Cognitive coping skills training and relaxation training as treatments for tension headaches

Abstract

Twenty-three tension headache subjects completed eight weekly sessions of small group treatment either with progressive relaxation therapy or with cognitive therapy. Compared with previous literature, the magnitude of improvements in the Headache Index in the cognitive therapy condition was similar to that typically observed in active psychological treatment conditions, and larger than that typically observed in placebo conditions. Improvements in the relaxation condition were within the range commonly observed for medication placebos, and smaller than those reported previously by others. The proportion of subjects showing clinically significant (≥50%) improvement in headache activity was greater for cognitive than for relaxation therapy. Of the two components of the Headache Index, one (mean number of days per week with a headache) clearly differentiated the two groups, whereas the other (mean severity of the worst headache of the week) did not. Both treatments appeared to produce improvements in self-rated ability to cope with headaches. Improvement in headache did not appear to be mediated by therapeutic expectancies.