Head Strong

OVERVIEW

The Head Strong program is a pain management program that uses minimal therapist contact.  Instead, it relies on a CD-ROM treatment program to help children reduce their headaches.  Children were either placed in a treatment group where they worked through a 4-week home-based CD-ROM program, or were placed on a waiting list and continued to follow their neurologist's advice.  Data were collected on the patients before the treatment began and for up to three months after the program ended.  Children who participated in the program were found to have a greater reduction in headache frequency, duration, and intensity than those children who did not participate in the Head Strong program.      

DESCRIPTION OF PROGRAM

Target population: Boys and girls ages 7-12 years with recurrent headaches, including migranes.

Approach: Children and their parents were asked to independently record the occurrence, duration, and intensity of the children's headaches at the end of each day before the Head Strong began.  The children and parents were split into two groups - one that received the CD-Rom treatment program, and one that did not receive the program.  All of the children were allowed to continue seeing their neurologists.  The children participating in the program worked through the 4-week CD-ROM program, completing one module per week.  The modules were on education, relaxation, thought-changing, and pain behavior modification.  Each lesson within the module took approximately 10 minutes to complete, and the whole module took approximately 1 hour to complete.  All children, including those who did not get the treatment, were asked to fill out weekly pain diaries throughout the four-week period, and for up to 3 months after the treatment ended.  The children who did not receive Head Strong were allowed to begin the program 2 months after the children in Head Strong completed the program.  All children received weekly calls to make sure that they were filling out the pain diaries.           

EVALUATION(S) OF PROGRAM

Evaluated population: There were 19 boys and 18 girls aged 7-12 years old in the Head Strong program.  A majority of the children were Caucasian (86%) and middle-class.  The rest of the population was as follows: 8% Hispanic, 3% African-American, and 3% Asian.    

Approach:  The children were recruited at an outpatient neurology clinic at a large children's hospital in the Northwest.  The children and their parents separately filled out a pain diary for 14 days before the children were allowed to enter into the group.  The children were separated by their ages, 7-9 and 10-12, and from there the children were randomly assigned to the group that would either receive or not receive the program.  All of the children were permitted to continue seeing their neurologists.  The neurologists who the children saw did not know whether their patient was participating in the program or not.  The children participating in Head Strong worked through a 4-week CD-ROM program completing one module per week.  The four modules that the children completed focused on education, relaxation, thought-changing, and pain behavior modification.  Each lesson within the module took approximately 10 minutes to complete, and the whole module took approximately1 hour to complete.  All children were asked to fill out weekly pain diaries throughout the treatment period and for up to 3 months after the treatment ended.  The children who did not initially receive the program were allowed to begin the program 2 months after the children in Head Strong completed the program.  All children received weekly calls.          

Results:  The results of the study suggest that combining the CD-ROM self-management treatment with standard medical care is more beneficial in reducing children's headaches than standard medical care alone.  Children who participated in the program had a significantly greater reduction in headache frequency, duration, and intensity than those children who did not participate in the program.  The reduction in headache frequency, duration, and intensity remained 3-months after the treatment was completed.  Significantly more of the children who participated in the program were found to have a greater reduction in pain level (50% reduction in headache pain) than those children who did not participate in the program.      

The authors suggest combining the Head Strong CD-ROM treatment with regular medical care for children with headaches.  The child's headache pain is decreased with minimal contact psychological intervention, the treatment is tailored to the child's needs, the treatment may help prevent the development of a life long syndrome, and the treatment will be easily accessible and will reduce costs for the family and healthcare system. 

SOURCES FOR MORE INFOMRATION

References

Connelly, M., Rapoff, M. A., Thompson, N., and Connelly, W. (2006). Headstrong: A pilot of a CD-ROM intervention for recurrent pediatric headache. Journal of Pediatric Psychology, 31(7), 737-747.

Program categorized in this guide according to the following:

Evaluated participants: 7-12 years / Program age ranges in guide: middle child; adolescents

Program components: CD-ROM-based, provider-based

Measured outcomes: Physical health

KEYWORDS: Middle Childhood (6-11), Children (3-11), Adolescence (12-17), Home-based, Caucasian or White, Hispanic or Latino, African American or Black, Asian, Computer-based, Physical Health, Self Regulation

Program information last updated 9/12/08

© Child Trends 2003