Two studies of the long-term follow-up of minimal therapist contact treatments of vascular and tension headache.

Tension and vascular headache patients, initially treated with biofeedback and/or relaxation training in either a minimal therapist contact protocol (3 visits) or an intensive individual protocol (10 or 16 visits) were followed-up prospectively for 2 years. In the first study, for the first 6 months of follow-up, half of all patients continued to keep headache diaries and were seen monthly and the other half had only minimal contact. The results at 1-year follow-up, based on 4 weeks of daily headache diaries, revealed equally good maintenance from both treatment protocols and from both follow-up conditions. In Study 2, we found that patients remained improved over pretreatment baseline levels at the 2-year follow-up regardless of initial treatment intensity. Approximately three quarters of vascular patients who were initially improved at posttreatment remained improved at 2 years. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Transferring psychotherapy clients: State of the art.

Transferring psychotherapy clients from one therapist to another is a common event that may pose clinical and administrative problems. Clinicians and therapists in training transfer clients when their professional role or activities change or when they leave their clinical settings. We review the literature on transferring psychotherapy clients and report on aspects of the transfer process and procedures used by a national sample of psychology training clinics. We also report and discuss the results of an exploratory analysis training clinic records in which we investigated the relation between transfer outcome (successful vs. unsuccessful) and a set of treatment and demographic factors. Last, we suggest several ways of handling difficulties that arise as a result of clinical and administrative reassignment. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Child and parent weight loss in family-based behavior modification programs.

Overweight preadolescents and parents from 76 families were assigned to 1 of 3 behavioral treatment groups: parent/child target, child target, or nonspecific target. Percent overweight changes at the end of the 8-mo treatment and 13-mo follow-up were equivalent for children in the 3 treatment groups, but parents in the parent/child group lost more weight during treatment. Weight changes for parents and children increased through the 8-mo treatment. Patterns of maintenance showed that 40% of the children were within 20% of their ideal weight by the end of treatment, achieving nonobese status. 100% of the newly nonobese children in the parent/child group maintained nonobesity during follow-up, whereas only 30% in the child-alone group and 33% in the nonspecific group maintained nonobesity. In addition, weight losses for parents and children in the same family correlated positively at the end of treatment but not at follow-up. Results suggest that parental modeling may be important during treatment, but long-term results probably are due to parental reinforcement of child self-regulation. (30 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Specific and nonspecific effects in the biofeedback treatment of tension headache: 3-Year follow-up.

In a previous study by the present authors (see record 1980-32946-001), 39 tension headache sufferers were assigned either to no treatment, standard biofeedback, or 1 of 2 biofeedback control procedures to test factors mediating the effectiveness of biofeedback. No differences were found between the 3 biofeedback conditions, indicating that learned reductions of frontal EMG activity had little to do with the observed treatment effect. Three-year follow-up collected from 28 of the 39 original Ss revealed high levels of maintenance for all biofeedback groups but again showed that reductions in EMG activity were unrelated to long-term maintenance. Results are consistent with the hypothesis that cognitive and behavioral factors may underlie biofeedback's treatment effect. (4 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Stress monitoring using a distributed wireless intelligent sensor system

We are developing personal health monitors based on a wireless body area network (BAN) of intelligent sensors. Individual monitors will be integrated into a distributed wireless system for synchronized monitoring of a group of subjects. This system could be used during the selection process and as part of a psychophysiological evaluation of military members undergoing intense training. We use measures of heart-rate variability to quantify stress level prior to and during training as well as to predict stress resistance. This task requires reliable, high-precision instrumentation and synchronized measurements from a group of individuals over prolonged periods (days of training).     

Two-, three-, and four-year follow-up on the self-regulatory treatment of chronic headache.

Chronic tension and vascular headache patients, initially treated with relaxation and biofeedback, were prospectively followed-up on an annual basis at 2-, 3-, and 4-years posttreatment. Although there was a fair degree of variability, tension headache patients generally showed good maintenance of initial headache reduction at Year 4. Vascular patients showed a nonsignificant trend for gradual deterioration of treatment effects over the 4 years of follow-up. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Placebo-controlled evaluation of abbreviated progressive muscle relaxation and of relaxation combined with cognitive therapy in the treatment of tension headache.

Sixty-six tension headache patients were randomly assigned to one of four conditions for 8 weeks: (a) progressive muscle relaxation (PMR) alone; (b) PMR plus cognitive therapy (PMR?+?Cog); (c) pseudomedication, a credible attention-placebo control; or (d) continued headache monitoring. A comparison of overall headache activity (headache index), derived from a daily headache diary, for 4 weeks before treatment to 4 weeks after treatment revealed that active treatment (PMR and PMR?+?Cog) was superior to either control condition. Moreover, level of headache medication consumption decreased significantly for the active treatment groups. Although headache-index comparisons of the two active treatments showed no advantage for adding cognitive therapy to PMR, a measure of clinically significant change showed a trend for PMR?+?Cog to be superior to PMR alone. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Biofeedback and relaxation training for chronic headache: A controlled comparison of booster treatments and regular contacts for long-term maintenance.

Assigned 55 adult Ss, successfully treated by 2 of the present authors in behavioral treatment for chronic headaches, to 1 of 2 follow-up conditions: (1) regular contact or (2) booster treatment. Ss assigned to regular contact were asked to continue daily monitoring of headache activity and home practice and were seen for a brief visit (10–25 min) on a monthly basis for 6 mo. Ss assigned to booster treatments received full sessions during their 6 monthly visits. Results show that at 1-yr follow-up diary records and interviews with Ss and significant others revealed no major differences between groups. Although Ss attributed a number of positive side effects to treatment, it is suggested that regular contact may be an efficient procedure for maintaining treatment gains. (21 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Home- versus clinic-based treatment of vascular headache.

Contrasted the efficacy of a traditional clinic-based relaxation training and thermal biofeedback treatment to a comparable home-based program with minimal therapist contact in the treatment of 40 vascular-headache sufferers (mean age 37 yrs). The home-based condition was at least as efficacious as the clinic-based treatment in terms of reduction of headache intensity and frequency and medication usage, and was clearly more cost-effective. Findings suggest that a minimal-therapist-contact condition may be a viable, low-cost alternative to more expensive clinic-based programs in the treatment of vascular headache. (14 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Assessing the reliability levels of self-report assertion inventories.

Reading grade levels were obtained for 11 commonly employed self-report assertion inventories by use of R. F. Flesch's (1948) Reading Ease formula. Directions for the inventories ranged from the 7th to college-graduate reading grade level; inventory items were typically more readable, with scores ranging from the 7th to the 12th grade level. Results show the importance of considering reading difficulty when selecting assertion scales. (23 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)