Cognitive Behavioral Therapy for Pediatric Headache and Migraine: Why to Prescribe and What New Research Is Critical for Advancing Integrated Biobehavioral Care

Purpose of ReviewTo highlight current evidence supporting the prescription of cognitive behavioral therapy (CBT) as part of first ‐line preventive treatment for children and adolescents with headache and discuss a research strategy aimed at: (1) understanding how and why CBT works, and (2) developing effective and efficient approaches for integrating CBT into headache specialty, neurology, and primary care settings.Recent FindingsAlthough preventive medications for pediatric headache and migraine are commonly prescribed, recent meta ‐analyses and an NIH‐funded, multi‐center clinical trial suggests that the effect of pill‐taking therapies may be mostly due to a placebo effect. These findings have led to greater consideration of prescription of non‐pharmacological therapies as first‐line interventions (either alone or in combination with pill‐based therapy). A literature that extends back to the 1980s and includes recent clinical trials and meta‐analyses demonstrates that CBT decreases headache frequency and related disability in youth with headache and migraine and has a favorable benefit to risk profile wi th almost no negative side effects.SummaryCBT has been repeatedly demonstrated as effective in treating pediatric headache and migraine. As such, it should be considered as part of first ‐line preventive treatment for pediatric headache (either alone or in combination with a pill‐based therapy). We need to better understand how this therapy works and w...
Source: Headache: The Journal of Head and Face Pain - Category: Neurology Authors: Tags: Headache Currents Source Type: research