BackgroundThe purpose of this study was to evaluate the efficacy of a self-guided CD-ROM program (“Headstrong”) containing cognitive-behavioral self-management strategies versus an educational CD-ROM program for treating headaches, headache-related disability, and quality of life.MethodsParticipants were 35 children ages 7–12 years with migraine recruited from one university medical center and two children’s hospital headache clinics. Participants were randomly assigned to complete the Headstrong or educational control CD-ROM program over a 4-week period. Data on headache frequency, duration, and severity, migraine-related disability, and quality of life (QOL) were obtained at baseline, post-intervention, and 3-months post-intervention.ResultsAt post-intervention, Headstrong resulted in lower severity (on a 10-point scale) than the control group by child report (5.06 ± 1.50 SD vs. 6.25 ± 1.92 SD, p = 0.03, ES = 0.7). At 3-months post-intervention, parents reported less migraine-related disability (on the PedMIDAS) in the Headstrong group compared to the control group (1.36 ± 2.06 SD vs. 5.18 ± 6.40 SD; p = 0.04, ES = 0.8). There were no other group differences at post treatment or at 3-months post-intervention.ConclusionsWhen compared to an educational control, Headstrong resulted in lower pain severity at post-treatment and less migraine-related disability at 3-months post-intervention, by child and parent report respectively. Headache frequency and quality of life did not change more for Headstrong versus control. Additional research is needed on the Headstrong Program to increase its efficacy and to test it with a larger sample recruited from multiple centers simultaneously.

Background Retrospective and cross-sectional studies have suggested a bidirectional relationship between migraine and mood disturbance. Objective The present prospective daily diary study examined the prevalence and temporal associations between migraine and daily mood, mood and next-day headache, and headache and next-day mood. Methods Sixty-nine children (50 females, 19 males) between the ages of 7–12 years and their parents attending neurology clinic appointments and having a diagnosis of migraine as defined by ICHD-II criteria completed measures on quality of life, headache disability, child emotions and child behaviors. Children and parents then recorded children’s headache occurrence, headache duration, headache severity, mood, daily hassles, and medication use on paper diaries once a day for two consecutive weeks. “Mood” was defined using the facial affective scale, which is a visual representation of negative and positive affect. Data were analyzed using multilevel models. Results Controlling for age, sex, quality of life, headache disability, and medication use, worse mood was associated with same-day occurrence, longer duration and more severe headache in both child and parent report. Today’s mood was not consistently associated with next-day headache and today’s headache was not associated with next-day mood in either child or parent report. Conclusions Results of this study lend support for a complex relationship between mood and headache in children with migraine. More research is needed to further elucidate the temporal nature of this relationship within a given day and over an extended period of time.

This article describes an innovative Motivational Interviewing (MI) training that is included in the current training program for psychology interns and fellows (trainees) at 1 institution and outlines how this training experience aligns with multiple core training competencies for pediatric psychologists. MI is an evidence-based approach to behavior change counseling that is efficacious in motivating change in many health-risk behaviors. The training module adds systematic practice with simulated patients and objective feedback regarding adherence and fidelity to MI principles and strategies to traditional didactics. This state-of-the-art training is particularly beneficial to our pediatric psychology trainees, as it impacts treatment interventions with their patients and families and maps onto several of the new pediatric psychology competencies. Specific examples of training components are provided and demonstrate how the MI training module aligns with the pediatric psychology competencies in several clusters: crosscutting knowledge competencies in pediatric psychology, interpersonal, professionalism, and application. MI training is well-suited to be included in competencybased training in pediatric psychology.