In Western Reiki, it is taught that Reiki works in conjunction with the meridian energy lines and chakras through the use of the hand-positions, which normally correspond to the seven major chakras on the body. These hand-positions are used both on the front and back of the body, and can include specific areas (see localised treatment). According to authors such as James Deacon, Usui used only five formal hand-positions, which focused on the head and neck. After Reiki had been given first to the head and neck area, specific areas of the body where imbalances were present would then be treated. The use of the chakras is widespread within Western Reiki, though not as much within Traditional Japanese Reiki, as it concentrates more on treating specific areas of the body after using techniques such as Byosen-hō and Reiji-hō, which are used to find areas of dis-ease (discomfort) in the auras and physical body.


In a typical whole-body Reiki treatment, the Reiki practitioner instructs the recipient to lie down, usually on a massage table, and relax. Loose, comfortable clothing is usually worn during the treatment. The practitioner might take a few moments to enter a calm or meditative state of mind and mentally prepare for the treatment, that is usually carried out without any unnecessary talking.


The treatment proceeds with the practitioner placing the hands on the recipient in various positions. However, practitioners may use a non-touching technique, where the hands are held a few centimetres away from the recipient’s body for some or all of the positions. The hands are usually kept in a position for three to five minutes before moving to the next position. Overall, the hand positions usually give a general coverage of the head, the front and back of the torso, the knees, and feet. Between 12 and 20 positions are used, with the whole treatment lasting anywhere from 45 to 90 minutes.


Many Western practitioners use a common fixed set of 12 hand positions, while others use their intuition to guide them as to where treatment is needed as is the practise in Traditional Japanese Reiki, sometimes starting the treatment with a “scan” of the recipient to find such areas. The intuitive approach might also lead to individual positions being treated for much shorter or longer periods. A Western Reiki treatment is considered a type of large-scale treatment in comparison to the more localised-style treatment of Traditional Japanese Reiki.