closing, though inconclusive, the results of the effects of Healing Touch are promising. It is encouraging that research is increasingly being done to address the effectiveness of therapies based on ancient healing practices involving the human energy field. The current challenge in this field of inquiry is to develop rigorous and replicable scientific research protocols that will demonstrate both the effectiveness and therapeutic capabilities of biofield therapies such as Healing Touch.

Source: Anderson, Joel G., Taylor, Ann Gill. Effects of Healing Touch in Clinical Practice: A Systematic Review of Randomized Clinical Trials. Journal of Holistic Nursing. Published online 12 January 2011; DOI: 10.1177/0898010110393353
The online version of this article can be found at: http://jhn.sagepub.com/content/early/2011/01/12/0898010110393353

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