None listed
Conditions
Brief summary
The standard clinical advice for individuals who suffer from recurrent headaches is that ‘the best way to prevent headaches is to avoid the triggers’. There is a plausible argument that such advice may be counter to the interests of headache suffers as it could lead to increased sensitisation and decreased tolerance of headache triggers and therefore more headaches. Research results suggest that it should be possible to increase individual’s tolerance of headache triggers through prolonged exposure for desensitisation or providing exposure as an opportunity to practice coping with headache triggers. The proposed study seeks to compare a psychological treatment that advocates avoidance of headache triggers, with a coping approach that uses exposure to triggers (supported by relaxation and cognitive techniques) except where this is not possible or would seem inappropriate. It is predicted that exposure will increase tolerance to headache triggers and lead to fewer headaches in the long term, whereas avoidance may at best provide short term relief. The study results will have important implications for our understanding of how headache disorders can be more effectively managed in the future.
Interventions
Intervention 1: Three 30-minute sessions scheduled for weeks 1, 4 and 8. Advice is given to avoid headache triggers and on how to accomplish avoidance, administered in an individual format by a registered psychologist. Intervention 2: 8 weekly sessions of cognitive behaviour therapy, relaxation techniques and exposure as an opportunity to practice coping skills or when not possible avoidance, administered in an individual format by a registered psychologist. Each session will be 60 minutes in du
Intervention 1: Three 30-minute sessions scheduled for weeks 1, 4 and 8. Advice is given to avoid headache triggers and on how to accomplish avoidance, administered in an individual format by a registered psychologist. Intervention 2: 8 weekly sessions of cognitive behaviour therapy, relaxation techniques and exposure as an opportunity to practice coping skills or when not possible avoidance, administered in an individual format by a registered psychologist. Each session will be 60 minutes in duration. Intervention 3: Eight 60-minute weekly sessions of cognitive behaviour therapy and relaxation, administered in an individual format by a registered psychologist.
Sponsors
Professor Paul Martin (Principal Investigator)
Study design
Allocation
Randomised controlled trial
Intervention model
Factorial
Primary purpose
Treatment
Masking
Blinded (masking used)
Eligibility
Sex/Gender
All
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
Inclusion criteria: (i) diagnosed as either ‘migraine without aura’, ‘probable migraine without aura’, ‘typical aura with migraine headache’, ‘probable migraine with aura’, ‘chronic migraine’, ‘frequent episodic tension-type headache’, probable frequent episodic tension-type headache’, ‘chronic tension-type headache’, ‘probable ergotamine-overuse headache’, ‘probable triptan -overuse headache’, ‘probable analgesic -overuse headache’, ‘probable opioid-overuse headache’, ‘probable combination analgesic-overuse headache’, ‘headache probably attributed to overuse of acute medication combinations’, ‘headache probably attributed to other medication overuse- Headache Classification Subcommittee of the International Headache Society (IHS), 2005; (ii) minimum of 6 headache days per month; (iii) minimum headache chronicity of 12 months, and pattern of headache symptoms stable over last 6 months.
Exclusion criteria
Exclusion criteria: (i) pregnant, planning pregnancy during trial period or lactating; (ii) currently taking headache prophylactic medication (one month wash-out period required); (iii) currently receiving psychological or psychiatric treatment.
Outcome results
None listed