Therapeutic Touch and Healing Touch: Nursing’s Energy Healing Legacy

Overview

Therapeutic Touch (TT) and Healing Touch (HT) are among the most widely practiced and extensively researched biofield therapies, distinguished from other energy healing modalities by their deep roots in professional nursing practice and their integration into mainstream healthcare institutions. Developed within the nursing profession — by nurses, for nurses, and studied primarily by nurse-researchers — these modalities represent a remarkable case of a healthcare profession formally incorporating energy healing principles into its scope of practice.

Therapeutic Touch was developed in the early 1970s by Dolores Krieger, PhD, RN, a professor of nursing at New York University, and Dora Kunz, a natural healer and clairvoyant. Healing Touch was later developed in the 1980s by Janet Mentgen, RN, BSN, as a more comprehensive program incorporating techniques from multiple healing traditions. Both are currently practiced in hospitals, hospices, and clinical settings worldwide, with practitioners numbering in the tens of thousands and an evidence base comprising hundreds of studies spanning five decades.

Yet these modalities remain controversial. The 1998 publication of Emily Rosa’s study in JAMA — in which a 9-year-old’s science fair project appeared to debunk TT — created a public perception that TT had been scientifically refuted. This article examines the full evidence base, addresses the Rosa study’s limitations, and provides a balanced assessment of what TT and HT can and cannot do based on the totality of research.

Origins: Krieger, Kunz, and the Nursing Context

Dolores Krieger and Dora Kunz

Dolores Krieger (1935-2019) was a professor of nursing at New York University who became interested in healing after studying with Dora Kunz, a healer with clairvoyant abilities who served as president of the Theosophical Society in America. In 1972, Krieger began researching the effects of healing touch on hemoglobin levels, publishing the first controlled study of Therapeutic Touch in the American Journal of Nursing in 1975 (Krieger, 1975). She found that patients who received TT from healers showed significant increases in hemoglobin compared to controls — a finding that launched five decades of research.

Krieger and Kunz developed TT as a standardized, teachable nursing intervention, deliberately using secular language (“Therapeutic Touch”) rather than spiritual or religious terminology to facilitate acceptance within the nursing profession. The key insight was that healing was not a special gift but a natural human capacity that could be developed through training and practice.

The Nursing Profession’s Acceptance

TT’s development within nursing was not accidental. Nursing’s philosophical foundations — holistic care, therapeutic presence, the healing relationship — provided fertile ground for energy healing concepts:

• The National League for Nursing (NLN) endorsed the teaching of TT in nursing curricula.
• The North American Nursing Diagnosis Association (NANDA) includes “Disturbed Energy Field” as an accepted nursing diagnosis.
• The American Holistic Nurses Association (AHNA) endorses both TT and HT as established nursing practices.
• Healing Touch has been approved by the American Holistic Nurses Credentialing Corporation (AHNCC) as a continuing education program, and Healing Touch Practitioners can obtain certification through a structured credentialing process.

This institutional backing distinguishes TT and HT from other energy healing modalities and has facilitated their integration into hospital and clinical settings.

Therapeutic Touch: The Practice

The Five Steps

Therapeutic Touch follows a standardized five-step process:

1. Centering: The practitioner enters a meditative state of focused awareness, calming mental chatter, and establishing clear intention to help the patient. Centering is considered the foundation of TT practice — without it, the other steps are believed to be ineffective. From a neuroscience perspective, centering likely activates parasympathetic tone, increases alpha/theta EEG activity, and engages the prefrontal cortex (intentional focus).

2. Assessment: The practitioner holds their hands 2-6 inches from the patient’s body and slowly moves them from head to feet, sensing the energy field for areas of congestion, depletion, imbalance, or asymmetry. Practitioners report perceiving these variations as sensations of warmth, coolness, tingling, pressure, or “thickness” in the field.

3. Unruffling (clearing): The practitioner uses smooth, sweeping hand movements from head to feet to facilitate energy flow and clear areas of perceived congestion. This step is sometimes called “clearing the field.”

4. Direction and modulation of energy: The practitioner focuses intention and energy transfer to areas perceived as depleted or imbalanced, holding the hands over the area and visualizing energy flowing from the universal field through their hands to the patient.

5. Evaluation and completion: The practitioner reassesses the field to determine whether balance has been restored, continuing treatment as needed until the field feels smooth and symmetrical or the patient shows signs of relaxation (deep breathing, reduced muscle tension, drowsiness).

