Clinical- versus home-based treatment formats for children with chronic headache
Abstract
This study evaluated the effectiveness of a cognitive–behavioural treatment programme, delivered in either clinic‐based group format, or home‐based minimal‐therapist‐contact format, in the treatment of chronic headache (migraine, tension or combined), for 10–12‐year‐old children. Subjects were assigned randomly to three conditions: clinic‐based treatment (eight sessions); home‐based treatment (three sessions supplemented by working at home from treatment manuals); and waiting‐list control. Both treatment conditions were associated with significant reductions in headaches, but no changes occurred for the control condition. The two treatment formats were equally efficacious; however, the home‐based format was over twice as cost effective as the clinic‐based format.
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The findings provide support for previous studies which demonstrated the efficacy of self-help type interventions with minimal therapist contact, for children with chronic headache and recurrent pain.
“they provide support for previous studies which demonstrated the efficacy of self-help type interventions with minimal therapist contact, for children with chronic headache and recurrent pain 22, 23 .”
From The Effectiveness of an Acceptance and Commitment Therapy Self-help Intervention for Chronic Pain. (2010) · cites this paper as [22]
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Systematic review and meta-analysis of psychological therapies for children with chronic pain
Fisher, E., Heathcote, L., Palermo, T. M., de C Williams, A. C., Lau, J., & Eccleston, C. (2014) · Journal of Pediatric Psychology · doi:10.1093/jpepsy/jsu008 · Cited by 710 · see citing works
Psychological therapies for the management of chronic and recurrent pain in children and adolescents
Eccleston, C., Palermo, T. M., Williams, A. C. D. C., Lewandowski Holley, A., Morley, S., Fisher, E., & Law, E. (2014) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd003968.pub4 · Cited by 745 · see citing works
Palermo, T. M., Eccleston, C., Lewandowski, A. S., de C. Williams, A. C., & Morley, S. (2010) · Pain · doi:10.1016/j.pain.2009.10.004 · Cited by 489 · see citing works
“Four trials conducted with youth with headache [12,23,25,26] directly compared two exposures of psychological therapy, therapist-administered versus self-administered (home-based).”
BackgroundEccleston, C., Morley, S., Williams, A. C. D. C., Yorke, L., & Mastroyannopoulou, K. (2002) · Pain · doi:10.1016/s0304-3959(02)00072-6 · Cited by 295 · see citing works
“…¼ 11.9; range ¼ 10–12; gender ¼ 23:26 Cognitive coping skills (25); standard care (24) One 45 min session Modified Coping Strategies Questionnaire; Pain sensitivity test £ Griffiths and Martin (1996) Clinic M ¼ 11.3; range 10–12; gender ¼ 21:21 CBT @ clinic (15); CBT @ home (15); WLC (12) 12 h…”
BackgroundInfluentialPsychological therapies for the management of chronic and recurrent pain in children and adolescents
Fisher, E., Law, E., Dudeney, J., Palermo, T. M., Stewart, G., & Eccleston, C. (2018) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd003968.pub5 · Cited by 289 · see citing works
Rapee, R. M., Abbott, M. J., & Lyneham, H. J. (2006) · Journal of Consulting and Clinical Psychology · doi:10.1037/0022-006x.74.3.436 · Cited by 228 · see citing works
Psychological Treatment of Recurrent Headache in Children and Adolescents - A Meta-Analysis
Trautmann, E., Lackschewitz, H., & Kröner‐Herwig, B. (2006) · Cephalalgia · doi:10.1111/j.1468-2982.2006.01226.x · Cited by 187 · see citing works
The Effectiveness of an Acceptance and Commitment Therapy Self-help Intervention for Chronic Pain.
