Predictors of Improvement in Pediatric Chronic Migraine: Results from the Cognitive-Behavioral Therapy and Amitriptyline Trial.

Explore predictors of improvement in headache days and migraine-related disability through a secondary analysis of the cognitive-behavioral therapy plus amitriptyline trial in children and adolescents (Clinical Trials Registration Number: NCT00389038). Participants were 135 youth aged 10-17 years old diagnosed with chronic migraine. Predictor variables included group assignment (treatment or control), baseline scores from depression and quality of life measures, and demographic variables. Criterion variables included headache days and migraine-related disability. Higher baseline depression scores were indicative of more days with headache post-treatment regardless of group assignment. Family income at the higher-end of the low-income range was significantly associated with less migraine-related disability regardless of group assignment (Household Income: HINC-01 in The United States Census Bureau. Bureau, U, 2020). Results from this secondary analysis identify depression symptoms and family income as predictors that can impact headache frequency and migraine-related disability. Self-reported symptoms of depression and family income are important factors to consider as part of the biopsychosocial model of care.

Supervising Culturally Informed Modified Trauma-Focused Cognitive Behavioral Therapy.

Supervision can be a dynamic and fluid process where the relationship between a supervisor and supervisee evolves and enhances the supervisee's knowledge, attitudes, and skills through the use of various assessments and interventions. As a student encounters clients who have experienced trauma, Trauma-Focused Cognitive Behavioral Therapy (TF-CBT)-an empirically based model-can be implemented with diverse populations. Supervisors must ensure that the supervisees can adequately adapt TF-CBT to maintain the fidelity of the model while addressing the contextual variables of the client. Specifically, supervisors must ensure that supervisees have a solid understanding of trauma, child development, and the culture they are addressing. This article will address the role supervisors must take to teach supervisees how to implement the components of TF-CBT, including both application and collection of outcome measurements; how the model can be modified to reflect culturally informed practices; and how supervisors can process with supervisees the challenges of working with trauma-related cases.