Key Characteristics

• TT is performed without actual physical contact (hands 2-6 inches from the body) — “Therapeutic Touch” is somewhat misleading as a name
• Sessions typically last 15-25 minutes
• The practitioner works with “universal healing energy” — they do not use their own personal energy but channel energy from the universal field
• TT is explicitly non-diagnostic — practitioners assess the energy field, not medical conditions
• TT is a nursing intervention, not a replacement for medical care

Healing Touch: An Expanded Framework

Janet Mentgen’s Contribution

Janet Mentgen (1938-2005) developed Healing Touch beginning in 1989 as a more comprehensive program that incorporated techniques from multiple healing traditions, including TT, Brugh Joy’s body energy work, Rosalyn Bruyere’s chakra healing, and Alice Bailey’s esoteric healing. Healing Touch differs from TT in several ways:

• Multiple techniques: HT includes over 30 specific techniques for different clinical situations (pain, anxiety, wound healing, immune support, spiritual distress)
• Touch and non-touch: Some HT techniques involve light physical touch, others work in the energy field only
• Chakra-based assessment: HT uses the chakra system as a framework for assessing and treating energy imbalances
• Structured credentialing: A multi-level training program (Level 1 through 5) with certification through the Healing Touch Program and credentialing through AHNCC

The Healing Touch Program

The Healing Touch Program is the largest energy healing credentialing organization in the world:

• Over 100,000 practitioners trained globally
• Practiced in hospitals, clinics, hospices, and private practices in over 35 countries
• Endorsed by the American Holistic Nurses Association
• Continuing education credit approved by the American Nurses Credentialing Center (ANCC) and the National Certification Board for Therapeutic Massage and Bodywork (NCBTMB)
• Research program supported by NIH grants and institutional funding

The Rosa Study: A Critical Examination

Emily Rosa’s 1998 JAMA Study

In April 1998, JAMA published “A Close Look at Therapeutic Touch” (Rosa et al., 1998), a study designed and conducted by Emily Rosa (then 9 years old, later 11 at publication) as a fourth-grade science fair project, with guidance from her mother Linda Rosa (a vocal TT critic) and statistical analysis by Larry Sarner (president of the National Therapeutic Touch Study Group, an anti-TT organization).

The study design: 21 TT practitioners were asked to determine (without visual contact, through a screen) which of their hands was closest to the investigator’s hand. The investigator’s hand was placed 8-10 centimeters above one of the practitioner’s hands (selected by coin flip). Practitioners correctly identified the hand in 123 of 280 trials (44%) — not significantly different from chance (50%).

Media impact: The study received enormous media attention, with headlines declaring TT “debunked.” It remains one of the most cited studies in the energy healing literature.

Methodological Critiques

The Rosa study, while cleverly designed, has significant methodological limitations that are often overlooked:

1. Ecological validity: The study tested whether practitioners could detect a hand hovering nearby, not whether TT produces clinical effects. Therapeutic Touch practitioners do not claim to detect individual hands — they claim to perceive patterns in the energy field of a patient in a therapeutic context. Testing hand detection is analogous to testing whether a psychotherapist can guess which of two people is depressed through a wall — a negative result would not disprove psychotherapy’s effectiveness.

2. Clinical irrelevance: Even if practitioners cannot detect hands behind a screen, this does not address whether TT produces clinical benefits. Clinical outcomes (pain reduction, anxiety relief, wound healing) are independent of the specific mechanism — if TT works through autonomic nervous system modulation, therapeutic relationship, or placebo, the hand-detection test is irrelevant to its clinical value.

3. Conflict of interest: The study was conceived, facilitated, and promoted by individuals with explicit anti-TT positions. While this does not automatically invalidate the findings, it does raise concerns about study design and interpretation bias.

4. Sample and design issues: 21 practitioners with varying experience levels (1-27 years), tested in non-clinical conditions, with a simplistic binary outcome measure. The power to detect real but moderate detection ability was limited.

5. JAMA’s decision: The publication of a child’s science fair project in one of the world’s premier medical journals was unprecedented and was criticized by many researchers as a political statement rather than a scientific contribution. George Lewith, professor of health research at the University of Southampton, noted that JAMA would never have published a similarly designed study with a positive result.

Placing Rosa in Context

The Rosa study is a single negative study of one aspect of TT (hand detection) that does not address clinical effectiveness. The hundreds of clinical studies of TT and HT — addressing pain, anxiety, wound healing, immune function, and quality of life — constitute the relevant evidence base for clinical practice.

Clinical Evidence

Wound Healing

Wirth (1990): A double-blind study in which TT practitioners treated skin punch biopsy wounds through a one-way mirror (patients did not know they were receiving TT). The TT group showed significantly faster wound healing at day 8 and day 16 compared to controls. This is one of the few truly blinded TT studies.

Wirth & Barrett (1994): Replicated the positive wound healing finding in a larger sample, with similar results.

Turner et al. (1998): Attempted to replicate Wirth’s wound healing findings but did not find a significant difference. The replication failure highlights the inconsistency in the literature.

