A randomized controlled trial of an internet-based treatment for chronic headache.
Devineni T, Blanchard EB.
Conemaugh Health System, 122 Montour Street, Johnstown, PA 15905 2422, USA.
Chronic headache is a significant public health problem in Western nations. Although controlled trials demonstrate the efficacy and cost-effectiveness of face-to-face behavioral therapy, most headache sufferers have limited access to these treatments. Delivery of behavioral interventions using Internet technology has the potential to reach a larger number of headache sufferers and reduce the burden of disease. This randomized controlled study evaluated an Internet-delivered behavioral regimen composed of progressive relaxation, limited biofeedback with autogenic training, and stress management versus a symptom monitoring waitlist control. Treatment led to a significantly greater decrease in headache activity than symptom monitoring alone. Thirty-nine percent of treated individuals showed clinically significant improvement on self-report measures of headache symptoms at post-treatment. At two-month follow-up, 47% of participants maintained improvement. Treatment had a significant impact on general headache symptoms and headache-related disability. There was a 35% within-group reduction of medication usage among the treated subjects. The Internet program was more time-efficient than traditional clinical treatment. Treatment and follow-up dropout rates, 38.1% and 64.8%, respectively, were typical of behavioral self-help studies. This approach to self-management of headache is promising; however, several methodological and ethical challenges need to be addressed.
PMID: 15680926 [PubMed - indexed for MEDLINE]
Behav Res Ther. 2005 Mar;43(3):277-92.
Internet-based cognitive behavioral therapy for tinnitus.
Andersson G, Kaldo V.
Department of Psychology, Uppsala University, Sweden.
Tinnitus is a common otological problem that is often resistant to surgical or medical interventions. In common with chronic pain, cognitive-behavioral treatment has been found to alleviate the distress and improve the functioning of tinnitus patients. Recently, a self-help treatment has been developed for use via the Internet. In this article, we describe the self-help program and apply it to a middle-aged woman with tinnitus. We report the case formulation, which was done in a structured interview, and the treatment interactions, which were conducted via e-mail. The self-help program was presented on Web pages, and weekly diaries were submitted to follow progress and give feedback. The treatment was successful with reductions of tinnitus-related annoyance and anxious and depressive mood. Implications for Internet administration of self-help treatment are discussed. Copyright 2003 Wiley Periodicals, Inc.
PMID: 14724924 [PubMed - indexed for MEDLINE]
J Clin Psychol. 2004 Feb;60(2):171-8.
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