Cognitive Behavioral Therapy (CBT) for Headache

CBT for headache typically includes relaxation training; the identification and management of headache triggers; stress management; improving daily functioning; and treating comorbid condition such as depression, anxiety, obesity, or sleep disturbance.

What is CBT?  |  Resources

What Is CBT For Headache?

CBT is a non-medication therapy that is used to treat a variety of disorders, both medical and psychological. CBT has shown to be extremely effective in managing headache and often works best in combination with medication. As a part of CBT, the behavioral health provider will first assist you in monitoring and analyzing factors that might bring on, maintain, or worsen your headaches - in other words, identifying and managing triggers and exacerbating factors. You may be asked to keep track of these triggers and exacerbating factors daily using a "headache diary." You will also likely be asked to rate your associated headache intensity and duration using this diary. This information is helpful to the clinician in judging progress during treatment. The following CBT techniques have shown to be effective for use with headache patients: biofeedback, relaxation training, and stress management training.

Relaxation also teaches control of bodily functions, such as muscle tension and breathing. One of the most well researched relaxation methods is Progressive Muscle Relaxation. This procedure first instructs you on how to slow your breathing and then walks you through a set of instructions that help you tense and relax your muscles. The goal is to better recognize and control muscle tension as it relates to headache. Whereas biofeedback targets specific areas of the body, relaxation works on the entire body.

Stress Management Training provides you with problem-solving and coping skills that are essential to managing headache. Stress management training for headache often includes monitoring stressful situations and how they correspond to headache frequency and severity. You will also be taught how to problem-solve more effectively, which can help with many facets of headache management. Cognitive restructuring techniques are often employed to help you interpret pain and upsetting situations more objectively. This can help you react more effectively in the presence of pain and stress.

Although the main goal of CBT is to help you become pain-free, for some, successful treatment is performing daily activities in spite of headache. Along with symptom reduction, improving patient functioning is another main goal of CBT.

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Relaxation Exercises

Use these audio clips to help you with your relaxation exercises:

Stop, Breathe, Think
Stop, Breathe, and Think

This app provides mindfulness meditation exercises and is brought to you by Tools for Peace.
(Free download on IOS, Android, and streaming on the web)


CBT-i Coach

CBTi logo

This app was designed for use by individuals who are participating in Cognitive Behavioral Therapy for Insomnia (CBT-i) treatment guided by a healthcare professional. This app includes features such as:

  • An interactive sleep diary for tracking sleep habits
  • Calculation of sleep prescription time with therapist adjustment options
  • Psychoeducation about sleep, healthy habits, and CBT-i
  • Customizable reminders

Although this app was designed for use for individuals with insomnia, it includes features that can be useful for many individuals, such as scheduled worry time, alternative thoughts about sleep and trauma, diaphragmatic breathing exercise, progressive muscle relaxation exercise, three guided imagery settings, mindfulness exercise.

This app was created by VA's National Center for PTSD in partnership with Stanford University Medical Center, and the DoD's National Center for Telehealth and Technology and VA Sierra Pacific Mental Illness Research, Education, & Clinical Center.

(Free download from iTunes (iOS) and Google Play (Android))

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Headache Center