Therapeutic Touch & Misleading Advertising: The power of adding “scientific” to your product

Hello all,

Last month two Therapeutic Touch (TT) outfits here in BC were found culpable of misleading advertising following complaints to Advertising Standards Canada.  They were the BC Therapeutic Touch Network Society (the organization promoting TT in BC), and  a TT Clinic in Delta who had a TT practitioner making unsubstantiated health benefit claims in a local newspaper advertisement.

Clause 1: Accuracy and Clarity
Clause 8: Professional or Scientific Claims

Advertiser: BC Therapeutic Touch Network Society
Industry: Health and beauty services
Region: British Columbia
Media: Digital – Marketer – Owned Websites
Complaint(s): 1
Description: A not-for-profit organization, which publicizes information in support of its members who provide Therapeutic Touch therapy to the public, published information on its website promoting the Therapeutic Touch therapy technique. Claims and statements regarding the efficacy of the technique included:

Therapeutic Touch therapy is a “benefit to the practitioner and the client, proving to be a significant antidote to burnout in healthcare professionals”

Therapeutic Touch therapy is “effectively used on humans, plants and animals”

“By producing a rapid relaxation response…your body will heal and recover faster” (with Therapeutic Touch therapy)

Therapeutic Touch therapy “(may be) used pre- and post-operatively to hasten recovery, to balance emotions, and relieve depression, to assist cancer patients to deal with side effects of therapy and to boost the immune system, to assist in recovery from addictions, to assist in pre and postnatal care, to calm anxiety and aggression in patients suffering from various forms of dementia, and to calm and support palliative care patients and their families”

“Over 50 doctoral and 20 post-doctoral studies are available through the (BC Therapeutic Touch) Network, which have proven the effectiveness of Therapeutic Touch”.

Complaint: The complainant alleged the advertised claims were not currently supported by reliable, science-based evidence.
Decision: It appeared to Council that the efficacy claims regarding Therapeutic Touch therapy were medical treatment outcomes for serious diseases and conditions that readers of the advertisement would associate, in whole or part, with conventional medicine practices and procedures. However, Council found that the studies and research provided by the advertiser were insufficient to support such claims. It concerned Council that the claims and statements could cause readers to believe that Therapeutic Touch therapy was an alternative for medical treatment for some of the identified conditions, rather than as complimentary to traditional medical treatment. The advertiser requested an appeal from Council’s decision.
Appeal: Following a careful review by the Appeal Panel, Council’s original decision was affirmed.
Infraction: Clauses 1 (e) and 8.
Clause 1: Accuracy and Clarity
Clause 8: Professional or Scientific Claims

Advertiser: Healthcare Service Provider
Industry: Health and beauty services
Region: British Columbia
Media: Newspapers
Complaint(s): 1
Description: A natural healthcare clinic advertised various services provided by the clinic’s practitioners. Among the claims made in the advertisement were efficacy claims about one of the procedures identified in the advertising.
Complaint: The complainant alleged the claims were not currently supported by science-based evidence.
Decision: Council found that the studies and research provided by the advertiser were insufficient to support the advertised claims.
Appeal: Council’s original decision was affirmed by an Appeal Panel, acting on the advertiser’s request for appeal. Notwithstanding the fact that the advertiser appealed Council’s original decision, the advertiser had withdrawn the advertising before the original Council hearing. On that basis, the advertiser is not identified in this case summary.
Infraction: Clauses 1 (e) and 8.

Their original advertisements on the web and in the paper made claims that  Therapeutic Touch (TT) was an evidence based practice that could effectively reduce symptoms of stress, anxiety and pain while supporting the immune system, accelerating healing.

After thoroughly deliberating these matters, taking expert advice, and reviewing a 56 page response and appeal by BCTTNS, the ASC panel finally concluded that the advertised claims in question clearly contravened Clauses 1(e) – Accuracy & Clarity, and 8 –  Professional and Scientific Claims, of the Canadian Advertising Code.

Provision 1 of the ASC Code requires that both in principle and practice, all advertising claims and representations must be supportable. If the support on which an advertised claim or representation depends is test or survey data, such data must be reasonably competent and reliable, reflecting accepted principles of research design and execution that characterize the current state of the art. At the same time, however, such research should be economically and technically feasible, with due recognition of the various costs of doing business.

Clause 8 of the Code requires that advertisements must not distort the true meaning of statements made by professionals or scientific authorities. Advertising claims must not imply that they have a scientific basis that they do not truly possess. Any scientific, professional or authoritative claims or statements must be applicable to the Canadian context, unless otherwise clearly stated.

Neither of those standards had been meet by the BCTTNS or the private clinic, but sadly neither saw a problem with their advertising either, as both appealed the original complaint decisions. BCTTNS submitted a summary of numerous TT research papers undertaken over the last 20 years to the ASC as evidence of efficacy. Unfortunately though, the vast majority of these were of very poor quality,and small scale-studies from self-interest journals (such as Holistic Nursing). They also omitted several other critical works from more established journals:

  • Hansen et al. 2006 – A Cochrane systematic review of evidence regarding TT and dementia, which found no evidence of effectiveness to date.
  • O’Mathúna and Ashford 2014 – A Cochrane of evidence regarding TT for healing acute wounds which found no evidence of effectiveness to date.
  • Robinson, Biley and Dolk 2007 – A Cochrane systematic review of evidence regarding TT for anxiety disorders, wounds which found no evidence of effectiveness to date.
  • Smith et al. 2013 – A Cochrane systematic review of evidence regarding TT debridement for surgical wounds which found no evidence of effectiveness to date.

