Psychological interventions for the treatment of chronic and recurrent headache in children and adolescents

Cochrane update on 47 RCTs. Psychological interventions (CBT, biofeedback, relaxation) reduce headache frequency at post-treatment (NNT ~3 for 50% reduction). Evidence strongest for face-to-face; digital delivery promising but lower quality. Combined with topiramate or amitriptyline trials (CHAMP, Powers 2017) suggesting psychological therapy may match or exceed pharmacotherapy in pediatric migraine.