Approximately 10 percent of children experience Migraine, yet few Migraine treatments have been approved to treat kids. A study published in the October 2016 issue of New England Journal of Medicine concluded that children are more likely to experience serious side effects and that some common pharmacological treatments are no better than placebo. Children are not just miniature adults. Their bodies respond differently, so treating pediatric Migraine requires a unique approach.
The use of cognitive behavioral therapy (CBT) in addition to medication has been shown effective in the treatment of adults with Migraine. However, the studies for kids have produced mixed results. A recent meta-analysis of 14 randomly controlled studies took a closer look and determined that CBT can be helpful to kids with Migraine in addition to medication therapy.
In fact, the analysis revealed that CBT alone produced a clinically significant improvement by reducing Migraine frequency and severity by 50 percent. These benefits persisted for up to a year. Let’s examine some of the reasons why CBT is so successful for pediatric Migraine treatment.
Components of CBT
- Psychoeducation provides information about Migraine and the psychological factors that may affect Migraine symptoms. This includes reassurance that Migraine symptoms are real and an explanation of the neurobiological process involved in Migraine.
- Self-monitoring training teaches patients how to track symptoms, identify triggers, and monitor progress.
- Coping skills training includes relaxation techniques and practice recognizing and challenging thought processes that might interfere with good Migraine management.
- Problem-solving skills training focuses on improving decision-making abilities regarding acute symptom management and trigger avoidance.
- Homework is given each session to encourage practice of new skills between sessions.
- No known side effects
- Doesn’t required daily medication compliance
- Improves self-efficacy
- Teaches skills for self-management of Migraine
- Reduces disability and health care costs
- May be costly
- Child may miss school or other activities to keep appointments
- May only be effective for kids who can reflect on their internal thought processes
- Distance therapy
- Self-paced courses
Benefits of CBT
- Provides better coping strategies to deal with Migraine symptoms.
- Modifies environmental factors that maintain pain behaviors.
See more helpful articles:
Ng Q, Venkatanrayanna N, Kumar L. A Systematic Review and Meta-Analysis of the Efficacy of Cognitive Behavioral Therapy for the Management of Pediatric Migraine. Headache, 2017; 57:349-362. doi: 10.1111/head.13016.
Powers S, Coffey C, Chamberlin L, et al for the CHAMP Investigators. Trial of Amitriptyline, Topiramate, and Placebo for Pediatric Migraine. New England Journal of Medicine. Online First. October 27, 2016.
Reviewed by David Watson, MD.
© Tammy Rome, 2017.
Headache disorders counselor and advocate Tammy Rome maintains a private practice specializing in treating clients with Migraine and other headache disorders. She also volunteers as vice chair of the American Headache and Migraine Association and as president of The Cluster Headache Support Group. You can read more of Tammy’s work on her website and follow her on Facebook, Twitter, StumbleUpon, Pinterest, LinkedIn, and Google+.