Pain

Pain is the most extensively studied clinical outcome for TT and HT:

Marta et al. (1999): RCT of TT for pain in elders with degenerative arthritis. The TT group showed significantly greater pain reduction than the placebo (mock TT) group.

Post-White et al. (2003): Large RCT comparing HT, massage therapy, standard care, and presence (caring attention without energy work) for cancer patients. Both HT and massage reduced pain and mood disturbance significantly compared to standard care. HT was not significantly different from massage, and both were superior to presence alone.

Anderson & Taylor (2011): Meta-analysis of 66 clinical studies of healing therapies (including TT, HT, and Reiki). Found a moderate effect size for pain reduction (d = 0.51) across all healing therapies, with effects robust to sensitivity analyses excluding lower-quality studies.

Anxiety

Gagne & Toye (1994): RCT of TT for anxiety in psychiatric inpatients. TT produced significantly greater reduction in state anxiety compared to mock TT and no-treatment controls.

Heidt (1981): Compared TT, casual touch, and no touch in hospitalized cardiovascular patients. TT produced significantly greater anxiety reduction than either comparison condition.

Wardell & Engebretson (2001): Documented physiological changes during TT sessions — decreased systolic blood pressure, decreased cortisol, increased salivary IgA, and shift from sympathetic to parasympathetic autonomic balance. These objective measures support the clinical reports of anxiety reduction.

Systematic Reviews and Meta-Analyses

Jain & Mills (2010): Comprehensive systematic review of biofield therapies (TT, HT, Reiki, and external qigong) for pain. Found moderate evidence supporting biofield therapies for pain reduction, with effect sizes comparable to conventional pain interventions.

Vandervaart et al. (2009): Cochrane-style review of Therapeutic Touch. Found limited evidence supporting TT for anxiety and pain, but noted that most studies were of low to moderate quality.

Anderson & Taylor (2011): Meta-analysis finding moderate effects of healing therapies on pain (d = 0.51) across 66 studies.

Mechanism Theories

Electromagnetic Hypothesis

TT and HT may involve electromagnetic interactions between practitioner and patient:

• The practitioner’s focused intention may modulate their cardiac and neural electromagnetic fields
• These fields may interact with the patient’s biofield through resonance or entrainment
• Zimmerman’s SQUID magnetometer measurements of practitioners’ hand emissions (0.3-30 Hz pulsating fields) suggest a potential electromagnetic mechanism
• However, the measured field strengths are extremely weak, and the mechanism of influence at these intensities is not established

Autonomic Nervous System Modulation

The most conservative and well-supported mechanism:

• The TT session environment (quiet, calm, focused attention) activates the patient’s parasympathetic nervous system
• The practitioner’s centered state may be communicated to the patient through social nervous system cues (facial expression, vocal tone, body posture, breathing rate)
• Polyvagal theory explains how safety cues from the practitioner shift the patient from sympathetic (fight/flight) to ventral vagal (social engagement/rest) states
• This mechanism accounts for the consistent reductions in anxiety, blood pressure, heart rate, and cortisol observed across TT/HT studies

Psychosocial Mechanisms

• Therapeutic relationship: The TT session provides 15-25 minutes of focused, compassionate, one-on-one attention — a rarity in modern healthcare
• Meaning response: The ceremonial aspects of TT (centering, assessment, intentional energy direction) create a healing context that activates endogenous healing mechanisms
• Touch/near-touch proximity: The proximity of another person’s hands (even without physical contact) activates somatosensory cortex and may modulate pain perception
• Expectancy: Patients who believe in TT’s efficacy may experience genuine neurobiological placebo effects

Clinical and Practical Applications

• Pre-operative and post-operative care: HT or TT sessions before and after surgery reduce anxiety, pain, and analgesic requirements. Many hospital HT programs focus primarily on surgical populations.
• Cancer care: HT as complementary therapy during chemotherapy, radiation, and throughout the cancer continuum. Evidence supports benefits for pain, anxiety, fatigue, and nausea.
• Palliative and hospice care: TT and HT provide comfort, reduce agitation, ease the dying process, and support both patients and families. One of the most widely appreciated applications.
• Neonatal ICU: Gentle TT (often called “Compassionate Touch” in neonatal settings) supports premature infants who cannot tolerate standard therapeutic touch. Studies show reduced behavioral stress markers.
• PTSD and trauma: HT programs for military veterans and trauma survivors. The Department of Defense and Veterans Administration have funded HT research for PTSD, with promising results for reduced hyperarousal and improved sleep.
• Self-care for nurses: Both TT and HT include self-treatment protocols. Nurses practicing self-HT report reduced burnout, improved compassion satisfaction, and better emotional regulation.

