Headache therapy components

The headache programme consists of the following main components:

  • • Module 1: Engagement and headache assessment
  • • Module 2: Headache clinic
  • • Module 3: Health management
  • • Module 4: Individual therapy

Module 1: Engagement and rapport building have huge potential to facilitate a therapeutic interaction. The trust in the therapist is a prerequisite to formulate the therapy rationale in a way that is fine-tuned to the patient’s psychosocial needs and headache symptoms. The importance of building motivation and getting the patient ready for change cannot be emphasised enough.

Assessment outcomes provide the tools for the therapist and patient alike to obtain a more rational overview of an otherwise psychologically intense experience.

Module 2: Headache clinics have the purpose of helping the person cope with headaches occurring immediately after the onset event and prevent secondary psychological symptoms and behaviours. They can be highly effective for many people who have sustained a mild brain trauma. The module incorporates the reformulation approach and provides tools for psychoeducation, reassurance and signposting to additional health management services.

Module 3: The health management programme aims to introduce relaxation as the main coping strategy. Lifestyle advice and psycho-education about headache dynamics form the essential ingredients of this intervention. This can be delivered in the form of individual or group sessions. Small group settings feel safe for the reluctant participant. They are also intimate enough for supportive social interactions, which can optimise therapy adherence.

Module 4: Individual headache therapy follows naturally after the health management component. Patients will have acquired robust relaxation skills already, which can then be tailored to their specification.

The individual programme outlines weekly therapy sessions and follow-up. The starting point is an educational component in which the headache and trauma symptoms are further clarified and strategies for their reduction and modification are explored. Later on, patients focus on hindering lifestyle factors that encourage and maintain headaches. The shift towards enhancing the quality of life during headache-free periods becomes the priority at this stage. Eventually, the therapy reaches out to families and friends to help them respond to the patient’s headaches in a health-promoting way.

Headache therapy sessions are supplemented by participants practising their developing skills between sessions. Level of engagement and intervention outcomes vary between patients and are difficult to predict. Most patients with posttraumatic headache have shown lifestyle improvements and have increased their use of proactive health management and coping strategies, preferring it to medication for the reduction of their headaches.

This therapy guide provides the therapist with a large selection of practical material including assessments, norms, session plans, worksheets and therapy scripts. It is offered as an all-inclusive manual, with the aim of optimising therapy preparations. Therapists or researchers who require additional norms or material that is copyrighted will have to refer to the original literature.

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