Program

Sep 12, 2008

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 parentswere
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 childrenwere 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
morebeneficial 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 INFORMATION

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.

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

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