Alternative and manual therapies explained (hypnotherapy, EFT, Shiatsu, kinesiology, fasciatherapy...)

Complementary and manual therapies have never been so popular. According to Miviludes (the French interministerial mission for vigilance and combat against sectarian aberrations), there are now over 400 non-conventional healthcare practices in France, and nearly four in ten French people report using them (4). This enthusiasm for "integrative approaches" meets genuine patient expectations, but it comes with a grey area: coordinates of these practices are, for the most part, neither regulated nor clinically evaluated in the way a drug would be.

A baseline legal point must be established from the outset: none of these approaches replaces conventional medicine. At best, they can complement it. Presenting a therapy as being capable of curing a medical condition without a clinical framework falls, depending on the case, under charlatanism or the illegal practice of medicine. This article is not intended to promote or condemn; rather, it describes what these practices involve, what actually happens, and what medical science says about them, so you can make an informed decision.

De-coding: what do these eight practices actually involve?

Behind names that sometimes sound similar lie very different rationale. Here is a factual definition of each.

1. Hypnotherapy. Through verbal delivery, the practitioner induces an altered state of consciousness characterised by focused attention and heightened suggestibility. This state is mobilised to manage anxiety, pain, or certain functional symptoms. It is the only one of the eight practices to have a dedicated official evaluation report from INSERM (the French National Institute of Health and Medical Research) (1).

2. EFT (Emotional Freedom Techniques, or "tapping"). The patient uses their fingertips to tap a sequence of acupressure points on the face and upper body, described as "meridian points", while verbalising a difficult emotion or memory. EFT belongs to "energy psychology" and is primarily aimed at stress, anxiety, and trauma work.

3. Shiatsu. A manual technique of Japanese origin derived from traditional Chinese medicine, shiatsu consists of applying pressure with thumbs and palms along theoretical pathways within the body (the "meridians"). It is generally offered for relaxation purposes.

4. Kinesiology. Not to be confused with academic kinesiology, which is the scientific study of human movement. Here, the practitioner relies on a "muscle test": they assess muscle resistance to, according to proponents, identify emotional or energetic "blockages".

5. Fasciatherapy. A manual approach focusing on the fascia, the connective tissues that envelop muscles and organs. The Danis Bois method is the best-known version. It is practiced by some physiotherapists as well as non-medical practitioners.

6. Reflexology. This is based on applying pressure to specific areas of the feet (sometimes hands or ears) that are believed to correspond to individual organs. The "zone" theory dates back to Fitzgerald's work in the 1910s.

7. Somatotherapy. A generic term grouping psycho-corporeal approaches that seek to untangle psychological tension "held in the body". The title is unregulated and its definitions remain vague.

8. Graphotherapy. This stands out from the others: it is a rehabilitation of writing handwriting movements, often recommended for children experiencing difficulties (dysgraphia). Its purpose is educational and paramedical, without an "energy" basis.

Why do patients seek these therapies?

Understanding these practices requires understanding the clinical and psychological needs they address.

• The first is the management of stress and anxiety, in a society where the demand for emotional relief is high.

• The second relates to chronic pain poorly relieved by conventional medical management, which drives patients to seek solutions elsewhere.

• Added to this is a search for holistic well-being and meaning, as well as a need for active listening and consultation time that the conventional pathway of care does not always satisfy.

This demand is particularly high among patients facing serious illness: according to Miviludes, oncology accounts for over half of all reports of healthcare-related deviances (3)(4).

These needs are clinically legitimate. But meeting a demand for supportive care is never equivalent to proving therapeutic efficacy. This is the very nuance found in therapeutic patient education for chronic pain, where supportive care is based on validated evidence rather than promises.

What actually happens during a session?

The procedure varies according to the approach, but a few constants emerge. All begin with an initial consultation (anamnesis) during which the practitioner notes your clinical history, symptoms, and expectations. The role of manual therapy then differs significantly.