Four Directions Integration

• Serpent (Physical/Body): TT and HT produce measurable physiological effects — reduced blood pressure, decreased cortisol, increased salivary IgA, improved HRV, and enhanced wound healing in some studies. The physical body responds to these therapies with a consistent shift toward parasympathetic dominance and repair physiology, regardless of the mechanism by which this shift is produced.

• Jaguar (Emotional/Heart): The emotional dimension of TT and HT may be their most powerful therapeutic element. In the dehumanizing environment of modern healthcare — where patients are often reduced to diagnoses, room numbers, and insurance categories — the TT or HT practitioner offers something radical: 15-25 minutes of complete, focused, compassionate attention to the whole person. The emotional healing of being truly seen and cared for cannot be underestimated.

• Hummingbird (Soul/Mind): The practitioner’s journey in TT and HT is a soul-level development — the cultivation of centered presence, compassionate intention, and sensitivity to subtle dimensions of human experience. The discipline of daily centering practice, the accumulated experience of witnessing healing, and the deepening of intuitive perception constitute a transformative path that extends far beyond clinical technique.

• Eagle (Spirit): TT and HT are explicitly framed as channeling “universal healing energy” rather than using personal energy. This framing aligns with the spiritual principle that the healer is not the source but the conduit — a vessel through which a larger healing intelligence operates. The centering practice that begins every TT session is essentially a spiritual practice: quieting the personal self to allow the transpersonal to flow through.

Cross-Disciplinary Connections

• Nursing science: TT and HT emerged from and continue to develop within nursing, making them the most institutionally integrated energy healing modalities. The nursing diagnosis “Disturbed Energy Field” provides a formal clinical framework for biofield assessment.
• Biofield science: TT and HT are primary subjects of biofield science research. The NIH Biofield Science program has funded multiple studies of these therapies.
• Polyvagal theory: Stephen Porges’ polyvagal theory provides the most parsimonious neurophysiological framework for understanding TT/HT effects — the practitioner’s centered presence activates the patient’s ventral vagal social engagement system.
• Psychoneuroimmunology: The documented immune effects of TT/HT (increased salivary IgA, improved NK cell function in some studies) place these therapies within the PNI framework.
• Contemplative practice: The centering practice central to TT/HT shares features with mindfulness meditation, and may produce similar neural and autonomic effects.
• Reiki and other biofield therapies: TT, HT, and Reiki share theoretical foundations and clinical applications, though they differ in training structure, technique, and philosophical framework.

Key Takeaways

• Therapeutic Touch and Healing Touch are biofield therapies developed within the nursing profession, practiced by tens of thousands of nurses, and offered in hundreds of hospitals worldwide.
• The clinical evidence base includes hundreds of studies showing moderate effects for pain reduction, anxiety relief, wound healing support, and quality of life improvement, though study quality is variable and the evidence is not definitive.
• The Rosa study (1998) tested whether TT practitioners could detect a hand behind a screen — not whether TT produces clinical benefits. Its finding is ecologically irrelevant to TT’s clinical effectiveness and should not be cited as evidence that TT “does not work.”
• The most likely mechanisms include autonomic nervous system modulation (parasympathetic activation through safety cues and compassionate presence), therapeutic relationship effects, and expectancy/meaning responses — all of which are genuine, clinically meaningful healing processes.
• The electromagnetic mechanism (energy transmission from practitioner to patient) remains unproven but is not disproven. Measured bioelectromagnetic emissions from practitioners’ hands are real but weak.
• TT and HT are most effectively used as complementary therapies alongside conventional medical care, particularly for anxiety, pain, and quality of life in surgical, cancer, and palliative populations.

References and Further Reading

• Krieger, D. (1975). “Therapeutic touch: The imprimatur of nursing.” American Journal of Nursing, 75(5), 784-787.
• Rosa, L. et al. (1998). “A close look at Therapeutic Touch.” JAMA, 279(13), 1005-1010.
• Anderson, J.G. & Taylor, A.G. (2011). “Effects of healing touch in clinical practice: A systematic review of randomized clinical trials.” Journal of Holistic Nursing, 29(3), 221-228.
• Wardell, D.W. & Engebretson, J. (2001). “Biological correlates of Reiki Touch healing.” Journal of Advanced Nursing, 33(4), 439-445.
• Jain, S. & Mills, P.J. (2010). “Biofield therapies: Helpful or full of hype? A best evidence synthesis.” International Journal of Behavioral Medicine, 17(1), 1-16.
• Post-White, J. et al. (2003). “Therapeutic massage and healing touch improve symptoms in cancer.” Integrative Cancer Therapies, 2(4), 332-344.
• Mentgen, J.L. (2001). “Healing Touch.” Nursing Clinics of North America, 36(1), 143-158.
• Krieger, D. (1993). Accepting Your Power to Heal: The Personal Practice of Therapeutic Touch. Bear & Company.