Chronic headaches in kids: How a psychologist can help your child cope

an illustration of a child and mother meeting with a psychologist
(Image: Adobe Stock; Illustrations: Fawn Gracey, Boston Children's)

For many young people, the pain of chronic daily headaches can be compounded by the concern that providers aren’t taking them seriously. Defined as headaches that occur at least 15 days per month for six months or more, chronic daily headaches can be so difficult to manage that some patients may feel that their pain is being dismissed as “all in their head.”

So it might seem confusing to learn that psychologists play a crucial role in the treatment of chronic headaches. In fact, when families visit the Chronic Headache Program at Boston Children’s Hospital, they meet not only with neurologists and other medical specialists, but also with a psychologist. “It’s such an important part of helping kids be well that we include it at the very beginning of care,” explains the clinic’s director, Dr. Alyssa Lebel.

Here’s more about how psychologists can help kids and their families cope with the very real pain of chronic daily headaches.

1. Psychologists are part of a well-rounded team.

Every child or teen who is seen at the Chronic Pain Medicine Headache Clinic is evaluated by a pain specialist, a nurse practitioner, and a psychologist — all of whom specialize in complex headache management. Each member of the team spends time talking with families in depth so they can better understand the child’s headaches and potential triggers. This multidisciplinary approach addresses all aspects of a child’s pain. Much like physical therapy and complementary approaches like acupuncture, psychology is a tool to help kids feel better.

2. Coping skills are crucial.

A trained psychologist can help teach your child practical skills for coping with chronic headache pain. For example, an approach called cognitive behavioral therapy (CBT) helps patients develop skills to restructure their thoughts like “thought stopping” or “reframing,” which can help them counteract some of the negative thoughts, feelings and behaviors that often arise as a consequence of living with pain. A psychologist can also teach your child relaxation therapies, such as deep breathing exercises, mindfulness and meditation to manage their pain.

Kids whose chronic headaches are vestibular in nature — meaning that they have an element of dizziness or vertigo — may be seen in the Balance and Vestibular Program. There, pediatric psychologist Katie Fleischman teaches patients and their families various coping skills, including CBT and biofeedback, which helps kids learn skills to become aware how their body works, which in turn may help them better control their symptoms.

3. Family support makes a big difference.

There’s no quick fix for chronic headaches in kids, which can make parents feel helpless. One of the most important things families can do, says Lebel, is to support their child. But that support isn’t necessarily what you might imagine. Indeed, natural parental reactions such as fear, protectiveness, and encouraging children to avoid regular activities can actually have the unintended effect of inhibiting kids from functioning properly. Research suggests that, when it comes to pain, there’s a direct link between parents’ behaviors and children’s ability to cope with pain.

The good news: A family-centered approach — including work with a psychologist — has been shown to help improve pain. “Chronic pain is complicated and it takes a village to treat,” says Dr. Lebel. “Psychologists can work with families to give them the tools they need to cope together.”

Learn more about the Chronic Headache Program.

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