Family-Based Cognitive-Behavioral Treatment of Chronic Pediatric Headache and Anxiety Disorders: A Case Study

Kelly Drake, Golda S. Ginsburg

Research output: Contribution to journalArticle

Abstract

Background: Chronic pediatric headache disorders are pervasive, debilitating, and associated with high rates of comorbid anxiety disorders. The combination of headaches and anxiety presents unique challenges for clinicians. Cognitive behavioral therapy (CBT) is a promising treatment for pediatric headache, however, available treatments fail to adequately address comorbid psychopathology resulting in less than optimal response rates. Objective: This case study illustrates the use of a family-based CBT for treating comorbid pediatric headache and anxiety disorders. Methods: A 10 year old boy with chronic daily headache was evaluated and treated as part of the Children's Headache and Anxiety Management Program (CHAMP). The patient and his parents were evaluated by an independent evaluator (IE) at pre- and post-treatment and one-month follow-up. Evaluations consisted of structured interviews as well as parent and child self-report measures of headache and anxiety symptoms and impairment. At baseline the child met diagnostic criteria for chronic headache disorder, separation (SAD), and generalized anxiety disorders (GAD), and had significant symptoms of obsessive-compulsive disorder (OCD). Treatment included 8 conjoint sessions of CBT. Results: Post-treatment evaluation revealed a significant reduction in headache-related severity and disability (but not frequency), and loss of initial GAD (but not SAD) diagnosis. By the one-month follow-up, the child no longer met criteria for any anxiety disorder and was no longer disabled by headaches. The case highlights how CHAMP may be effective in reducing headache and anxiety symptoms and associated impairment. Conclusions: This case illustrates the challenges in treating this population and suggests specific interventions that might enhance treatment outcome.

Original languageEnglish (US)
Pages (from-to)579-598
Number of pages20
JournalChild and Youth Care Forum
Volume41
Issue number6
DOIs
StatePublished - Dec 2012

Fingerprint

anxiety
parents
psychopathology
evaluation
management
diagnostic
disability
interview

Keywords

  • Anxiety
  • Children
  • Cognitive behavioral therapy
  • Headaches
  • Parenting

ASJC Scopus subject areas

  • Social Sciences (miscellaneous)
  • Life-span and Life-course Studies

Cite this

Family-Based Cognitive-Behavioral Treatment of Chronic Pediatric Headache and Anxiety Disorders : A Case Study. / Drake, Kelly; Ginsburg, Golda S.

In: Child and Youth Care Forum, Vol. 41, No. 6, 12.2012, p. 579-598.

Research output: Contribution to journalArticle

@article{d8afc9b8a2af42da972983d1bd0b931d,
title = "Family-Based Cognitive-Behavioral Treatment of Chronic Pediatric Headache and Anxiety Disorders: A Case Study",
abstract = "Background: Chronic pediatric headache disorders are pervasive, debilitating, and associated with high rates of comorbid anxiety disorders. The combination of headaches and anxiety presents unique challenges for clinicians. Cognitive behavioral therapy (CBT) is a promising treatment for pediatric headache, however, available treatments fail to adequately address comorbid psychopathology resulting in less than optimal response rates. Objective: This case study illustrates the use of a family-based CBT for treating comorbid pediatric headache and anxiety disorders. Methods: A 10 year old boy with chronic daily headache was evaluated and treated as part of the Children's Headache and Anxiety Management Program (CHAMP). The patient and his parents were evaluated by an independent evaluator (IE) at pre- and post-treatment and one-month follow-up. Evaluations consisted of structured interviews as well as parent and child self-report measures of headache and anxiety symptoms and impairment. At baseline the child met diagnostic criteria for chronic headache disorder, separation (SAD), and generalized anxiety disorders (GAD), and had significant symptoms of obsessive-compulsive disorder (OCD). Treatment included 8 conjoint sessions of CBT. Results: Post-treatment evaluation revealed a significant reduction in headache-related severity and disability (but not frequency), and loss of initial GAD (but not SAD) diagnosis. By the one-month follow-up, the child no longer met criteria for any anxiety disorder and was no longer disabled by headaches. The case highlights how CHAMP may be effective in reducing headache and anxiety symptoms and associated impairment. Conclusions: This case illustrates the challenges in treating this population and suggests specific interventions that might enhance treatment outcome.",
keywords = "Anxiety, Children, Cognitive behavioral therapy, Headaches, Parenting",
author = "Kelly Drake and Ginsburg, {Golda S.}",
year = "2012",
month = "12",
doi = "10.1007/s10566-012-9174-x",
language = "English (US)",
volume = "41",
pages = "579--598",
journal = "Child and Youth Care Forum",
issn = "1053-1890",
publisher = "Springer New York",
number = "6",

