Randomized Controlled Trial of the Acceptability, Feasibility, and Preliminary Effects of a Cognitive Behavioral Skills Building Intervention in Adolescents With Chronic Daily Headaches: A Pilot Study

Introduction: The treatment challenge of adolescents with chronic daily headaches (CDHs) creates an urgent need for evidence-based interventions. Therefore the purpose of this pilot study was to evaluate the acceptability, feasibility, and preliminary effects of a brief cognitive behavioral skills building intervention with 36 adolescents, 13 to 17 years of age, who had CDHs and mild to moderate depressive symptoms. Methods: Participants were randomly assigned either to the Creating Opportunities for Personal Empowerment-Headache Education Program (COPE-HEP) or to a headache education comparison group. Results: Adolescents and parents found the COPE-HEP to be highly acceptable. Medium to large positive effects were demonstrated on the adolescents' depression in both groups and on anxiety and beliefs in the COPE-HEP group. COPE-HEP offered additional benefits of a larger decrease in adolescent anxiety over time and stronger beliefs in the teens' ability to manage their headaches. Discussion: Adolescents with CDHs and elevated depressive/anxiety symptoms should be offered headache hygiene education plus cognitive-behavioral skills building interventions.A full-scale trial to determine the more long-term benefits of COPE-HEP is now warranted.