Positive Health Online

Abstract

KORNER-HERWIG, Department of Clinical Psychology and Psychotherapy, Georg-Elias-Muller Institute of Psychology, Georg-August-University of Gottingen, Gottingen, Germany. bkroene@uni-goettingen.de  evaluate the clinical efficacy of relaxation training, biofeedback and multimodal cognitive-behavioral therapy for headaches in children and adolescents.

Background

Headache is the most common pain problem in children and adolescents and, in a considerable proportion, a source of suffering and disability.

Methodology

Medical intervention mainly relies on abortive pharmacological agents (analgesics and antimigraine drugs). Psychological therapies aim at the prevention of headache episodes and the modifications of cognitive-emotional and cognitive-behavioral processes influencing pain. Three main forms of therapy have been evaluated in randomized controlled trials and reviewed in meta-analyses: relaxation training, biofeedback and multimodal cognitive-behavioral therapy.

Results

So far there is only scarce evidence on hypnosis and acceptance and commitment therapy, although they seem to be promising. Evidence demonstrates that psychological therapies are efficacious, and that clinically relevant improvement is found in approximately 70% of the treated children at follow-up examination.

Conclusion

Future research needs to focus on mechanisms of change, and to extend its view of effects induced by therapy beyond headache improvement to indicators of quality of life.

References

Kroner-Herwig B. Psychological treatments for pediatric headache. [Review]  Expert Review of Neurotherapeutics. 11(3):403-10, Mar 2011.