Johnston, M., Foster, M., Shennan, J., Starkey, N. J., & Johnson, A. (2010) · The Clinical Journal of Pain · doi:10.1097/ajp.0b013e3181cf59ce · Cited by 142 · see citing works
“These findings are in keeping with those reported in Watkins and Clum(10) review of self-help interventions and they provide support for earlier studies which showed the efficacy of self-help type interventions with minimal therapist contact, for children with chronic headache and recurrent pain.(22,23) Acceptance is…”
ResultPsychological therapies for the management of chronic and recurrent pain in children and adolescents
Eccleston, C., Palermo, T. M., Williams, A. C. D. C., Lewandowski, A. S., Morley, S., Fisher, E., & Law, E. F. (2012) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd003968.pub3 · Cited by 129 · see citing works
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Headstrong: A Pilot Study of a CD-ROM Intervention for Recurrent Pediatric Headache
Connelly, M. A., Rapoff, M. A., Thompson, N., & Connelly, W. (2005) · Journal of Pediatric Psychology · doi:10.1093/jpepsy/jsj003 · Cited by 103 · see citing works
“…of those in treatment conditions who were clinically improved by 1-month posttreatment ranges from 38–67% (Allen & McKeen, 1991; Burke & Andrasik, 1989; Griffiths & Martin, 1996; Guarnieri & Blanchard, 1990; Kroener-Herwig & Denecke, 2002; Larsson, Daleflod, Hakansson, & Melin, 1987; McGrath et…”
Psychological therapies for the management of chronic and recurrent pain in children and adolescents
Eccleston, C., Yorke, L., Morley, S., Williams, A. C. D. C., & Mastroyannopoulou, K. (2003) · doi:10.1002/14651858.cd003968 · Cited by 97 · see citing works
Assessment and psychological management of recurrent headache disorders.
Holroyd, K. A. (2002) · Journal of Consulting and Clinical Psychology · doi:10.1037//0022-006x.70.3.656 · Cited by 109 · see citing works
Kröner‐Herwig, B., Mohn, U., & Pothmann, R. (1998) · Applied Psychophysiology and Biofeedback · doi:10.1023/a:1022267104369 · Cited by 82 · see citing works
Cognitive–behavioral therapy of pediatric headache
Kröner‐Herwig, B., & Denecke, H. (2002) · Journal of Psychosomatic Research · doi:10.1016/s0022-3999(02)00345-8 · Cited by 81 · see citing works
“Griffith and Martin [8] used a similar research design in a study on Australian pupils.”
ResultDo anxiety-disordered children need to come into the clinic for efficacious treatment?
Cobham, V. E. (2012) · Journal of Consulting and Clinical Psychology · doi:10.1037/a0028205 · Cited by 82 · see citing works
Psychological therapies for the management of chronic and recurrent pain in children and adolescents
Eccleston, C., Palermo, T. M., Williams, A. C. D. C., Lewandowski, A., & Morley, S. (2009) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd003968.pub2 · Cited by 78 · see citing works
Assessment and psychological management of recurrent headache disorders.
