Alternative Approaches to Healing

“We’ve had a unique opportunity to explore a whole range of treatments that Americans have used for pain and other conditions—but that hadn't been studied well before.”

Dan Cherkin, PhD,
Group Health Research Institute Senior Investigator (Emeritus)

Research overview

Americans are increasingly using complementary and alternative medicine (CAM) for pain and other health problems, according to national surveys. Group Health Research Institute (GHRI) has one of the nation's leading teams researching these approaches to healing. The team uses rigorous scientific methods to evaluate the effectiveness—and cost-effectiveness—of CAM therapies delivered as in real-world practice.

GHRI researchers work with investigators at the University of Washington (UW), Oregon Health and Science University, University of Arizona, and Bastyr University to study CAM therapies. Many of the studies concern musculoskeletal conditions such as back pain, which accounts for a large portion of visits to alternative providers. National guidelines for treating back pain now include four CAM approaches: three of them—massage, yoga, and acupuncture—on the strength of Group Health research.

"Our research has shown that massage, yoga, acupuncture, and to a lesser extent spinal manipulation help relieve chronic low back pain," said GHRI Senior Investigator Dan Cherkin, PhD. "But the reasons why these treatments are helpful remain unclear."

Stress reduction?

One possibility is that the stress-reducing aspects of those treatments may be more important than the physical ones. Also, CAM practitioners often approach their patients with optimism, offer suggestions for ways they can achieve more balance in their lives, and coach them on becoming more involved in their own healing and self-care. “We’re very interested in self-care: things that people can do for themselves,” said Senior Investigator Karen Sherman, PhD, MPH.

"Evidence is growing that the mind and body are intricately connected, with both important for healing to occur," Dr. Sherman said. "In primary care, we hope to harness the mind-body connection to enhance healing for various health problems that don't respond well to conventional treatments. "

Drs. Cherkin and Sherman are studying the effects of mindfulness-based stress reduction and cognitive behavioral therapy on back pain. And they have worked with Clarissa Hsu, PhD, an assistant investigator at GHRI’s Center for Community Health and Evaluation, on qualitative research for several projects. These projects have included exploring: perspectives from participants in randomized controlled trials of various CAM treatments for back pain; patients' and clinicians' views of what healing involves; and opportunities and barriers to including CAM treatment options in primary care.

Recent publications on Alternative Approaches to Healing

Cherkin DC, Sherman KJ, Balderson BH, Cook AJ, Anderson ML, Hawkes RJ, Hansen KE, Turner JA. Effect of mindfulness-based stress reduction vs cognitive behavioral therapy or usual care on back pain and functional limitations in adults with chronic low back pain: a randomized clinical trial. JAMA. 2016 Mar 22-29;315(12):1240-9. doi: 10.1001/jama.2016.2323. PubMed

Keosaian JE, Lemaster CM, Dresner D, Godersky ME, Paris R, Sherman KJ, Saper RB. "We're all in this together": A qualitative study of predominantly low income minority participants in a yoga trial for chronic low back pain. Complement Ther Med. 2016 Feb;24:34-9. doi: 10.1016/j.ctim.2015.11.007. Epub 2015 Dec 2. PubMed

Chubak J, Hawkes R. Animal-assisted activities in pediatric oncology: results from a survey of top-ranked pediatric oncology hospitals. J Pediatr Oncol Nurs. 2015 Nov 20. pii: 1043454215614961. [Epub ahead of print].

Cook AJ, Wellman RD, Cherkin DC, Kahn JR, Sherman KJ. Randomized clinical trial assessing if additional massage treatments for chronic neck pain improve 12 and 26 week outcomes. Spine J. 2015 Oct 1;15(10):2206-15. doi: 10.1016/j.spinee.2015.06.049. Epub 2015 Jun 19. PubMed

Eaves ER, Sherman KJ, Ritenbaugh C, Hsu C, Nichter M, Turner JA, Cherkin DC. A qualitative study of changes in expectations over time among patients with chronic low back pain seeking four CAM therapies. BMC Complement Altern Med. 2015 Feb 5;15(1):12. [Epub ahead of print]. PubMed

Researchers in Alternative Approaches to Healing

Daniel C. Cherkin, PhD

Senior Investigator (Emeritus)
206-287-2875
cherkin.d@ghc.org

Curriculum vitae (CV)

Karen J. Sherman, PhD

Senior Investigator
206-287-2426
sherman.k@ghc.org

Curriculum vitae (CV)

Katherine M. Newton, PhD

Senior Investigator (Emeritus)
206-287-2973
newton.k@ghc.org

Curriculum vitae (CV)

Andrea J. Cook, PhD

Senior Investigator
206-287-4257
cook.aj@ghc.org

Curriculum vitae (CV)

Clarissa Hsu, PhD

Assistant Investigator
206-287-4276
hsu.c@ghc.org

Curriculum vitae (CV)

Ben Balderson, PhD

Research Associate
206-287-2803
balderson.b@ghc.org

Curriculum vitae (CV)

Eric Johnson, MS

Biostatistician
206-287-2105
johnson.ex@ghc.org

Curriculum vitae (CV)

Robert D. Wellman, MS

Biostatistician
206-287-2557
wellman.r@ghc.org

Curriculum vitae (CV)

Lorella Palazzo, PhD

Research Associate
206-287-2173
palazzo.l@ghc.org

Curriculum vitae (CV)

Marlaine Gray, PhD

Research Associate
206-287-2620
gray.m@ghc.org

Curriculum vitae (CV)

Affiliate researcher

Susan D. Reed, MD, MPH

Harborview Medical Center; University of Washington (UW) Department of Obstetrics and Gynecology