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Health Forum Online    The Psychologist's Source for C.E. Credits Online

A Review of Behavioral Medicine Treatments of Headaches

by Lucy Rathier, PhD 6 CE Credits

Approximately 90% of the U.S. population experiences occasional headache pain with 23 million headache sufferers experiencing severe migraines. The experience of headache, especially migraine, often results in pain, disability, and psychological distress for the individual.  Among migraine sufferers, over 80% experience some degree of headache-related disability.  Migraine alone accounts for an estimated 157 million days lost from work.  In addition, there are high rates of co-morbid psychiatric disorders among individuals with headaches such as depression, anxiety, and post-traumatic stress disorder. Mental health professionals can play a key role in the multidisciplinary approach to headache treatment.  Behavioral Medicine techniques such as biofeedback, cognitive-behavioral therapy, and relaxation have proven efficacious, either alone or in combination with pharmacotherapy, to manage co-morbid psychiatric disorders, address treatment adherence problems, and modify some risk factors for the progression of headaches.  This course provides evidence-based clinical behavioral medicine interventions for this patient population.  The principal types of headaches and their causes are described and biobehavioral variables are discussed.  Clinical assessment is addressed and elements of nonpharmacological behavioral medicine alternative treatment of headache are presented, along with specific ways to coordinate/integrate care with providers of pharmacological treatment.


This online course is approved for APA CE credit, NBCC CE clock hours, ASWB Clinical CE clock hours, and NYSED CE credit.


Course Sections/Outline:

  • Introduction: Prevalence, Incidence, and Cost of Headaches
  • Principal Types of Headaches
  • Psychosocial and Behavioral Variables that Influence Headache
  • Behavioral Medicine Clinical Assessment of Headache
  • How Does Behavioral Medicine Fit into HeadacheTreatment?
  • The Psychoeducational Component of Behavioral Medicine Treatment
  • Complementary and Alternative Medicines
  • Evidence-Based Biobehavioral Treatments of Migraine
  • Treatment Planning and Matching
  • Promoting Treatment Adherence: Another Possible Role for the Mental Health Provider
  • Coordinating Care among Health Care Providers
  • Internet Resources
  • References

Learning Objectives:

After completing this course, health professionals will be able to:
  • Identify the prevalence, symptoms and causes of 4 types of ‘primary’ and 5 types of ‘secondary’ headaches
  • Apply a biopsychosocial model to identify 3 critical factors — behavioral, affective, & cognitive — that influence headache pain
  • Conduct a psychological assessment specific to patients with headache drawing from at least 10 headache-specific and 6 additional, relevant assessment areas
  • Discuss 2 evidence-based non-pharmacologic interventions designed to manage headache pain including trigger/pattern identification and management, as well as how to apply cognitive-behavioral therapy, relaxation strategies, and biofeedback into the care of these patients
  • Recognize at least 3 models of medical interventions in this domain (e.g., abortive, preventive, symptomatic) and the drugs commonly used within them, as well as 6 complementary/alternative medicines, in order to assist with medication adherence and reduce medication overuse
  • Explain 4 advantages and 2 approaches to coordinating headache care with other health care providers