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Therapeutic Touch Assessment Scale

Also known as: TTAS, TT Assessment, Therapeutic Touch Competency Scale

OriginatorKrieger, D.; Kunz, D.Year1979Sources3Related methods7

The TTAS measures the application and outcomes of therapeutic touch (TT), an energy-based healing modality developed by Krieger and Kunz in which practitioners use intentional hand movements proximal to or in contact with the patient's body to promote relaxation, reduce pain, and facilitate healing. Used both as a competency assessment for practitioners and as an outcome measure for patients receiving TT.

Key highlights

  • Captures both practitioner technique and patient outcomes, providing comprehensive assessment of TT implementation and efficacy.
  • Patient outcome measures are simple and directly relevant to TT rationale (relaxation, comfort, pain reduction).
  • Suitable for integration into clinical settings where TT is offered (hospitals, hospice, integrative medicine clinics).
  • Brief administration facilitates routine use and research data collection.

Intuition

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How it works

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When to use it

The TTAS is appropriate for assessing TT competency in practitioners undergoing training or certification, measuring patient outcomes from TT sessions in clinical or research settings, and evaluating integration of TT into clinical care (e.g., pain management, anxiety reduction in hospitalized patients). Use the practitioner version for credentialing and supervision; use the patient version for routine outcome tracking and research.

Strengths & limitations

Strengths
  • Captures both practitioner technique and patient outcomes, providing comprehensive assessment of TT implementation and efficacy.
  • Patient outcome measures are simple and directly relevant to TT rationale (relaxation, comfort, pain reduction).
  • Suitable for integration into clinical settings where TT is offered (hospitals, hospice, integrative medicine clinics).
  • Brief administration facilitates routine use and research data collection.
Limitations
  • Evidence base mixed: clinical trials of TT show variable results, with some studies demonstrating effects on pain and anxiety, while others find effects equal to sham/placebo control. Unclear whether observed effects are specific to TT or reflect placebo, practitioner attention, and expectancy.
  • Mechanism contested: the purported energy field that TT practitioners perceive is not detectable by instruments; some skeptical of the theoretical basis.
  • Subjective outcome bias: patient self-reports of relaxation and well-being are susceptible to placebo expectancy and social desirability.
  • Practitioner skill variation: lack of standardized training programs and credentialing creates wide variation in TT technique and quality.

Common pitfalls

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Applications

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Frequently asked

Is there scientific evidence that therapeutic touch works?

The evidence is mixed. Some studies show TT reduces pain and anxiety compared to baseline; other well-controlled trials find TT effects equal to sham TT or no-treatment control, suggesting placebo/expectancy effects. Use outcomes (pain, anxiety, relaxation) as indicators of patient response, but don't assume effects are specific to TT mechanisms rather than expectancy or attention.

Can anyone learn therapeutic touch, or does it require special ability?

TT training programs teach practitioners the protocol and intentionality regardless of prior experience. Whether successful outcome requires special 'energy' perception or ability is debated. Competency should be assessed on actual patient outcomes (pain, relaxation) rather than practitioners' reports of 'sensing energy.'

Should TT be used instead of pain medication or other treatments?

No. TT is best viewed as a complementary approach to enhance relaxation and comfort within a comprehensive pain or anxiety management plan. It should not replace evidence-based pharmacological or behavioral interventions for clinical pain or psychiatric conditions.

What TTAS score indicates an effective therapeutic touch session?

For patients: clinically meaningful improvement is typically 2–3 points on a 0–10 pain scale or 1–2 points on a 1–5 relaxation scale. For practitioners: higher competency scores correlate with more structured technique, but don't necessarily predict patient outcomes; both competency and patient response should be monitored.

Sources

  1. 1.
    Krieger, D. (1979). Therapeutic touch: How to use your hands to help or heal. New York: Prentice-Hall.
    https://scholar.google.com/scholar?q=Krieger%2C%20D.%20(1979).%20Therapeutic%20touch%3A%20How%20to%20use%20your%20hands%20to%20help%20or%20heal.%20New%20York%3A%20Prentice-Hall.
  2. 2.
    Barret, E. A. M., & Yates, M. E. (2002). The Rogerian science of unitary human beings in nursing practice. In M. E. Parker (Ed.), Nursing theories and nursing practice (2nd ed., pp. 47–75). Philadelphia: F.A. Davis.
    https://scholar.google.com/scholar?q=Barret%2C%20E.%20A.%20M.%2C%20%26%20Yates%2C%20M.%20E.%20(2002).%20The%20Rogerian%20science%20of%20unitary%20human%20beings%20in%20nursing%20practice.%20In%20M.%20E.%20Park
  3. 3.
    Hutchison, T. L. (2008). Therapeutic touch: A review of the evidence. Journal of Nursing Administration, 38(10), 439–445.
    https://scholar.google.com/scholar?q=Therapeutic+touch%3A+A+review+of+the+evidence+Hutchison

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ScholarGate. (2026, June 3). Therapeutic Touch Assessment Scale. ScholarGate. https://scholargate.app/integrative-medicine/therapeutic-touch-assessment

Therapeutic Touch Assessment Scale | ScholarGate