Transcript Rusty Lozano M.ED LPC BCB Director: Center for Biofeedback

Behavioral Approaches for
Migraine Headaches
Rusty Lozano M.ED, LPC, BCB
Director: Center for Biofeedback & Behavior Therapy
15028 Beltway Dr
Addison, TX 75001
469-358-1309
www.onlinebiofeedback.com
Underlying Psychological
Factors
• Anxiety and Headache
• Chicken or the egg syndrome
• Triggers in the body
• Symptoms reinforce negative thought and vice versa
(the vicious cycle)
Underlying Psychological
Factors
• Pain Behavior
• “I can’t because I’m in pain” versus “I can’t because I
will experience pain”
• “Human-imprinting” in pain cycle
• Classical conditioning
• “Conditioned vs. unconditioned response”,
“conditioned vs. unconditioned stimulus”, “positive
punishment vs. negative punishment” “positive
association vs. negative association”
Underlying Psychological
Factors
• School Related Stress
• School environment (ex. AP courses, absenteeism,
social)
• Performance
• Homework load
• Parent pressure
Underlying Psychological
Factors
• Environmental Association
• Negative association and the “branching” anxiety effect
• Avoidant behavior
• Inadvertent parental reinforcement
Tension vs. Vascular
• Behavioral Detection Methods
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Diagnostic interview of symptoms
Symptom checklist
Peripheral biofeedback assessment
Cranium vs. myofacial muscle regions
Treatment Intervention Types:
Adjuncts to Medication Management
• Peripheral Biofeedback
• Adjunct to medication management
• Peripheral biofeedback modalities (ex. temp training,
muscle training)
• Peripheral nervous system- sympathetic vs.
parasympathetic nervous system
• Rehearsal/Generalization (ex. CBBT’s Pendulum
Obstacle Course)
Treatment Intervention Types:
Adjuncts to Medication Management
• Progressive Muscle Training
• Tense/relax training
• Localized muscle relaxation
• Strategic stretching
Treatment Intervention Types:
Adjuncts to Medication Management
• Relaxation Training
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Breathing techniques
Deep relaxation
Autogenic phrases
Yoga
Treatment Intervention Types:
Adjuncts to Medication Management
• Cognitive Behavioral Therapy
• Identifying triggers
• Building a coping strategy database
• Thought restructuring
Biofeedback Demo
*CBBT’s Pendulum Gym
*Live Demo
CBBT’s Pendulum
Footage
Courtesy of:
Alex Lozano
References
Allen, K. D. (2006). Recurrent pediatric headaches: Behavioral concepts and interventions. Journal of Early and Intensive Behavioral Intervention, 3, 211–219. doi:10.1037/h0100333
Fall, K. A., Holden, J. M., & Marquis, A. (Eds.). (2010). Theoretical models of counseling and psychotherapy (2nd ed.). New York, NY: Rutledge Taylor & Francis Group.
Khazan, I. Z. (2013). The clinical handbook of biofeedback: A step-by-step guide for training and practice with mindfulness. Malden, MA: Wiley-Blackwell.
Miller, L. (1994). Biofeedback and behavioral medicine: Treating the symptom, the syndrome, or the person. Psychotherapy, 31, 161–169. doi:10.1037/0033-3204.31.1.161
Peper, E., & Shaffer, F. (2010). Biofeedback history: an alternative view. Biofeedback, 38, 142–147, doi:10.5298/1081-5937-38.4.03
Riva, D., Usilla, A., Aggio, F., Vago, C., Treccani, C., & Bulgheroni, S. (2012). Attention in children and adolescents with headache. Headache, 52, 374–384. doi:
10.1111/j.1526-4610.2011.02033.x
Schwartz, M. S., & Andrasik, F. (2005). Biofeedback: A practitioner’s guide (3rd ed.). New York, NY: Guilford Press.
Skinner, B. F. (1963). Operant behavior. American Psychologist, 18, 503–515. doi:10.1037/h0045185
Rusty Lozano M.ED, LPC, BCB
469-358-1309
www.onlinebiofeedback.com
• Pediatric & Adolescent Biofeedback
• Counseling & Behavior Therapy
• Group Therapy