Home-based multicomponent treatment of pediatric migraine.

The present investigation examined a home-based multicomponent treatment program incorporating biobehavioral technology in the treatment of pediatric migraine. Twenty-one children ages 7-12 participated in home-based practice of thermal biofeedback while parents implemented guidelines designed to encourage the use of biofeedback and eliminate support for maladaptive pain behavior. Treatment was introduced sequentially across three groups of children in a multiple baseline design. When subjects and their families were complaint with treatment recommendations, 87% of the children experienced clinically significant reductions in headache activity, with these reductions maintained at 3 and 8 month followups. Treatment outcome was found to be closely related to frequency of home practice, parental support for the use of adaptive coping (biofeedback) rather than maladaptive coping (pain) behaviors, and ability to warm hands. Discussion is provided concerning potential mechanisms of action and directions for future research.