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Well-Established and Empirically Supported Behavioral Treatments for Migraine


This paper provides an overview of the well-established and empirically supported behavioral interventions for the treatment of migraine. The considerable evidence base addressing behavioral interventions amassed since 1969 has conclusively established the efficacy of therapies featuring combinations of relaxation, biofeedback, and stress management training, and demonstrated they are capable of yielding benefits on par with pharmacological therapies for migraine. Behavioral interventions also are well suited for delivery across a variety of different contexts (e.g., group vs. individual, standard clinic vs. limited therapist contact, face-to-face vs. technology-assisted). Despite the amply established efficacy and effectiveness of these self-management interventions for the treatment of migraine, the availability and implementation of these approaches remain limited for many headache sufferers. We anticipate the technological advances in delivery platforms will provide better access to behavioral self-management strategies for migraine.

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Papers of particular interest, published recently, have been highlighted as: •• Of major importance

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Conflict of Interest

Donald B. Penzien reports grants from Merck and Co., Inc.

Megan B. Irby declares no potential conflicts of interest.

Todd A. Smitherman receives research support from Merck.

Jeanetta C. Rains reports National Institute of Health R21, Sleep Regulation and Circadian Phase in Chronic Migraine Position: Consultant (principal investigator: Jason Ong, PhD, Rush University) (2013–2015).

Timothy T. Houle reports grants from Merck and Co., Inc.

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This article does not contain any studies with human or animal subjects performed by any of the authors.

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Correspondence to Donald B. Penzien.

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This article is part of the Topical Collection on Psychological and Behavioral Aspects of Headache and Pain

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Penzien, D.B., Irby, M.B., Smitherman, T.A. et al. Well-Established and Empirically Supported Behavioral Treatments for Migraine. Curr Pain Headache Rep 19, 34 (2015).

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  • Migraine
  • Self-management
  • Behavioral treatment
  • Relaxation training
  • Biofeedback
  • Cognitive behavioral therapy
  • Stress management training