Self‐help Treatment for Migraine Headaches: A Controlled Outcome Study

SYNOPSIS A self‐help approach for the control of migraine headaches was evaluated. Self‐help refers to a self‐directed effort, without therapist contact aimed at reducing the symptoms of migraine. The experimental plan involved giving migraine headache patients one of two experimental books and then evaluating the effect. Subjects were recruited through newspaper announcements and were required to have had at least two vascular headaches per month. During the first six weeks of the study, the baseline period, all subjects recorded headache frequency, intensity and duration. Subjects were then matched for headache frequency and then randomly assigned to receive either the treatment or control book. The treatment book contained instructions for thermal biofeedback, relaxation and cognitive behavior therapy. A liquid crystal device for measuring fingertip temperature was also included. Instructions in the treatment book were written such that a self‐help, no‐therapist treatment could be followed by the subject. The control book was a popularly available paperback in which a series of case studies on headache treatment and diagnosis were discussed. It was selected because it was easy to read and contained information about headaches but did not necessarily direct the reader to start a self‐help program. Data was obtained for 51 subjects who completed a three‐ and six‐month followup data collection period (treatment N = 22, control N = 29). There was a 62% decrease in headache frequency at six months for subjects who received the treatment book and a 14% drop for those who received the control book. Corresponding findings were also obtained for duration and pain levels of the headache as well as for prescribed medication use. Although the results indicated that this type of self‐help treatment could be effective for many migraine patients, limitations and cautions in interpretation of these results were discussed.