Contact Reflex Analysis

Contact Reflex Analysis (CRA) is a muscle-testing assessment carried out by other practitioners, mostly chiropractors, and is usually linked to nutritional recommendations. This guide describes CRA as its promoters publish it (sections 1–3) and sets out the psychotherapist's own work with a client who uses it (sections 4–5). The psychotherapist never performs CRA or any muscle test, and never sells, prescribes or recommends CRA, supplements or a CRA-derived diet.

1. Introduction

Version followed: Contact Reflex Analysis as Dick Versendaal, DC, presented it in his seminars for health professionals (Planet Chiropractic seminar listing, 2013), with later concepts named from the CRA "Module 2" textbook sold through the CRA shop. Critical descriptions (Quackwatch, 2009) are used only where promoters' pages are silent, and are labelled.

• What it is. CRA is described by its promoters as "an energy connection": a practitioner contacts a reflex point on the body while testing the strength of the client's outstretched arm, and reads the muscle response as an indicator of the "energy status" of organs, glands, systems and structures. The reflexes are likened to acupuncture points and meridians. [source: Planet Chiropractic seminar page]
• Stated aim. To find the "root cause" of a health problem, which may be emotional, nutritional, structural or a combination, and then to choose the way to resolve it. [source: Planet Chiropractic seminar page]
• Founder. Versendaal is presented as a chiropractor who studied under and was mentored by B.J. Palmer and who refined CRA over about 50 years; a critical source calls him its "co-developer and chief promoter", so whether others shared in its origin is [uncertain: not verified]. [source: Planet Chiropractic; Quackwatch 2009]
• Core idea of change (as the method holds it). A weak muscle response at a reflex is said to show an energy imbalance in the related organ or system; correcting the identified cause, often with dietary supplements, is said to restore the reflex and health. These energy and organ claims belong to CRA; they are attributed here, not adopted. [source: Planet Chiropractic; Quackwatch 2009 for the supplement link]
• Evidence status (one line). No validation studies of CRA itself are identified; studies of closely related applied-kinesiology muscle testing found no agreement between testers or with laboratory nutrient tests and insufficient evidence of diagnostic accuracy. [source: Kenney et al. 1988; Hall et al. 2008; Haas et al. 2007]
• Regulatory status (one line). There is no CRA-specific licence; it is practised under the practitioner's own licence and scope, and any supplements sold are regulated in the US as dietary supplements (FDA) with their advertising under FTC health-claim rules. [source: Wisconsin Chiropractic Examining Board order via Quackwatch; FDA; FTC guidance via Covington]

2. Framework

2a. CRA as its promoters describe it

What a client typically experiences, as described: lying or standing with one arm held out, the practitioner touching points on the body one after another while pressing the arm, then being told which organs or systems are "weak" and what to take or change. A critical account reports remote "testing" from telephone descriptions of dreams and faxed handwriting samples, and a licensing board found a CRA-linked chiropractor diagnosing and prescribing supplements by testing herself or an unrelated person in the client's place; these are reported practices, not part of the promotional description. [source: Planet Chiropractic; Quackwatch 2009]

Regulation by jurisdiction (one line each):

• United States: practised under state licences (mainly chiropractic); state boards decide scope. The Wisconsin Chiropractic Examining Board (2009) found that diagnosing from handwriting and dreams, and prescribing supplements from testing a substitute person, fell outside chiropractic scope. [source: Quackwatch reproduction of the board order]
• US products and advertising: supplements are reported to FDA through the Safety Reporting Portal; health-related advertising, including through practitioners, must meet the FTC standard of competent and reliable scientific evidence. [source: FDA; Covington on FTC Health Products Compliance Guidance, Dec 2022]
• UK, Canada, Australia and elsewhere: CRA-specific regulatory positions [uncertain: not verified]; the practitioner's own professional regulator and the national product and advertising regulators apply.

