• Justin M Nash.
• Centers for Behavioral and Preventive Medicine, Brown Medical School and The Miriam Hospital, CORO Building, Suite 500, One Hoppin Street, Providence, RI 02903, USA. Justin_Nash@Brown.edu
• Curr Pain Headache Rep. 2003 Dec 1; 7 (6): 475-81.

AbstractUsed as an adjunct or alternative to medication treatment, psychologic and behavioral approaches to tension-type headache decrease headache frequency, affective distress, and headache-related disability. These approaches directly address the psychologic and behavioral factors that contribute to the disorder and to the individual headache episodes. There is well-established evidence of efficacy for the three broad approaches: relaxation training, electromyographic biofeedback training, and cognitive-behavioral stress management. Treatment has been difficult to access, with most care provided by behavioral specialists in tertiary care settings using clinic-based or home-based treatment protocols. Recent attempts to make treatment more accessible to a wider range of tension-type headache sufferers include using medical personnel to deliver treatment from physician practices and using existing and emerging technologies to provide care in a purely self-administered format without face-to-face contact with therapists. These attempts are promising, but remain preliminary; therefore, there is a need for further development and testing.

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