Holroyd, K. A. (2002) · Journal of Consulting and Clinical Psychology · doi:10.1037/0022-006x.70.3.656 · Cited by 77 · see citing works
Husain, K., Browne, T., & Chalder, T. (2007) · Child and Adolescent Mental Health · doi:10.1111/j.1475-3588.2006.00419.x · Cited by 61 · see citing works
Self‐administered psychosocial treatments for children and families
Elgar, F. J., & McGrath, P. J. (2003) · Journal of Clinical Psychology · doi:10.1002/jclp.10132 · Cited by 59 · see citing works
Thabrew, H., Stasiak, K., Hetrick, S. E., Donkin, L., Huss, J. H., Highlander, A., Wong, S., & Merry, S. (2018) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd012488.pub2 · Cited by 61 · see citing works
“…in six trials (Chadi 2016; Grey 2009; Kashikar-Zuck 2005; Szigethy 2007; Szigethy 2014; Van der Veek 2013), multiple imputation in seven trials (Griffiths 1996; Hains 2000; Hickman 2015; Kanstrup 2016; Kashikar-Zuck 2012; Levy 2010; Wei 2017) and unclear methods in fifteen trials (Beebe 2010;…”
BackgroundMethodInfluentialFeasibility Assessment of Telephone‐Administered Behavioral Treatment for Adolescent Migraine
Cottrell, C., Drew, J. B., Gibson, J., Holroyd, K., & O’Donnell, F. (2007) · Headache The Journal of Head and Face Pain · doi:10.1111/j.1526-4610.2007.00804.x · Cited by 52 · see citing works
Media-based behavioural treatments for behavioural problems in children
Montgomery, P., Bjornstad, G. J., & Dennis, J. A. (2006) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd002206.pub3 · Cited by 47 · see citing works
Parker, G. M., Spiers, G., Gridley, K., et al. (2012) · Child Care Health and Development · doi:10.1111/j.1365-2214.2011.01350.x · Cited by 45 · see citing works
Boerner, K. E., Eccleston, C., Chambers, C. T., & Keogh, E. (2016) · Pain · doi:10.1097/j.pain.0000000000000803 · Cited by 45 · see citing works
Leong, J., Cobham, V. E., de Groot, J., & McDermott, B. (2009) · European Child & Adolescent Psychiatry · doi:10.1007/s00787-008-0723-7 · Cited by 45 · see citing works
“Some studies have suggested the value of videotapes to teach child management skills [40] and written instructions for headache [16] and enuresis [38].”
BackgroundThabrew, H., Stasiak, K., Hetrick, S. E., Wong, S., Huss, J. H., & Merry, S. (2017) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd012488 · Cited by 45 · see citing works
A cognitive-behavioural approach to pain management
Turk, D. C., & Okifuji, A. (2003) · Elsevier eBooks · doi:10.1016/b978-0-443-07201-7.50040-0 · Cited by 44 · see citing works
Psychological Interventions for Headache in Children and Adolescents
Sieberg, C. B., Huguet, A., von Baeyer, C. L., & Seshia, S. S. (2012) · Canadian Journal of Neurological Sciences / Journal Canadien des Sciences Neurologiques · doi:10.1017/s0317167100012646 · Cited by 39 · see citing works
A cognitive-behavioural program for adolescents with chronic pain—a pilot study
Merlijn, V. P. B. M., Hunfeld, J. A. M., van der Wouden, J. C., Hazebroek-Kampschreur, A. A. J. M., van Suijlekom‐Smit, L. W. A., Koes, B. W., & Passchier, J. (2005) · Patient Education and Counseling · doi:10.1016/j.pec.2004.10.010 · Cited by 37 · see citing works
“Nevertheless, the reductions in pain reported after our program is in line with other studies on the effectiveness of cognitive-behavioural treatment for children and adolescents with chronic pain [6,11,16,17,24–26].”
BackgroundResultEvaluating outcomes: Empirical tools for effective practice.
Cone, J. D. (2001) · American Psychological Association eBooks · doi:10.1037/10384-000 · Cited by 38 · see citing works
Cognitive behavioral therapy for pediatric chronic pain: The problem, research, and practice
Noel, M., Petter, M., Parker, J. A., & Chambers, C. T. (2012) · Journal of Cognitive Psychotherapy · doi:10.1891/0889-8391.26.2.143 · Cited by 30 · see citing works
The cognitive-behavioural approach to pain management
Turk, D. C., & Flor, H. (2006) · Elsevier eBooks · doi:10.1016/b0-443-07287-6/50027-8 · Cited by 23 · see citing works
Lavigne, J. V. (2016) · Journal of Pediatric Psychology · doi:10.1093/jpepsy/jsv161 · Cited by 20 · see citing works
O’Connell, C., Shafran, R., & Bennett, S. (2020) · Clinical Child Psychology and Psychiatry · doi:10.1177/1359104519855415 · Cited by 19 · see citing works
“Several studies illustrated reduction in medically unexplained symptoms, but not improvement in depression or anxiety (e.g. Bussone et al., 1998; Griffiths & Martin, 1996; McGrath et al., 1992).”