Shiatsu, reflexology, and fasciatherapy are manual approaches: you usually remain fully clothed, lying down or seated, while the practitioner applies pressure or slow movements. Conversely, hypnotherapy and EFT rely on verbal delivery and structured protocols: induction and suggestion for hypnotherapy, repeated tapping sequences for EFT. Kinesiology alternates between questioning and manual muscle testing.

A session typically lasts 45 to 60 minutes and usually costs between £40 and £90, rarely covered by statutory health insurance, although some private healthcare policies may provide partial coverage. These interventions fall outside standard medical tariff schedules. A useful warning sign: a practitioner who asks you to discontinue medical treatment, guarantees a cure, or discourages you from consulting your doctor should immediately raise a red flag.

What does medical science say, and where are the boundaries?

The state of clinical evidence is highly uneven from one practice to another.

• Hypnotherapy is the most documented. The 2015 INSERM report concludes there is a potential therapeutic benefit, particularly in intraoperative anaesthesia and functional bowel disorders (irritable bowel syndrome), while finding insufficient or disappointing evidence for other indications such as smoking cessation (1). A network meta-analysis published in Gastroenterology in 2024 found a positive signal for gut-directed hypnotherapy on abdominal pain in irritable bowel syndrome, but pointed out that none of the trials were at low risk of bias (2).

• For reflexology, several systematic reviews (2008, 2011, 2015) found no demonstrated efficacy for any pathological condition, and no plausible biological mechanism links a specific zone of the foot to an organ; the observed relaxation effect is non-specific (6).

• Regarding EFT, independent analyses consider the evidence to be methodologically weak and not exceeding the placebo effect; any eventual benefit would be attributable to the exposure and relaxation techniques borrowed from behavioural therapies, rather than the tapping of "meridians".

• Kinesiology and fasciatherapy are among a dozen non-conventional practices evaluated by INSERM since 2010 (3). The French National Council of the Order of Masseurs-Physiotherapists classifies them, along with microkinesitherapy and biokinergy, as therapeutic deviances: the code of ethics (Article R.4321-87 of the French Public Health Code) forbids recommending any illusory or insufficiently proven procedure and prohibits charlatanism (5). The "muscle test" in kinesiology, in particular, has demonstrated zero reliability under controlled trial conditions.

The most serious issue relates to safety. Miviludes warns of the rise of "risky and unproven" practices, such as reiki and kinesiology, and the risk of lost opportunity of recovery or therapeutic delay when they substitute for medical treatment (4). INSERM notes that because these approaches are unregulated and non-standardised, anyone can claim to be a therapist, which increases the risk of medical manipulation (3). However, "unproven" does not mean "sectarian": in 2017, the Administrative Court of Appeal of Paris ordered the removal of fasciatherapy from the official guide on sectarian drift, due to a lack of evidence of such drift. Lack of evidence of clinical efficacy and sectarian deviation are two separate issues.

This is precisely where the audit trail of healthcare matters. When a physiotherapist anchors their management in validated exercises, shared transparently with the patient and their GP, they are at the opposite spectrum of an opaque practice. Tools like Andrew®, an exercise prescription and therapeutic education software, make it possible to document every stage of patient follow-up on an evidence-based footing. Healthcare professionals wishing to explore this approach can connect with the Andrew® team.

Transparency and dialogue: the golden rule before consulting

Using a complementary therapy is not inappropriate in itself, provided you maintain three key practices.

1. Always inform your general practitioner of the therapies you are using.

2. Be wary of any promise of a cure, any advice to stop medical treatment, and any practitioner who refuses to collaborate with your doctor.

3. Verify the qualifications, stated limits of competence, and pricing transparency of the person you consult.

A good practitioner is recognised by their ability to recognize the limits of their practice and refer patients to medical doctors when necessary. The best protection remains a three-way dialogue between you, your doctor, and the practitioner.

For healthcare professionals, structuring a transparent and evidence-based patient follow-up also requires the right tools: you can request a free demo of Andrew® to see how to formalise visible patient management, in line with best-practice standards for remote patient monitoring.