Behavioral Headache Treatment: History, Review of the Empirical Literature, and Methodological Critique
Abstract
Theoretical developments and burgeoning research on stress and illness in the mid-20th century yielded the foundations necessary to conceptualize headache as a psychophysiological disorder and eventually to develop and apply contemporary behavioral headache treatments. Over the past three decades, these behavioral headache treatments (relaxation training, biofeedback, cognitive-behavioral therapy, and stress-management training) have amassed a sizeable evidence base. Meta-analytic reviews of the literature consistently have shown behavioral interventions to yield 35% to 55% improvements in migraine and tension-type headache and that these outcomes are significantly superior to control conditions. The strength of the evidence has lead many professional practice organizations to recommend use of behavioral headache treatments alongside pharmacologic treatments for primary headache. The present overview was prepared as a companion article to and intended to provide a background for the Guidelines for Trials of Behavioral Treatments for Recurrent Headache also published within this journal supplement. This article begins with a synopsis of key historical developments leading to our current conceptualization of migraine and tension-type headache as psychophysiological disorders amenable to behavioral intervention. The evolution of the behavioral headache literature is discussed, exemplified by publication trends in the journal Headache. Leading empirically-based behavioral headach…
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These findings are comparable and better than the average improvement seen in behavioral treatment for migraine and tension-type headaches (TTHs), ranging from 33% to 55%.
“These findings are comparable and better than the average improvement seen in behavioral treatment for migraine and TTHs, ranging from 33% to 55%,64”
From Acceptance and Commitment Therapy for Primary Headache Sufferers: A Randomized Controlled Trial of Efficacy (2021) · cites this paper as [64]
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“[47].”
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- Authors
- Rains, J. C., Penzien, D. B., McCrory, D. C., & Gray, R. N.
- Affiliations
- Elliot Hospital (US)
- Venue
- Headache: The Journal of Head and Face Pain
- Publisher
- Wiley
- Published
- 2005-05
- Volume
- 45
- Issue
- s2
- Pages
- S92-109
- ISSN
- 0017-8748 (ISSN-L)
- 1526-4610
- OpenAlex
- W2071648203
- Cited by
- 209
- References
- 125
- Citations by year
- 2026: 3 · 2025: 4 · 2024: 3 · 2023: 5 · 2021: 11 · 2020: 3 · 2019: 10 · 2018: 9 · 2017: 12 · 2016: 14 · 2015: 13 · 2014: 13 · 2013: 16 · 2012: 10
- FWCI
- 2.05
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Headache The Journal of Head and Face Pain (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Migraine and Headache Studies
- Health Sciences › Health Professions › Complementary and Manual Therapy › Temporomandibular Joint Disorders
- Health Sciences › Medicine › Pharmacology › Musculoskeletal pain and rehabilitation
- Keywords
- migraine, tension-type headache, psychosomatic disorders, relaxation training, biofeedback, cognitive behavioral therapy, stress management training, primary headache, methodological quality of clinical trials, trial design
- MeSH terms
- Behavior Therapy, Clinical Trials as Topic, Humans, Research, Research Design, Meta-Analysis as Topic, Headache Disorders
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