2b. The psychotherapist's framework alongside CRA [synthesis]

3. Guiding principles

• Curiosity, not verdict. Practical meaning: ask about CRA as you would any health practice; the client's trust matters more than winning an argument. [synthesis]
• Attribute, do not adopt or ridicule. Practical meaning: say "CRA holds that…" for energy and organ claims; give the evidence status plainly when asked. [synthesis]
• The therapist does not perform, sell, prescribe or recommend. Practical meaning: no muscle testing in the room, no referrals to CRA practitioners, no supplement opinions; route product and medicine questions to the prescriber or pharmacist. [source: APA Ethics Code 2.01 Boundaries of Competence, 2.04 Bases for Scientific and Professional Judgments]
• Ground professional judgments in established knowledge. Practical meaning: your own clinical decisions rest on "established scientific and professional knowledge of the discipline", not on a test result the client brings. [source: APA 2.04]
• Manage conflicts of interest. Practical meaning: no financial or referral ties to CRA practitioners or supplement sellers; decline roles where interests could "impair their objectivity, competence, or effectiveness". [source: APA 3.06; also 3.05 Multiple Relationships, 3.08 Exploitative Relationships]
• Autonomy with information. Practical meaning: the client decides; your job is that the decision is informed, free of pressure, and fits their values. [source: APA 3.10 Informed Consent; synthesis]
• Coordinate, with consent. Practical meaning: with permission, the client's doctor or pharmacist learns what products are being taken. [source: APA 3.09 Cooperation with Other Professionals]
• Avoid harm; act on risk. Practical meaning: delayed medical care, harm to children, restrictive eating or financial exploitation override the stance of neutrality. [source: APA 3.04 Avoiding Harm; synthesis]
• Stay in your lane on emotional "root causes". Practical meaning: if CRA labels a problem "emotional", that is an invitation to explore in therapy, not a diagnosis you inherit. [synthesis]
• Never advise on medicines or supplements. Practical meaning: no starting, stopping or changing anything; always route to the prescriber or pharmacist. [synthesis]

4. Intervention inventory

All interventions below are the psychotherapist's own work alongside CRA. None involves muscle testing, touch, product advice or endorsement. The steps are clinical synthesis drawing on the ethics standards and regulator pages cited; no CRA source describes a role for psychotherapists. [synthesis unless tagged]

4.1 Routine, non-judgemental inquiry and recording

• Purpose / when: at intake and at periodic reviews, so that CRA use (and the supplements or diet changes that often follow) is known. Clients often do not mention practices they expect to be judged.
• Steps: (1) Ask about all health practices in a list that normalises complementary use (doctor, chiropractor, naturopath, "muscle testing", supplements, special diets). (2) If CRA or "muscle testing" is named, ask who does it (profession), how often, what was found, what was recommended, and what it costs per month. (3) Ask whether their doctor and pharmacist know. (4) Record practitioner type, products named by the client (as the client names them), diet changes, costs and whether medical care is ongoing. (5) Revisit at reviews.
• Example language (illustrative): "Lots of people use things alongside regular medicine: chiropractors, muscle testing, supplements, special diets. What are you using at the moment?" / "What did the practitioner find, and what did they suggest you do?"
• Watch for: hesitation or apology (a sign of expected judgement); vague answers about cost; mention that a medical appointment or medicine was dropped. Working: the client volunteers updates without being asked.

4.2 Understanding the client's experience of a CRA session

• Purpose / when: once CRA is known to be in use; to understand concretely what happened, without endorsing or debunking it.
• Steps: (1) Ask the client to walk you through a visit: what they were asked, where they were touched, what they were told. (2) Note whether touch was explained and agreed, whether they felt free to decline, and whether any testing was done on someone else on their behalf or at a distance (practices a licensing board has found outside chiropractic scope). (3) Note what was sold on the day and whether buying felt expected. (4) Reflect back without adding your opinion.
• Example language (illustrative): "Can you take me through the last appointment, from when you walked in?" / "How did it feel when they pressed your arm and told you what it meant?" / "Did you have a choice about buying the products there?"
• Watch for: any touch that was not explained, consented, or that felt sexual or boundary-crossing (treat as a safeguarding and professional-board matter, 4.11); surrogate or remote testing of children or absent relatives; on-the-spot sales pressure. Working: the client describes it in their own words and notices their own reactions.

