BIOFEEDBACK AND RATIONAL‐EMOTIVE THERAPY IN THE MANAGEMENT OF MIGRAINE HEADACHE

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Abstract
Migraine patients (24) were randomly assigned to 1 of 4 conditions: self-monitoring of headache activity (waiting list), frontalis EMG [electromyogram] biofeedback, digit temperature biofeedback and digit temperature biofeedback plus Rational-Emotive Therapy (RET). Bidirectional control over the target physiological response was assessed through a reversal design in each session. Following at least a 4-wk baseline, the 3 biofeedback groups received 8-10, 30-min sessions of bidirectional biofeedback training, scheduled twice a wk. Subjects in the combined digit temperature biofeedback plus RET group received three 40-min sessions of RET as an addition to the 3rd, 5th and 7th biofeedback sessions. Records of daily home practice were kept throughout treatment and 3-mo. followup. Subjects on the waiting list monitored headaches for at least 5 mo., corresponding to baseline, treatment and 3-mo. followup. Digit temperature biofeedback alone and in conjunction with RET was no more effective than the control conditions. All the EMG subjects reduced headache activity to 2/3 or less of the baseline level by the 3rd mo. of followup. Bidirectional digit temperature performance did not improve with training, was demonstrated in only 33% of the biofeedback sessions, was not maintained over time and was unrelated to improvement in headache activity. EMG subjects reported biofeedback performance to be an easier task and met the performance criterion on 85% of the sessions. The frequency of home practice contributed over 55% of the variance in retrospective estimates of headache improvement but was not related to changes in daily records of headache activity.

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