}

TY - JOUR

T1 - Family-Based Cognitive-Behavioral Treatment of Chronic Pediatric Headache and Anxiety Disorders

T2 - A Case Study

AU - Drake, Kelly

AU - Ginsburg, Golda S.

PY - 2012/12

Y1 - 2012/12

N2 - Background: Chronic pediatric headache disorders are pervasive, debilitating, and associated with high rates of comorbid anxiety disorders. The combination of headaches and anxiety presents unique challenges for clinicians. Cognitive behavioral therapy (CBT) is a promising treatment for pediatric headache, however, available treatments fail to adequately address comorbid psychopathology resulting in less than optimal response rates. Objective: This case study illustrates the use of a family-based CBT for treating comorbid pediatric headache and anxiety disorders. Methods: A 10 year old boy with chronic daily headache was evaluated and treated as part of the Children's Headache and Anxiety Management Program (CHAMP). The patient and his parents were evaluated by an independent evaluator (IE) at pre- and post-treatment and one-month follow-up. Evaluations consisted of structured interviews as well as parent and child self-report measures of headache and anxiety symptoms and impairment. At baseline the child met diagnostic criteria for chronic headache disorder, separation (SAD), and generalized anxiety disorders (GAD), and had significant symptoms of obsessive-compulsive disorder (OCD). Treatment included 8 conjoint sessions of CBT. Results: Post-treatment evaluation revealed a significant reduction in headache-related severity and disability (but not frequency), and loss of initial GAD (but not SAD) diagnosis. By the one-month follow-up, the child no longer met criteria for any anxiety disorder and was no longer disabled by headaches. The case highlights how CHAMP may be effective in reducing headache and anxiety symptoms and associated impairment. Conclusions: This case illustrates the challenges in treating this population and suggests specific interventions that might enhance treatment outcome.

AB - Background: Chronic pediatric headache disorders are pervasive, debilitating, and associated with high rates of comorbid anxiety disorders. The combination of headaches and anxiety presents unique challenges for clinicians. Cognitive behavioral therapy (CBT) is a promising treatment for pediatric headache, however, available treatments fail to adequately address comorbid psychopathology resulting in less than optimal response rates. Objective: This case study illustrates the use of a family-based CBT for treating comorbid pediatric headache and anxiety disorders. Methods: A 10 year old boy with chronic daily headache was evaluated and treated as part of the Children's Headache and Anxiety Management Program (CHAMP). The patient and his parents were evaluated by an independent evaluator (IE) at pre- and post-treatment and one-month follow-up. Evaluations consisted of structured interviews as well as parent and child self-report measures of headache and anxiety symptoms and impairment. At baseline the child met diagnostic criteria for chronic headache disorder, separation (SAD), and generalized anxiety disorders (GAD), and had significant symptoms of obsessive-compulsive disorder (OCD). Treatment included 8 conjoint sessions of CBT. Results: Post-treatment evaluation revealed a significant reduction in headache-related severity and disability (but not frequency), and loss of initial GAD (but not SAD) diagnosis. By the one-month follow-up, the child no longer met criteria for any anxiety disorder and was no longer disabled by headaches. The case highlights how CHAMP may be effective in reducing headache and anxiety symptoms and associated impairment. Conclusions: This case illustrates the challenges in treating this population and suggests specific interventions that might enhance treatment outcome.

KW - Anxiety

KW - Children

KW - Cognitive behavioral therapy

KW - Headaches

KW - Parenting

UR - http://www.scopus.com/inward/record.url?scp=84869870934&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84869870934&partnerID=8YFLogxK

U2 - 10.1007/s10566-012-9174-x

DO - 10.1007/s10566-012-9174-x

M3 - Article

AN - SCOPUS:84869870934

VL - 41

SP - 579

EP - 598

JO - Child and Youth Care Forum

JF - Child and Youth Care Forum

SN - 1053-1890

IS - 6

ER -