The C.A.M. Report
Complementary and Alternative Medicine: Fair, Balanced, and to the Point
  • About this web log

    This blog ran from 2006 to 2016 and was intended as an objective and dispassionate source of information on the latest CAM research. Since my background is in pharmacy and allopathic medicine, I view all CAM as advancing through the development pipeline to eventually become integrated into mainstream medical practice. Some will succeed while others fail. But all are treated fairly here.

  • About the author

    John Russo, Jr., PharmD, is president of The MedCom Resource, Inc. Previously, he was senior vice president of medical communications at, a complementary and alternative medicine website.

  • Common sense considerations

    The material on this weblog is for informational purposes. It is not medical advice or counsel. Be smart, consult your health professional before using CAM.

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    Using the Internet to manage headache in children

    The benefits of 2 self-help training programs (multimodal cognitive-behavioral training [CBT] and applied relaxation [AR]) presented via the Internet were compared by researchers from the University of Göttingen, in Germany.

    First, the details.

    • 65 children and adolescents (average age: 13 years) with recurrent headache (at least 2 per month) were assigned to a treatment group.
      • CBT presented via the Internet
      • AR presented via the Internet
      • Educational intervention not involving the Internet
    • Changes in headache frequency, intensity, duration and frequency were recorded.
    • Pain catastrophizing and general well-being (depression, psychopathological symptoms, and health-related quality of life) were also reported.

    And, the results.

    • All groups had a significant reduction in headache frequency, duration, and pain catastrophizing.
    • There were no differences in headache intensity, depression, psychopathological symptoms, or health-related quality of life.
    • Rates of response by the end of treatment were 63% for CBT, 32% with AR, and 19% for educational intervention.
    • Statistical analysis of the results show that it requires 2 people to be treated with CBT for 1 person to benefit, vs 5 for AR and educational intervention.
    • At follow-up, no significant differences were found (CBT: 63%, AR: 56%, educational intervention: 55%).

    The bottom line?

    The abstract is short on details. For example it fails to tell us the duration of treatment and the timing of follow-up.

    That said, in this study, children and adolescents treated with CBT showed improvement in headache frequency, duration, and pain catastrophizing.

    And these results are supported by other studies of Internet-based treatment. Researchers from the Netherlands and Sweden recently conducted a review of 12 studies and concluded, “Internet interventions targeting pain were comparable to the effects found for face-to-face treatments, and the same was true for interventions aimed at headache.”

    Offering CBT  through the Internet potentially saves therapist time, reduces waiting-lists, eliminates travel time, and provides an opportunity to reach patients who can’t easily access more traditional forms of treatments. What’s needed is a study to confirm these benefits in order to make the Internet more available as a reimbursed healthcare service.

    4/24/10 17:13 JR

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