4.3 Meaning, hopes, expectations and explanatory model

• Purpose / when: after 4.1–4.2, and whenever CRA comes up in relation to distress, decisions or relationships.
• Steps: (1) Ask what drew them to CRA: being heard, a sense of control, hope after failed treatments, distrust of medicine, identity, family or community ties. (2) Ask how they understand their problem ("root cause", energy, organ weakness) and how they think CRA helps. (3) Ask what they hope will be different and how they will know. (4) Ask what their doctor's explanation is, and how the two explanations sit together for them. (5) Summarise both models neutrally, attributing CRA's ideas to CRA.
• Example language (illustrative): "What made CRA feel right for you?" / "In CRA terms, what is going on in your body? And how does your doctor see it?" / "If this works the way you hope, what would you notice in three months?"
• Watch for: hopes that depend on avoiding a feared diagnosis or treatment; an "all or nothing" stance towards medicine; the test giving a sense of certainty that relieves anxiety (relevant to 4.9). Working: the client can hold both explanations in view and name their own criteria for success.

4.4 Working with the "test as answer" frame

• Purpose / when: when the client relies on muscle-test "answers" for decisions (foods, relationships, emotional "root causes", whether to see a doctor). CRA presents the push as a "question" and the muscle's reaction as the "answer". [source: Planet Chiropractic]
• Steps: (1) Explore which decisions are being handed to the test. (2) Ask how the client weighs the test against their own judgement, symptoms and medical advice. (3) If asked for your view, give the evidence status briefly and neutrally: studies of related muscle-testing methods found testers did not agree with each other or with laboratory tests. [source: Kenney et al. 1988; Hall et al. 2008] (4) Return the decision to the client's values and reasoning. (5) Do not run your own "test" of the test.
• Example language (illustrative): "It sounds like the arm test has become the way you decide quite a lot. What would you decide if you went by what you know and value?" / "You asked what I think. Research on similar muscle tests hasn't found that they match lab results. You get to weigh that alongside your experience."
• Watch for: distress when the test is questioned (dependence or anxiety-relief function); decisions with real stakes being outsourced (medical care, child's diet). Working: the client starts treating test results as one input among several.

4.5 Informed, values-based decision support

• Purpose / when: when the client is choosing whether to start, continue, combine or stop CRA-linked plans, especially if this affects medical care.
• Steps: (1) Clarify the decision and options (continue alongside medical care; pause; stop; seek a second medical opinion). (2) Help the client list what matters most (safety, cost, feeling cared for, autonomy). (3) Ask what they know about benefits and risks of each option and where that information came from; encourage them to ask their doctor and pharmacist questions directly. (4) Check for pressure from the practitioner, family or community. (5) Respect the decision; record it and any risk discussion. No published decision aid specific to CRA is identified [uncertain: not verified].
• Example language (illustrative): "Let's lay out the options side by side and what each would mean for you." / "Whose voice is loudest when you think about this decision? Is it yours?"
• Watch for: coercion in either direction, including from you; a decision that removes medical care for a serious condition (go to 4.8). Working: the client can state their decision and reasons in their own words.

4.6 Coordination with the doctor or pharmacist (with consent)

• Purpose / when: whenever supplements, diet changes or reduced medical contact are involved.
• Steps: (1) Ask consent to share what the client is taking or doing with their GP/physician or pharmacist, or encourage the client to bring the product list themselves. (2) Share facts only: the products as named on labels, diet changes, any stopped or reduced medicines, the client's concerns. (3) Do not comment on whether a product or medicine should be taken. (4) Record consent, what was shared, and the reply.
• Example language (illustrative): "Would it be OK if I let your doctor know which supplements you're taking, so they have the full picture?" / "That's a question for your pharmacist. Shall we write it down so you can ask?"
• Watch for: the client changing prescribed medicines on CRA advice (urge prompt prescriber contact; do not advise yourself); refusal of consent (respect it, keep encouraging direct disclosure, and act on risk if it rises). Working: the medical team knows what is being taken.

4.7 When CRA names an "emotional" root cause

• Purpose / when: CRA states that a root cause may be emotional. [source: Planet Chiropractic] Clients may arrive with an emotional label from a muscle test.
• Steps: (1) Treat the label as the client's starting point, not as a finding. (2) Carry out your usual assessment. (3) Agree goals based on what the client experiences. (4) Keep CRA-based emotional work and psychotherapy separate; do not interpret CRA results in therapy.
• Example language (illustrative): "You were told this might be emotional. What do you make of that? Let's look at what you've actually been going through."
• Watch for: the client feeling blamed for physical illness ("it's my emotions"); conflicting instructions from two helpers. Working: goals are framed in the client's own experience.

