Cognitive behavioural therapy
Cognitive behavioural therapy (CBT)
How CBT works: Sometimes when doctors recommend CBT with a psychotherapist or clinical psychologist to a person, that person feels like the doctor is saying that their pain is just in their head. This is not the case with CBT; CBT is a way to re-wire the brain so that it feels less pain. CBT usually consists of guided therapy with a trained professional where people learn how pain works in the body and how pain can be influenced by behaviour, emotions, and thoughts. In CBT people also learn coping skills, and sometimes parents will learn how to use reinforcement and praise to help a child to manage their headaches. 1
Evidence in children: A study investigating CBT for children with chronic migraine found that CBT in combination with amitriptyline reduced the number of headache days and the migraine-related disability that a child experienced. 1 a benefit of CBT is that, unlike medication, it has the potential to continue to be beneficial after the treatment is finished.
Cautions: The downsides of CBT are cost and time commitment. Undergoing CBT can be time-consuming and also hard work for a child and their family but ultimately with little to no negative side effects and generally positive outcomes.
1. Powers, S. W. et al. Cognitive Behavioral Therapy Plus Amitriptyline for Chronic Migraine in Children and Adolescents: A Randomized Clinical Trial. JAMA 310, 2622–2630 (2013).