Recurrent headaches in a pediatric population: the applicability of a cognitive-behavioural treatment program for preadolescents

Hill, Marilyn Louise (1993) Recurrent headaches in a pediatric population: the applicability of a cognitive-behavioural treatment program for preadolescents. Masters thesis, Memorial University of Newfoundland.

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Abstract

Despite a burgeoning interest in the treatment of pediatric pain, few studies have evaluated cognitive-behavioural treatment approaches for recurrent pain in young children. The present study describes the development of a pain clinic for preadolescents with recurrent headaches in St. John’s, Newfoundland. The goal of this study was to determine how successfully the preadolescents referred to the clinic could use cognitive-behavioural skills to reduce their headache activity, as well as to isolate any symptom or treatment-related variables associated with treatment success. Lack of referrals and problems eliciting parental cooperation made it impossible to address these goals with any confidence. During a 12 month trial period only 15 referrals were received, 5 of whom began the treatment program. Once in the program adherence to record keeping was high (86%), as was compliance with the assigned relaxation practice. All 5 children were able to significantly reduce their tension levels using relaxation, and 2 children were able to adapt and personalize the relaxation approach to fit certain stress inducing situations. Clearly, these children were able to use cognitive-behavioural strategies to combat stress. As a group, the children showed reductions following treatment in headache frequency, intensity, and medication use. Three of the subjects showed improvements in overall headache symptomatology of 93-99% and were largely headache-free post-treatment. One subject was moderately improved (42%) following treatment, while the final subject remained unimproved. These results suggest that young children are able to use cognitive behavioural skills to reduce headache symptomatology, although many practical problems may make it difficult to establish regular treatment sessions with this age group. Several of the problems faced during the course of this study are outlined, and suggestions are made regarding both the source of these difficulties and possible approaches to improve treatment availability for these young people.

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