4.8 Recognising and responding to risk

• Purpose / when: at every review, and immediately when any red flag below appears. [synthesis; APA 3.04 Avoiding Harm]
• Red flags and responses:
  • Stopping or delaying medical care (e.g. replacing diagnosis, tests or prescribed treatment with CRA findings): name your concern plainly, encourage prompt contact with the doctor, offer consented coordination (4.6), document. No method is a treatment for cancer or other physical disease.
  • Children: a child tested by surrogate or remote methods, put on restrictive diets, or kept from medical care or vaccination. Discuss with the parent, consult your safeguarding lead, and follow local child-protection procedures where a child is deprived of medical care or adequate nutrition.
  • Pregnancy: new supplements or diet changes in pregnancy should be known to the midwife or obstetric team; encourage disclosure and coordinate with consent.
  • Eating disorders: CRA-linked lists of foods to avoid can feed restriction or orthorexic patterns. Screen for restriction, weight loss, rigid food rules and distress around "wrong" foods; refer for medical assessment where restriction is significant.
  • Financial exploitation: ongoing supplement purchases, packages of visits, or practitioner-sold products. Ask about monthly costs and affordability; explore felt obligation.
  • Multi-level marketing pressure: the client being recruited to sell products or recruit others. Explore pressure, debt and relationship strain.
  • Group pressure: a family, congregation or community that treats CRA results as authoritative and shames dissent. Explore autonomy and support.
  • Boundary violations: unexplained, non-consensual or sexual touch, or a sexual relationship with a practitioner (a licensing board has disciplined a CRA-linked chiropractor for a sexual relationship with a patient). Support the client to report (4.11) and attend to trauma.
• Example language (illustrative): "I'm concerned about stopping that medicine without your doctor knowing. Would you be willing to call them this week? I can help you plan what to say." / "How much are you spending each month on the visits and products? How is that for you?"
• Watch for: concealment after a risk conversation; escalating costs; a child's growth, illness or school absence. Working: the client re-engages medical care, or risks are known to those responsible.

4.9 Health anxiety, somatic symptoms and environmental intolerance presentations

• Purpose / when: when CRA use is driven by persistent worry about illness, distressing bodily symptoms, or beliefs about sensitivities, and repeated testing gives short-term relief. Cross-ref Domain II for full protocols.
• Steps: (1) Assess using established approaches for health anxiety and somatic symptom presentations (Domain II). (2) Map the cycle: symptom or worry → test or reassurance → short relief → renewed worry. (3) Agree a formulation that includes reassurance-seeking (medical and complementary alike). (4) Work on the cycle with the established treatment, not on CRA itself. (5) Coordinate with the doctor about a single, consistent medical plan.
• Example language (illustrative): "After each appointment, how long does the relief last? What happens when the worry comes back?"
• Watch for: increasing frequency of tests or products; new "weaknesses" found each visit. Working: reduced checking and testing, more tolerance of uncertainty.

4.10 Managing your own conflicts of interest and boundaries

• Purpose / when: always; especially in shared clinics, wellness centres, or referral networks with chiropractors or supplement sellers.
• Steps: (1) Have no financial, referral or product ties to CRA practitioners or sellers. (2) Do not sell any products or courses to clients. (3) Do not receive or give muscle testing as part of therapy. (4) If you work in a setting that offers CRA, explain to clients that your role is separate and that their therapy does not depend on using it. (5) Seek supervision where your own beliefs (for or against) are influencing the work. [source: APA 3.05, 3.06, 3.08, 6.04 Fees and Financial Arrangements]
• Example language (illustrative): "I don't recommend or sell any of the treatments offered here. Whatever you decide about them, therapy with me stays the same."
• Watch for: clients assuming you endorse CRA because of where you work; your own urge to persuade. Working: the client experiences your stance as neutral and safe.