BackgroundMethodPalermo, T. M., Kashikar‐Zuck, S., Friedrichsdorf, S. J., & Powers, S. W. (2018) · PAIN Reports · doi:10.1097/pr9.0000000000000649 · Cited by 19 · see citing works
Law, E. F., Beals‐Erickson, S. E., Fisher, E., Lang, E. A., & Palermo, T. M. (2017) · Clinical Practice in Pediatric Psychology · doi:10.1037/cpp0000216 · Cited by 18 · see citing works
Conservative treatments of children with episodic tension–type headache
Verhagen, A. P., Damen, L., Berger, M. Y., Passchier, J., Merlijn, V. P. B. M., & Koes, B. W. (2005) · Journal of Neurology · doi:10.1007/s00415-005-0940-7 · Cited by 18 · see citing works
“Of these, 18 publications concerned children of which we excluded seven publications because these papers did not provide a separate analysis in children with TTH [14–20], leaving a total of 11 trials to be included in this review.”
BackgroundPsychological approaches in pain management: what works?
Turk, D. C., & Okifuji, A. (1998) · Current Opinion in Anaesthesiology · doi:10.1097/00001503-199810000-00017 · Cited by 16 · see citing works
Media-based behavioural treatments for behavioural disorders in children
Montgomery, P. (2001) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd002206 · Cited by 16 · see citing works
Efficacy of Psychological Treatment for Headaches
Huguet, A., McGrath, P. J., Stinson, J., Tougas, M. E., & Doucette, S. P. (2013) · Clinical Journal of Pain · doi:10.1097/ajp.0b013e318298dd8b · Cited by 15 · see citing works
McGrath, P. A., & Holahan, A.-L. V. (2003) · Seminars in Pain Medicine · doi:10.1016/s1537-5897(03)00008-9 · Cited by 15 · see citing works
Parker, G. M., Spiers, G., Gridley, K., et al. (2011) · White Rose Research Online (University of Leeds, The University of Sheffield, University of York) · Cited by 13 · see citing works
Pediatric Headache: An Examination of Process Variables in Treatment
Cvengros, J. A., Harper, D. C., & Shevell, M. I. (2007) · Journal of Child Neurology · doi:10.1177/0883073807305786 · Cited by 12 · see citing works
“Studies of Mixed Headache Griffiths and Martin (1996).23 This study compared the efficacy of clinic-based and home-based treatments for the treatment of headache among children.”
BackgroundA meta‐analytic review of brief guided self‐help education for chronic pain
Liegl, G., Boeckle, M., Leitner, A., & Pieh, C. (2016) · European Journal of Pain · doi:10.1002/ejp.881 · Cited by 12 · see citing works
“The two samples with the largest standard errors produced the largest effect sizes (Richardson and McGrath, 1989; Griffiths and Martin, 1996), indicating small study bias and a risk of overestimating the pooled effect size.”
BackgroundInfluentialRecurrent Pediatric Headache: A Comprehensive Review
Connelly, M. A. (2003) · Children s Health Care · doi:10.1207/s15326888chc3203_1 · Cited by 12 · see citing works
“…devices) has resulted in comparable treatment efficacy to lengthier clinic-based treatments (Blanchard et al., 1985; Blanchard & Schwarz, 1988; Griffiths & Martin, 1996; Guarnieri & Blanchard, 1990; Larsson, Daleflod, Hakansson, & Melin, 1987; Larsson, Melin, & Doberl, 1990; McGrath et al.,…”
MethodStructural Models of Comorbidity among Common Mental Disorders: Connections to Chronic Pain
Krueger, R. F., Tackett, J. L., & Markon, K. E. (2006) · KARGER eBooks · doi:10.1159/000095366 · Cited by 8 · see citing works
Evidence Mapping Based on Systematic Reviews of Cognitive Behavioral Therapy for Neuropathic Pain
Li, C., Hou, W., Ding, D., Yang, Y., Gu, S., & Zhu, Y. (2023) · Neural Plasticity · doi:10.1155/2023/2680620 · Cited by 8 · see citing works
Drake, K. L., & Ginsburg, G. S. (2012) · Child & Youth Care Forum · doi:10.1007/s10566-012-9174-x · Cited by 5 · see citing works
“However, many youth continued to have clinically significant headaches and treatment has not been consistently associated with a reduction in medication usage (Griffiths and Martin 1996).”
