Behavioral management of headaches: A review of the evidence

It is clear that a number of behavioral treatments that do not involve biofeedback training are also effective against headaches. The evidence is strongest for relaxation training, which has been shown to be helpful in both tension headaches and migraines. Controlled group outcome studies have also demonstrated the value of transcendental meditation and training in cognitive coping skills for tension headaches and of hypnotherapy for migraine. Again, the mechanisms of treatment are not clear. Relaxation training as a treatment for headaches has a number of advantages over most other techniques, chief among them that it does not require sophisticated equipment or highly trained personnel for its administration. Hence, currently it would appear to be the behavioral treatment of choice for headaches. Theoretical and empirical considerations suggest that the effectiveness of relaxation training is increased by including in the treatment program one or two other behavioral techniques, such as biofeedback training or training in cognitive coping skills.