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Behavioral approaches to headache: A practical guide for non-mental health providers

机译：头痛的行为方法：非心理健康提供者的实用指南

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Behavioral treatments such as relaxation training, biofeedback, and cognitive behavioral therapy have repeatedly demonstrated significant efficacy for the treatment of migraine-and tension-type headache. Behavioral treatments and pharmacologic treatments together also have an additive effect such that the combination of the 2 treatments is more effective than either treatment alone. The action mechanisms of behavioral approaches revolve around the following constructs: (1) self-efficacy; (2) internal vs external locus of control; (3) stress management skills; and (4) pain-coping skills. As these constructs can remain relatively stable over time, behavioral treatments offer lasting results for the management of pain. Despite the aforementioned clinical insights, financial constraints and limited access to behavioral health experts make it difficult to fully integrate behavioral approaches into treatment. As such, this article serves as a guide for medical doctors and clinicians of various disciplines to gain awareness of and integrate these approaches into their headache armamentarium. We present approaches to maximize patients' openness to a multimodal model and keys to distinguish patients who require specialist-level care. We close with a call for greater inclusion of behavioral medicine in graduate level medical training.
机译：诸如放松训练，生物反馈和认知行为疗法之类的行为疗法已反复证明可有效治疗偏头痛和紧张型头痛。行为治疗和药物治疗也共同具有累加作用，因此两种治疗的组合比单独使用任何一种治疗更有效。行为方法的作用机制围绕以下构架：（1）自我效能感; （2）内部与外部控制源; （3）压力管理技巧; （4）应对疼痛的技巧。由于这些构造可以随时间保持相对稳定，因此行为治疗可为疼痛的治疗提供持久的结果。尽管有上述临床见解，但经济拮据和行为健康专家的访问受到限制，使得难以将行为方法完全纳入治疗。因此，本文可作为各种学科的医生和临床医生的指南，以了解这些方法并将其整合到他们的头痛药房中。我们提出了使患者对多模式模型开放性最大化的方法和区分需要专家级护理的患者的关键。最后，我们呼吁将行为医学更多地纳入研究生水平的医学培训中。

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