Cognitive-behavioral therapy of pediatric headache - Are there differences in efficacy between a therapist-administered group training and a self-help format?

Objective: The efficacy of cognitive-behavioral training in a therapist-administered group format (TG) and a self-help format (SH) for children with recurrent headache was compared, Methods: A total of 77 children (10-14 years) were randomly assigned to TG (n=29), SH (n=27) and a waiting-list control group (WC; n = 19). TG consisted of eight 90-min sessions with groups of five children. SH was conducted via a written manual in which instructions were given and homework tasks were assigned. In both training formats, the topics covered were identical (e.g., self-monitoring of headache, trigger analysis, relaxation, etc.). Main outcome variables related to changes in headache intensity, duration and frequency as assessed with a diary prior to and following training, as well as at 6-month follow-up. Results: Children reported a high degree of satisfaction with the training. No significant differences between the two conditions were found. Differences between treatment groups and WC were statistically corroborated for two headache variables. In both treatments, headache decreased markedly from posttraining to follow-up, with 68-76% of children reporting clinically significant improvement. No differential effects of age, gender or headache diagnosis were found. Changes in self-concept and ability to cope with stress after training point to further positive effects of the intervention. Conclusion: The efficiency of the two training formats is nearly identical. The group format, because of its better acceptance, is recommended for practical use. (C) 2002 Elsevier Science Inc. All rights reserved.