Cited by 203Migraine and Headache StudiesDigital Mental Health InterventionsTemporomandibular Joint Disorders

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A randomized controlled trial of an internet-based treatment for chronic headache

Devineni, Trishul, Blanchard, Edward B.·2005·Behaviour Research and Therapy

DOI 10.1016/j.brat.2004.01.008

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Abstract

Chronic headache is a significant public health problem in Western nations. Although controlled trials demonstrate the efficacy and cost-effectiveness of face-to-face behavioral therapy, most headache sufferers have limited access to these treatments. Delivery of behavioral interventions using Internet technology has the potential to reach a larger number of headache sufferers and reduce the burden of disease. This randomized controlled study evaluated an Internet-delivered behavioral regimen composed of progressive relaxation, limited biofeedback with autogenic training, and stress management versus a symptom monitoring waitlist control. Treatment led to a significantly greater decrease in headache activity than symptom monitoring alone. Thirty-nine percent of treated individuals showed clinically significant improvement on self-report measures of headache symptoms at post-treatment. At two-month follow-up, 47% of participants maintained improvement. Treatment had a significant impact on general headache symptoms and headache-related disability. There was a 35% within-group reduction of medication usage among the treated subjects. The Internet program was more time-efficient than traditional clinical treatment. Treatment and follow-up dropout rates, 38.1% and 64.8%, respectively, were typical of behavioral self-help studies. This approach to self-management of headache is promising; however, several methodological and ethical challenges need to be addressed.

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Authors: Devineni, T., & Blanchard, E. B.
Affiliations: Conemaugh Health System (US)
University at Albany, State University of New York (US)
Corresponding author: Devineni, Trishul
Venue: Behaviour Research and Therapy
Publisher: Elsevier BV
Published: 2005-03
Volume: 43
Issue: 3
Pages: 277-292
ISSN: 0005-7967 (ISSN-L)
DOI: 10.1016/j.brat.2004.01.008
OpenAlex: W2009393470
Cited by: 203
References: 27
Citations by year: 2026: 4 · 2025: 2 · 2024: 3 · 2023: 8 · 2022: 6 · 2021: 6 · 2020: 7 · 2019: 10 · 2018: 7 · 2017: 6 · 2016: 16 · 2015: 7 · 2014: 17 · 2013: 13 · 2012: 12
FWCI: 4.17
Type: journal article
Language: en
Open access: closed
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations: Behaviour Research and Therapy (publishedVersion)
PubMed (publishedVersion)
Funders: National Institute of Neurological Disorders and Stroke (R01NS033072, NS-33072)
Topics: Health Sciences › Medicine › Clinical Neurology › Migraine and Headache Studies
Social Sciences › Psychology › Applied Psychology › Digital Mental Health Interventions
Health Sciences › Dentistry › Oral Surgery › Temporomandibular Joint Disorders
Keywords: chronic headache, internet-delivered treatment, behavior therapy, progressive muscle relaxation, biofeedback, autogenic training, stress management, headache-related disability, medication reduction, self-management, treatment discontinuation, waitlist control
MeSH terms: Adult, Autogenic Training, Behavior Therapy, Biofeedback, Psychology, Cost-Benefit Analysis, Female, Humans, Male, Migraine Disorders, Patient Dropouts, Relaxation Therapy, Stress, Psychological, Treatment Outcome, Telemedicine, Tension-Type Headache, Internet, Headache Disorders

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