It’s not often that an elementary school science project raises questions about the validity of a nursing intervention. But that’s just what happened when 9-year-old Emily Rosa designed and carried out a study about therapeutic touch.
Emily had a little help from her mother, Linda Rosa, RN, a longtime skeptic of therapeutic touch (TT). And last month the mother-daughter team, along with two other co-authors, published the research in the Journal of the American Medical Association.
Since the study appeared in the April 1 issue, TT has received national media coverage. On major network news shows and in national publications Rosa has explained the study’s results and her views, and supporters of TT have also been sought for comments on Emily’s study.
What is it, anyway?
What is therapeutic touch? Advocates admit the therapy is not easy to define. Developed in 1972 at the New York University Division of Nursing by Dolores Krieger, PhD, RN, it’s used to reduce pain and enhance the body’s restorative processes. Its supporters call TT a consciously directed process of energy exchange during which the practitioner’s hands serve as a focus to gently manipulate the body’s energy field flow. The goal is to create a balance of the mind, body, and spirit by stimulating and enhancing the patient’s own natural healing ability.
TT detractors say: “Prove it.” At this point, proponents can’t, admits former Krieger student Nelda Samarel, EdD, RN, associate professor at William Paterson College of New Jersey in Wayne. She says the idea of human energy fields “is a working hypothesis, which in science is absolutely acceptable to have.” But in Krieger’s opinion, “there’s no denying the therapy works.”
The trial, the criticism
The study engaged 21 therapeutic touch therapists (nine were RNs). Emily set up a cardboard screen for practitioners to put their hands through. With their vision blocked, the practitioners were asked by Emily to identify which of their hands was near hers on the other side of the screen.
In the initial trial, the study participants stated the correct location of Emily’s hand in 47 percent of the tries. In a second trial, that number dropped to 41 percent. Chance alone would have produced an average score of 50 percent. “If the human energy field perception through TT was possible, the studies should have been able to detect the experimenter’s hand in 100 percent of the trials,” Rosa said.
The results didn’t surprise Samarel. TT practitioners say the therapy is based on a fluid energy field, which is why a therapist constantly moves hands over the patient. Emily’s hands remained static. According to Samarel, “had a therapeutic touch therapist been on JAMA’s Review Board, this design flaw would have been spotted immediately.”
More research, please
Samarel agrees with Rosa on one point: With the exception of research conducted by Janet Quinn, PhD, RN, no study in the last 20 years offers a positive result. “Most have been technically flawed because most have been conducted by doctoral students with very limited funds available,” Samarel said. “No one wants good research more than therapeutic touch proponents, but good science doesn’t come free. Historically, nursing research has not been well funded.”
But according to Rosa, “plenty of money has been funneled into this research. The University of Alabama and the National Institutes of Health between them have received about a third of a million dollars to study TT.” She also said good research can be done without lots of money. “Emily’s study proved you can do good, basic research for about $10.”
Another former student of Krieger’s, N.Y.U. associate professor Janet McCray, PhD, RN, says even if the Rosa study had produced different results, Linda Rosa would have explained them away. “When people don’t want to believe, there’s nothing you can do to turn them around.”
“I admit to being a skeptic,” Rosa said. “But let me define that term. A skeptic isn’t out to rob another of their beliefs. A skeptic simply wants evidence. Show me scientific evidence that TT works, and I’ll be turned around.”
Rosa says she questions TT because she wants to protect the consumer. “Patients are neglecting effective treatments in favor of ineffective ones.” Or, nurses using therapeutic touch may be distracted from caring for other patients.
TT proponents disagree. “I’ve never known one nurse who has advised against conventional treatment,” McCray said. “This therapy is complementary, which means it’s used in addition to, not instead of.”
But for now, the jury’s still out on TT’s effectiveness.