Patients' experiences of a behavioural intervention for migraine headache: a qualitative study
Open accessAbstract
BACKGROUND: Migraine headache has a high prevalence and a severe impact on personal, social and work life, forming a significant burden on patients, service providers and society. There is some evidence of the effectiveness of behavioural interventions to supplement drug therapy but a recognised need to identify an effective minimal contact approach to enhance access and provide a model for use in publicly funded health systems. This study uses in-depth interviews to examine patients' experience and responses to a behavioural intervention with relaxation and CBT components delivered in three individual therapist sessions with follow-up. METHODS: Qualitative study of 20 adults aged 18-75 years in London, UK, with clinically diagnosed migraine and at least four headache days per month. Semi-structured and tape recorded interviews were held post intervention based on a topic guide. Transcripts were coded and charted for all participants and analysed thematically. RESULTS: The majority of participants cited the impacts of migraine and a desire for additional non-drug treatment as their main reasons for taking part and almost all completed the course. They valued contact with the therapist and almost all reported benefiting from the therapy. Post intervention they used those techniques they found most beneficial and implemented them flexibly in their daily life to reduce stress and risks of migraine or to respond to migraine. Relaxation training (deep breathing) was easily adopted and often used post intervention. The CBT components were mainly viewed positively but regarded as more challenging to learn and implement. CONCLUSIONS: Patients' selectively identified and employed the techniques learned as 'tools' to assist in preventing and managing their migraines, with reported benefits supporting the development of minimal contact behavioural therapy to increase accessibility for adults with migraine headache and the conduct of a definitive trial.
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Participants of the RLX group found the relaxation exercises probably easier to implement since CBT techniques are supposed to be more challenging to apply in everyday life.
“The participants of the RLX found the relaxation exercises probably easier to implement since CBT techniques are supposed to be more challenging to apply in everyday life (51).”
From Efficacy of Cognitive-Behavioral Therapy for the Prophylaxis of Migraine in Adults: A Three-Armed Randomized Controlled Trial (2022) · cites this paper as [51]
The Discussion says participants found deep breathing in relaxation training easy to implement, while identifying thoughts, emotions and behaviours in the CBT component was the main challenge. The source studied a combined relaxation-and-CBT intervention, not a separate RLX group, so it supports the comparison but not the group-specific finding. (LLM, conf=0.84)
Experimental — accuracy not yet measuredPatients are probably capable to select and employ behavioral techniques that are suitable for their individual needs by self-management.
“Probably, patients are capable to select and employ behavioral techniques that are suitable for their individual needs by self-management (51).”
From Efficacy of Cognitive-Behavioral Therapy for the Prophylaxis of Migraine in Adults: A Three-Armed Randomized Controlled Trial (2022) · cites this paper as [51]
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The Social Life of Migraine: A Meta-Ethnography of Lived Experience in Adults With Migraine
Ng, Q. X., Zhou, K. X., Lin, C. Y. X., Chan, C. K. M., Murugasu, S., Ang, A. Y. H., Sandhu, G. S., Lim, Y. L., & Tang, A. S. P. (2026) · Health Services Insights · doi:10.1177/11786329261457982
- Authors
- Morgan, M., Cousins, S., Middleton, L., Warriner-Gallyer, G., & Ridsdale, L.
- Affiliations
- King's College London (GB)
- Corresponding author
- Morgan, Myfanwy
- Venue
- The Journal of Headache and Pain
- Published
- 2016-02-27
- Volume
- 17
- Issue
- 1
- Pages
- 16-16
- ISSN
- 1129-2369 (ISSN-L)
- 1129-2377
- PMC
- PMC4769711
- OpenAlex
- W2274421780
- Cited by
- 25
- References
- 37
- Citations by year
- 2026: 1 · 2025: 3 · 2024: 1 · 2023: 2 · 2022: 1 · 2021: 1 · 2020: 2 · 2019: 5 · 2018: 2 · 2017: 4 · 2016: 3
- FWCI
- 4.15
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Locations
- The Journal of Headache and Pain (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Bristol Research (University of Bristol) (publishedVersion)
- Research Portal (King's College London) (submittedVersion, cc-by)
- Funders
- National Institute for Health Research (PB-PG-0610-22373)
- 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 › Epidemiology › Traumatic Brain Injury Research
- Keywords
- migraine, behavioral interventions, cognitive behavioral therapy, relaxation training, deep breathing, non-pharmacological treatment, patient experience, migraine prophylaxis, stress management, therapist contact
- MeSH terms
- Adolescent, Adult, Aged, Female, Humans, Male, Middle Aged, Migraine Disorders, Relaxation Therapy, Cognitive Behavioral Therapy, Treatment Outcome, Qualitative Research, Young Adult
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