Cognitive-Behavioral Therapy for Migraine Headaches: A Minimal-Therapist-Contact Approach Versus a Clinic-Based Approach


  • This research was supported in part by a grant from The National Headache Foundation and by a Medical Research Council of Canada Studentship to G. M. Richardson. Dr. P. J. McGrath is supported by a Career Scientist Award of the Ontario Ministry of Health.



The efficacy of a clinic-based cognitive-behavioral program for the treatment of common migraine was compared to the same approach using a minimal-therapist-contact format by means of a randomized controlled trial. Forty-eight subjects between 18 and 50 years of age completed the program. Following four weeks of recording headache activity, subjects were randomly assigned to a waiting list control condition or to one of the two treatment conditions. Treatment was followed by four weeks of recording of headache activity immediately posttreatment and again six months later. Multivariate analysis of variance indicated that there was a significant reduction in headache frequency, duration and peak intensity following treatment for both treated groups. These reductions were maintained at six months follow-up. Treatment for the minimal-contact group was significantly more cost-effective than for the clinic group.