A major problem here is the lack of scientific literacy of those making claims that TT works. I am sure it is not the case that the majority of TT practitioners are trying to deliberately deceive the public, but that, as with several complementary and alternative medicine (CAM) practices these practitioners are unwilling to question their own beliefs critically. Reading their responses, I don’t believe there is actually anything that would dissuade them that TT is most likely nonsense. As it is impossible to prove a negative, this sort of blind faith in TT is likely to continue. Science involves testing our theories and when they don’t work out, considering we got it wrong and moving on; faith-based explanations do not require this.

Scientifically we have very good evidence that the  bioenergy field as postulated by TT practitioners does not appear to exist. Scientific attempts to demonstrate a bio-energy field and quantify how it can be manipulated have actually been pretty been minimal. Instead, proponents have relied on mystical explanations or pseudoscience from supporters, primarily in  CAM journals. In 1999 review of the physics of complementary therapies stated that the existence of a “bio-field” or “bio-energetic field” directly contradicts principles of physics, chemistry, and biology (Stenger, 1999). However, it is possible (although improbable) that there is an energy beyond our abilities to currently detect (although, strangely, those initiated to feel the force in a short TT course, can do so by waving their hands around). However, proving scientifically, it does not exist is impossible. Absence of evidence is not the same as evidence of absence. It is the old Russell’s Cosmic Teapot argument, and yet again we are asked to believe, because we can’t prove it doesn’t exist.

At this point it would seem very clear that TT should  be considered metaphysical/ magical as it is explained in terms that are not able to be addressed by scientific inquiry, and involves ritual rather than demonstrable practical skills. I.e. only those initiated and approved by the professionals can detect and manipulate the bio-field. So why do these practitioners continue to claim its science?

The better quality studies actually demonstrate no effect of TT (or none better than placebo). There are no good-quality Randomized Controlled Trials (RCTs) or other high-quality experimental work that supports TT (which given the volume of pilot work and time this intervention has been practiced would be expected for a truly valuable therapy). All of the quality meta-analysis studies undertaken reveal no effect better than placebo.

It would be relatively simple to test the claims of TT practitioners in being able to detect bio-fields, and yet little work to do this has been undertaken. If they want to fund me to do it, I’d very happily recruit some grad students and do some experiments, and I promise if it is shown to work I’ll be very happy to publicize the results widely. It is of note that there is still a $1,000,000 prize offered by the James Randi Organization for anyone who can demonstrate TT working, and it still remains unclaimed: for over 20 years now.

Nevertheless, TT continues to have quite a following here in BC. The BC Cancer Agency supports its use, and you can do courses to gain qualification in it at Langara College. Canadian Nurse has also published a couple of supportive articles on TT over the last 10 years.

Looking at their website today I see that the BCTTNS continues to make the same claims it was cited against. Whilst a local TT practitioner offers sessions charging the not-inconsiderable fee of $120 for an hour and a half initial “Quantum Healing” session of therapy.

Regrettably, the current state of TT as with much other new-age research relies on very bad-science and pseudoscience and it is clearly not accurate to claim that TT is an evidence-based therapy, or an effective intervention for any of the conditions claimed by these practitioners (at least any better than placebo or simple relaxation techniques). To do so represents a form of deception, and as commercial service providers TT practitioners should not be using such claims in their advertising. It seems the ASC at least, agrees. So why don’t TT practitioners just advertise TT as a mystical/magical therapy and be done with it?  I wouldn’t have a problem with that, but claiming TT is evidence-based science, is at worst disingenuous, and at best simply vacuous nonsense.

Bernie

Reference

Ernst, E. (2003) Distant healing — An “update” of a systematic review. Wiener Klinische Wochenschrift.
115(7), pp 241-245

Hansen NV, Jørgensen T, Ørtenblad L. Massage and touch for dementia. Cochrane Database of Systematic Reviews 2006, Issue 4. Art. No.: CD004989. DOI: 10.1002/14651858.CD004989.pub2

O’Mathúna, D. N. P.; Ashford, R. L. (2012). O’Mathúna, Dónal P, ed. Cochrane Database of Systematic Reviews (Online) 6: CD002766

Robinson J, Biley FC, Dolk H. Therapeutic touch for anxiety disorders. Cochrane Database of Systematic Reviews 2007, Issue 3. Art. No.: CD006240. DOI: 10.1002/14651858.CD006240.pub2

Smith F, Dryburgh N, Donaldson J, Mitchell M. Debridement for surgical wounds. Cochrane Database of Systematic Reviews 2013, Issue 9. Art. No.: CD006214. DOI: 10.1002/14651858.CD006214.pub4.

Stenger, Victor (1999). “The Physics of ‘Alternative Medicine’ Bioenergetic Fields”. TheScientific Review of Alternative Medicine. 3(1) 79-84