Home-based, largely self-administered, non-pharmacological treatments for chronic headache, based on instruction manuals and sets of autiotapes will be compared, in controlled studies, to comparable office-based treatments in terms of efficacy, or the extent of headache reduction, and also in terms of cost effectiveness, or the extent of headache reduction per unit of therapist time. Two separate, but parallel and highly similar, studies are proposed: For tension headache, after a one month baseline of daily headache recording we will randomly assign 40 patients to one of two conditions to compare our standard office-based relaxation training program to similar training conducted largely at home by means of instruction manuals and audiotapes. For vascular headache (migraine and combined migraine and tension headache) again after a one-month baseline, we will randomly assign 42 patients to one of two conditions: An office-based treatment which combines relaxation training and thermal biofeedback or a comparable home-based program. We use a combined treatment for two reasons: our own data point out the advantage of adding thermal biofeedback to relaxation training, especially for combined headache; and it is practical to add thermal biofeedback to a home treatment regimen through the use of very simple devices. Comparisons will be made in each study of efficacy for headache reduction and cost effectiveness. We will follow-up the patients treated in both studies for at least a year to investigate maintenance of treatment effects. In both cases the home-based treatments are designed for practical adoption in medical practices, through providing for the combination of some limited professional instruction in the office with the bulk of treatment being self-administered. Should the home-based, self-administered treatment packages be as cost-effective, or more cost-effective, than individual office-based treatment, it could lead to overall reduction in health care costs for this large scale, minor health program. Moreover, it could also provide a ready alternative, or adjunct, to pharmacological treatment forthe chronic headache sufferer. Finally, we propose to extend the follow-up data collection on our initial cohort of chronic headache sufferers treated with relaxation, and possibly biofeedback, to at least two years to add to knowledge in this area.

Agency
National Institute of Health (NIH)
Institute
National Institute of Mental Health (NIMH)
Type
Research Project (R01)
Project #
9R01MH041341-07
Application #
3379957
Study Section
Behavioral Medicine Study Section (BEM)
Project Start
1986-04-01
Project End
1988-03-31
Budget Start
1986-04-01
Budget End
1987-03-31
Support Year
7
Fiscal Year
1986
Total Cost
Indirect Cost
Name
State University of New York at Albany
Department
Type
Schools of Arts and Sciences
DUNS #
City
Albany
State
NY
Country
United States
Zip Code
12222
Blanchard, E B; Peters, M L; Hermann, C et al. (1997) Direction of temperature control in the thermal biofeedback treatment of vascular headache. Appl Psychophysiol Biofeedback 22:227-45
Blanchard, E B; Appelbaum, K A; Radnitz, C L et al. (1990) A controlled evaluation of thermal biofeedback and thermal biofeedback combined with cognitive therapy in the treatment of vascular headache. J Consult Clin Psychol 58:216-24
Blanchard, E B; Appelbaum, K A; Nicholson, N L et al. (1990) A controlled evaluation of the addition of cognitive therapy to a home-based biofeedback and relaxation treatment of vascular headache. Headache 30:371-6
Guarnieri, P; Blanchard, E B (1990) Evaluation of home-based thermal biofeedback treatment of pediatric migraine headache. Biofeedback Self Regul 15:179-84
Blanchard, E B; Appelbaum, K A; Radnitz, C L et al. (1990) Placebo-controlled evaluation of abbreviated progressive muscle relaxation and of relaxation combined with cognitive therapy in the treatment of tension headache. J Consult Clin Psychol 58:210-5
Michultka, D M; Blanchard, E B; Appelbaum, K A et al. (1989) The refractory headache patient--II. High medication consumption (analgesic rebound) headache. Behav Res Ther 27:411-20
Morrill, B; Blanchard, E B (1989) Two studies of the potential mechanisms of action in the thermal biofeedback treatment of vascular headache. Headache 29:169-76
Blanchard, E B; Appelbaum, K A; Radnitz, C L et al. (1989) The refractory headache patient--I. Chronic, daily, high intensity headache. Behav Res Ther 27:403-10
Michultka, D M; Poppen, R L; Blanchard, E B (1988) Relaxation training as a treatment for chronic headaches in an individual having severe developmental disabilities. Biofeedback Self Regul 13:257-66
Blanchard, E B; Andrasik, F; Guarnieri, P et al. (1987) Two-, three, and four-year follow-up on the self-regulatory treatment of chronic headache. J Consult Clin Psychol 55:257-9

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