people who make this shift will obtain a significant benefit that is sustainable for the rest of their lives.”
The University of Alabama trial integrates mindfulness meditation with traditional cognitive behavioral therapy and mindfulness-based stress reduction. The goal is to extract the key components of each approach to form an integrated treatment package.
As part of the study’ s MBCT program, treatment groups meet once a week for two-hour sessions. Each session consists of an extended, guided meditation, which becomes more advanced as the program progresses. Patients also get a series of meditation CDs for daily, at-home practice.
“ On the surface, the meditation techniques serve as a relaxation exercise that lowers stress reactions,” Thorn says.“ More deeply, meditation exercises are thought to train the brain so it is less prone to react reflexively with negative thoughts, emotions and behaviors that elevate the stress thermostat.”
Sessions also include basic yoga and other group exercises to help patients“ get out of their head.” Both Thorn and Day hope to conclude that MBCT will be a feasible treatment alternative or a solid complement to medication-based pain management.
“ We know that traditional biomedical approaches can only go so far and [ have ] substantial side effects,” Thorn says.“ Physicians recognize that triggers, such as stress and lifestyle, are important components of overall headache management, yet they lack the time and expertise to address this critical aspect of headache pain.”
The researchers are using a randomized controlled trial that compares MBCT— an immediate treatment strategy— to a delayed treatment control group. Participants complete pre-, mid- and post-treatment assessments, in addition to a six-month follow-up, to determine any long-term benefits.
Throughout the eight-week program, patients in both the MBCT and control group complete a daily headache diary online. MBCT patients also complete a daily practice diary.
“ This allows us to track patients on a day-to-day basis and examine patterns of change across individuals,” Day says.
In addition to researching outcomes, such as headache intensity, frequency and pain-related disability, researchers also want to know how patients carve out time for meditation, how they react to mindfulness exercises and how
MBCT changes the way they approach their headaches.“ One patient said at the end of [ her ] program,‘ I still have headache pain, but it doesn’ t have me,’” Day says.
While the researchers say it’ s too early to report the statistical findings of this trial, interim analysis suggests patients who completed treatment substantially improved on one or more headache-related outcome measures. Patients randomly assigned to the control group experienced minimal change.
“ The biggest challenge to patients has been overcoming the obstacle of carving out time from their busy lives for daily meditation practice,” Thorn says.“ However, around midway through treatment, most patients have come to place their practice at the top of their to-do list.”
The researchers expect those who stick with MBCT practice to not only experience reductions in the frequency of their headaches and in the amount of medication they take, but also to be more aware and accepting of the present moment— even if that moment brings a headache. HW
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