4.11 Reporting routes

• Purpose / when: when there is harm, deceptive marketing, practice outside scope, a boundary violation, or risk to a child. Support the client to report; report yourself where law or your code requires it.
• Steps and routes:
  • Product harm (US): FDA Safety Reporting Portal for problems with dietary supplements; FDA's Health Fraud Scams page for fraud. [source: FDA Report an Adverse Event page]
  • Deceptive health advertising (US): the Federal Trade Commission, which expects health claims to rest on competent and reliable scientific evidence and treats practitioners and endorsers as potentially liable. [source: FDA page; Covington on FTC guidance]
  • Practitioner conduct: the practitioner's licensing board (for chiropractors, the state chiropractic board), for practice outside scope, surrogate or remote diagnosis, or sexual misconduct. [source: Wisconsin board order via Quackwatch]
  • Children and vulnerable adults: local safeguarding or child-protection services, per your jurisdiction and service policy. [synthesis]
  • Other countries: the national medicines or product regulator, advertising regulator and the practitioner's professional regulator; specific routes for CRA [uncertain: not verified].
• Example language (illustrative): "What happened isn't OK. There is a board that oversees chiropractors; would you like to look at how to make a complaint together?"
• Watch for: fear of retaliation or loss of community; your own mandatory duties. Working: the client makes an informed choice about reporting, and your statutory duties are met and documented.

5. Handling problems

All guidance in this section is [synthesis] unless tagged; the CRA sources do not address psychotherapy.

• Client is defensive or expects judgement. Slow down; return to curiosity (4.1–4.3); acknowledge that many clinicians are dismissive. Say you are interested in what helps them.
• Client asks you to endorse or try CRA. Decline warmly and explain your role (4.10): "That's outside what I do. I'm here to help you think it through."
• Client asks your opinion of a supplement or medicine change. Do not answer on substance; route to prescriber or pharmacist, and help them prepare questions (4.6).
• Client is stuck between two explanations. Use 4.3 and 4.5: map both models, the stakes of each choice, and the client's values; tolerate ambivalence rather than resolving it for them.
• Rupture after you voice concern. Name the rupture, take responsibility for how it landed, restate respect for their autonomy, and keep the risk point if it remains valid.
• Non-adherence to medical care. Explore the barriers (side effects, cost, fear, distrust, past bad experiences) separately from CRA; problem-solve those; coordinate with consent.
• Overwhelm from many recommendations. Help the client list everything they have been told to do, notice the load, and prioritise with their medical team.
• Health anxiety deepens with testing. Shift the focus to the reassurance cycle (4.9; Domain II).
• Practitioner discourages psychotherapy or medical care. Explore the client's experience of that pressure; review risk (4.8); consider reporting (4.11).
• Family conflict over CRA. Offer a joint session focused on communication and shared safety concerns, not on deciding who is right.
• Child involved. Hold the safeguarding line (4.8): a parent's beliefs are respected, but a child's access to medical care and adequate nutrition is not negotiable; consult and follow local procedures.
• Grief or regret after delayed care. Work with guilt and anger without blame; support any complaint they choose to make.
• Your own reactions. Notice contempt or enthusiasm; take it to supervision.

Sources

Promoter and method sources:

• Contact Reflex Analysis Chiropractic Seminars with Dick Versendaal (Planet Chiropractic, 2013)
• Module 2 Book – Printed (CRA shop listing; author given as Dawn Ranae Hoezee (Versendaal)). Book itself not reviewed beyond the listing [uncertain: not verified].

Critical and regulatory sources:

• Contact Reflex Analysis Disciple Disciplined in Wisconsin (Quackwatch, 2009; reproduces Wisconsin Chiropractic Examining Board Final Decision and Order, case LS0908134CHI)
• Report an Adverse Event (U.S. Food and Drug Administration)
• FTC Issues New Guidance on Health-Related Claims to Replace the Dietary Supplements Advertising Guide (Covington, January 2023). Secondary summary of the FTC Health Products Compliance Guidance (December 2022); the FTC text itself [uncertain: not verified].

Evidence on muscle testing:

• Kenney JJ, Clemens R, Forsythe KD (1988). Applied kinesiology unreliable for assessing nutrient status. Journal of the American Dietetic Association 88(6):698–704 (AGRIS record)
• Hall S, Lewith G, Brien S, Little P (2008). A review of the literature in applied and specialised kinesiology. Forschende Komplementarmedizin 15(1):40–46 (University of Southampton ePrints)
• Haas M, Cooperstein R, Peterson D (2007). Disentangling manual muscle testing and Applied Kinesiology: critique and reinterpretation of a literature review. Chiropractic & Osteopathy 15:11

Ethics:

• American Psychological Association. Ethical Principles of Psychologists and Code of Conduct. Standards 2.01, 2.04, 3.04, 3.05, 3.06, 3.08, 3.09, 3.10, 6.04.

Cross-references: Domain II (health anxiety, somatic symptom presentations).