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Internet-Based Treatment of Headache: Does Telephone Contact Add Anything?


Address all correspondence to Dr. Gerhard Andersson, Department of Psychology, Uppsala University, Box 12 25, SE-751 42 Uppsala, Sweden.


Objective.—To study the contribution of therapist-initiated telephone contact in the treatment of recurrent headache via the Internet.

Background.—Internet-based cognitive behavioral self-help is a promising new venue for the treatment of recurrent headache. While cost-effective, there are indications that this modality may be associated with high dropout rates.

Design and Methods.—The role of therapist-initiated contact was investigated in a randomized controlled trial in which 44 self-recruited headache sufferers were randomized to either a Web-based self-help program with e-mail support or to a group receiving, in addition, weekly individual telephone calls. An additional 8 control subjects were recruited to receive similar treatment outside of the study.

Results.—Dropout rates were 29% in the telephone support group and 35% in the control group, suggesting that the telephone calls did not affect dropout. Results showed significant reductions in headache-related disability, depression, maladaptive coping strategies, and perceived stress but little to indicate any superior performance in the Internet-only group and little improvement in the headache index. In short, therapist-initiated telephone calls did not influence the results.

Conclusions.—Internet-based treatment for headache is not affected by minimal therapist-initiated telephone contact.