The following was taken from Reuters Health –
Even when a headache specialist refers migraine patients for proven behavioral treatments like biofeedback, relaxation training or cognitive behavioral therapy ( C.B.T) , barely half of them go, suggests a recent U.S. study.
Of 69 migraine sufferers treated at a large academic headache practice and referred for behavioral therapy, just 57 percent got as far as making an appointment with the behavioral practitioner, researchers found.
The patients who ignored their doctor’s recommendation cited time limitations as the main barrier to treatment. Concerns about cost and insurance coverage were also an issue. And some were skeptical about whether the treatment would work; others worried about the potential stigma of seeing a psychologist, the study team reports in the journal Pain Medicine June 5.
Opioids are still being prescribed as the first line of treatment for migraines when evidence shows that behavioral therapy is more effective and safer in treating migraines
“I don’t think that people realize that behavioral therapy alone can result in a 50 percent reduction in headache days. It’s not only effective alone, but when combined with medications it can have a synergistic effect. Behavioral therapy improves patients’ quality of life : they perceive less pain, miss less work and can enjoy their activities again,” said Dr. Nauman Tariq, director of the Johns Hopkins Headache Center in Baltimore, who was not involved in the study.

Richard katesmark comments. “ It is not a great surprise that many people do not try behavioural approaches to help with their headpain, In my opinion this is either because they are simply unaware of the benefits or because they are under the impression that ‘talking’ therapies are only for ‘mad’ people. It is important to realise that from a brain perspective they can change the perception of pain & may be very effective for many chronic migraine sufferers . Therefore C.B.T. is just one of the therapies that may be recommended at the Headpain relief clinic here in Surrey

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