Behavioral Self-management in an Inpatient Headache Treatment Unit: Increasing Adherence and Relationship to Changes in Affective Distress

Objective.–To evaluate prospectively the contribution of a psychological self‐management program to the amelioration of headache‐related distress of patients with intractable migraine treated in a comprehensive, multidisciplinary, inpatient program. Background.–Previous research has shown the effectiveness of this overall inpatient program but did not examine the relationships between the use of relaxation and other headache‐related behavioral factors. Methods.–Data from 221 admissions to a Commission on Accreditation of Rehabilitation Facilities‐accredited, nationally recognized, inpatient treatment unit were analyzed for the current study. On admission and on discharge (average length of stay, 12.9 days), subjects completed a 7‐day retrospective, self‐report questionnaire assessing health behavior compliance and emotional factors. The intervention consisted of intensive medical therapy in addition to cognitive‐behavioral treatment delivered in a group setting. Results.–Adherence increased significantly for relaxation practice and life‐style modifications of diet, exercise, and sleep regulation for headache prevention (P