Behavioral treatment approaches to chronic headache.

Over 3 decades of research have shown the utility of a number of behavioral treatments, chiefly relaxation, biofeedback, and cognitive behavior therapy, for uncomplicated forms of migraine and tension-type headache. However, the literature base is much less extensive for chronic, complicated, and refractory forms of headache. This paper reviews extant work on the usefulness of behavioral treatment for headache accompanied by medication overuse; chronic, daily, high intensity headache; refractory headaches; cluster headache; chronic tension-type headache; posttraumatic headache; and headache accompanied by psychiatric comorbidity. It concludes with a discussion of the role of environmental and familial factors in influencing chronic headaches. Suggestions for future research are pointed out along the way.