Objective: To review the empirical research examining behavioral treatments
for recurrent pediatric headache.
Methods: Thirty-one investigations published after 1980 were reviewed using
predetermined criteria to evaluate the adequacy of research methodologies.
A modification of criteria proposed for evaluating the efficacy of psychol
ogical interventions for adults (Task Force on Promotion and Dissemination
of Psychological Procedures, 1995) was used to evaluate the adequacy of evi
dence available for individual intervention strategies.
Results: Sufficient evidence exists to conclude that relaxation/self-hypnos
is is a well-established and efficacious treatment for recurrent headache.
Furthermore, enough evidence exists to conclude that thermal biofeedback al
one is a probably efficacious treatment. Other promising interventions have
been tested that combine relaxation and biofeedback or integrate other cog
nitive-behavioral treatment approaches, but are limited by inadequate resea
rch methodologies.
Conclusions: We discuss the importance of developmentally based conceptual
models and the impact of diagnostic heterogeneity and offer specific recomm
endations for future intervention research in the area of recurrent pediatr
ic headache.