BackgroundSystematic review of autistic representation in the treatment literature for pediatric chronic pain
Boerner, K. E., Pawliuk, C., Heran, A., Donaghy, B., Moore, D., Leong, K., Devan, H., & Oberlander, T. F. (2025) · Journal of Pain · doi:10.1016/j.jpain.2025.105390 · Cited by 4 · see citing works
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The Role of Minimal- and No-Contact Behavioural Treatments in Migraine
Scharff, L., & Etherage, J. R. (2000) · Disease Management & Health Outcomes · doi:10.2165/00115677-200008060-00002 · Cited by 2 · see citing works
“Griffiths and Martin[17] conducted a similar study with the same measures, which compared a clinic-administered 8-session thermal biofeedback treatment with a home-based treatment including 3 clinic sessions and a set of treatment manuals in a group of of 12-year-old patients with headache (see table I).”
BackgroundApproches psychothérapeutiques dans les céphalées chez l’enfant et l’adolescent
Amouroux, R., Rousseau‐Salvador, C., Bittar, M., & Goff, J.-F. L. (2014) · Springer eBooks · doi:10.1007/978-2-8178-0235-0_7 · Cited by 1 · see citing works
Cochrane review: Media‐based behavioural treatments for behavioural problems in children
Montgomery, P., Bjornstad, G. J., & Dennis, J. (2007) · Evidence-Based Child Health A Cochrane Review Journal · doi:10.1002/ebch.204 · Cited by 1 · see citing works
Minimal Therapist Contact Treatments
Rowan, A. B., & Storey, J. M. (2002) · Elsevier eBooks · doi:10.1016/b0-12-343010-0/00138-0 · Cited by 1 · see citing works
Media-based behavioural treatments for behavioural disorders in children
Montgomery, P., & Dennis, J. A. (2005) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd002206.pub2 · Cited by 1 · see citing works
Abordaje conductual-cognitivo en el tratamiento del dolor
Turk, D. C., & Flor, H. (2007) · Elsevier eBooks · doi:10.1016/b978-84-8174-949-6.50022-8 · Cited by 1 · see citing works
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Self-citation
- Authors
- Griffiths, J. D., & Martin, P. R.
- Affiliations
- The University of Western Australia (AU)
- Corresponding author
- Martin, Paul R.
- ORCID
- Martin, Paul R.
- Venue
- British Journal of Health Psychology
- Publisher
- Wiley
- Published
- 1996-05
- Volume
- 1
- Issue
- 2
- Pages
- 151-166
- ISSN
- 1359-107X (ISSN-L)
- 2044-8287
- OpenAlex
- W2025279030
- Cited by
- 57
- References
- 0
- Citations by year
- 2025: 1 · 2023: 1 · 2019: 1 · 2018: 3 · 2017: 3 · 2016: 4 · 2014: 3 · 2013: 2 · 2012: 6
- FWCI
- 0.65
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- British Journal of Health Psychology (publishedVersion)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Migraine and Headache Studies
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Pediatric Pain Management Techniques
- Health Sciences › Health Professions › Complementary and Manual Therapy › Temporomandibular Joint Disorders
- Keywords
- chronic headache, children, migraine, tension-type headache, cognitive behavioral therapy, home-based therapy, cost-effectiveness
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