Coping Strategies Can Help Headache Sufferers; Volunteers Needed in UA Psychologist’s Treatment Study

TUSCALOOSA, Ala. – Headaches. What a pain. Nearly everyone gets them, but for some they are more than an occasional annoying event. Instead, they are severe and life altering, resulting in missed time away from work and family activities.

Dr. Beverly Thorn, professor of psychology at The University of Alabama and director of UA’s clinical psychology doctoral program, has been helping people learn to reduce and manage their chronic pain, including severe headaches, for some 20 years.

“Pain is a stress-related disorder,” Thorn said. “That doesn’t mean that pain is all in your head. It is real, and it is a stress-related disorder.”

The UA professor’s focus is on cognitive behavioral therapy, a widely accepted treatment method for various problems, including pain and depression. In her group therapy sessions, Thorn teaches participants relaxation exercises, tips on how to better pace themselves in their daily routines and the effects negative thoughts can have on their pain and ways to counter those thoughts.

“When you experience a stress event, your body reacts to that in ways you are not aware of and in ways you may be aware of,” Thorn said. “We teach people to be aware of their automatic thoughts and evaluate them and change them to an alternative response that’s more adaptive, that’s more realistic.”

“We know it works,” Thorn said of the therapy, “but it doesn’t work for all people under all conditions. The kind of research I do is to try to figure out what, exactly, in an effective treatment program is causing the positive effect. If we can find out the exact mechanism that’s causing the change, we can tailor the treatment to fit the individual needs of particular patients. We’re looking at the order of the treatment module to see if the order makes a difference, particularly in certain types of headache patients.”

The National Institutes of Health has awarded Thorn a three-year grant to continue her cognitive behavioral study, and she’s looking for headache sufferers to participate. Qualified participants will receive free treatment throughout a 10-week program, along with pre-, mid- and post-treatment assessments.

In addition to the free treatment, participants who complete the program will receive a $25 payment at the midpoint and again at the conclusion of the program.

Thorn’s work focuses on three types of headaches, migraine headaches, muscle tension headaches, and a combination of the two, known as mixed migraine/muscle tension headaches.

To qualify, participants must be 18 or older; seen by a physician for headaches within the past six months; suffer from frequent headaches, usually at least three significant headaches per month; and obtain a release by their primary physician that allows their participation in the study. They must also be able to meet once a week for therapy for one and one-half hours. The sessions are typically held in the evenings.

Excluded from the study are those with seizure disorders, long-term sinus problems necessitating surgery, and people who have changed medications within the four weeks immediately prior to entering the study.

“The treatment I offer is group treatment,” Thorn said. “Sometimes, people are hesitant to join a group for fear they will have to talk about personal things. This is not that kind of group. We don’t go into a lot of psychological depth the way individual psychotherapy would. This is more a ‘class’ approach than a traditional therapy approach,” Thorn said.

Headache is the most common pain problem, and women are more likely to seek treatment than men, said Thorn who is authoring a book “Cognitive Therapy for Chronic Pain.” Under contract for publication by Guilford Press, the book is geared toward the medical/psychological practitioner and is expected to be released in 2004.

“People with headaches remain functional, although they do have to alter their schedule,” Thorn said. “They miss time from work and often miss family activities. They tend to be highly functional, they work hard, and tend to have full schedules.”

Those with severe headaches also often feel misunderstood by others who wrongly try and equate infrequent mild headaches with severe headaches.

“People will often say, ‘well, I get headaches, and I don’t go home from work.’ I don’t even call what some of my patients have ‘headaches,’” Thorn said. “I call them neurological events! Considering the enormity of the problem for some of these folks, it’s remarkable that this treatment can and does work. When clients start to get some control over their symptoms through the use of these techniques, they feel empowered and hopeful.”

Therapy sessions such as the ones UA is offering free, would cost between $50 and $150 a session if obtained elsewhere, Thorn said. “Assisting people through this treatment program can go a long way to helping them have a much fuller everyday life.”

To find out more or to apply for participation in the study, call 205/348-5000.