| Psychological treatments have been shown to be largely effective for recurrent pediatric headache, but the time and cost required to complete such interventions can be prohibitive for many families. Cost-effective approaches to the treatment of this common pediatric pain condition represent a much needed advance for the field.; A randomized wait-list controlled trial was used to evaluate the efficacy of the "Headstrong" intervention, a computer-based cognitive-behavioral intervention for recurrent pediatric headache developed as part of this dissertation. Fifty, children aged 7--12 attending a pediatric neurology clinic for evaluation of recurrent headaches were randomly assigned to the treatment group (standard medical care plus the Headstrong program) or a wait-list control group who received standard medical care only. Data on baseline headache activity were collected using daily headache dairies and brief questionnaires over a 14-day period. Subsequently, participants in the treatment group worked through the Headstrong headache management program on home computers over the course of 4 weeks while those in the waitlist group continued following the prescriptions of their pediatric neurologist. Daily headache activity was then again assessed during 1-, 2-, and 3-month post-treatment follow-up periods.; Data currently available indicate that members of both groups generally attained improvements in overall headache activity, headache-free days, health-related quality of life and headache-related disability. However, children who received the Headstrong program generally had significant improvements above and beyond those in the wait-list group with respect to reductions in headache frequency, duration, and intensity. In addition, there was a significant association between clinically significant improvement and group assignment, with 60% of those in the treatment group attaining clinically significant improvement versus 8% of the wait-list group. Changes in headache index values appeared to be maintained during follow-up and were corroborated by parent proxy daily headache diaries.; Results of the present study provide initial support for the utility of adding an adjunctive self-management psychological intervention to standard medical care for recurrent pediatric headache. The appeal, cost-efficiency, flexibility and apparent efficacy of the CD-ROM intervention format augur well for its continued refinement and use as an adjunctive therapy option for pediatric headache and potentially other pain conditions. |
