Cognitive-behavioral therapy of pediatric headache: are there differences in efficacy between a therapist-administered group training and a self-help format?
Researchers from the University of Goettingen in Germany compared the efficacy of cognitive-behavioral training in a therapist-administered, group format, to a self-help format (no therapist) with 77 children, ages 10-14, suffering from recurrent headache. The children were randomly assigned to either the therapist CBT group (n=29), the self-help group (n=27) or a wait list condition (n=19). In both formats, the topics covered were identical (e.g., self-monitoring of headache, trigger analysis, relaxation, etc.). Sessions were 90 minutes with groups of 5 children assigned to each. The self-help groups were given a written manual in which instructions were given and homework tasks assigned. The main outcome variables were related to changes in headache intensity, duration and frequency, as assessed in a diary prior to and following training, as well as at 6-month follow-up. The children reported an equally high degree of satisfaction with the training, with no significant differences between the two conditions. In both, headaches decreased markedly from posttraining to follow-up, with 68-76% of the children reporting clinically significant improvement. There were also significant changes in self-concept and ability to cope with stress after both types of intervention. In addition, the investigators found no differences by age, gender or headache diagnosis. The study concludes that the efficacy of the two training formats is nearly identical.