Multisite Study Comparing Clinic-Based and Telemedicine Cognitive Behavioral Therapy for Chronic Posttraumatic Headache in Military Service Members and Veterans

What this Trial Is About

Posttraumatic headache PTH is a frequent and disabling condition following traumatic brain injury TBI, especially common among U.S. military service members and veterans. This trial evaluates the effectiveness of cognitive behavioral therapy CBT for chronic PTH when delivered in person at clinics versus through telemedicine, compared to treatment as usual TAU. The study aims to improve headache-related disability and assess whether telemedicine can provide comparable results across multiple military and VA medical centers. Participants will be randomly assigned to one of three groups Clinic-based CBT CCBT with 8 weekly face-to-face sessions, Telemedicine-based CBT TCBT with 8 weekly sessions delivered remotely using telehealth technology, or TAU where they continue usual clinical care for 8 weeks. Both CBT approaches use a manualized intervention focused on headache awareness, relaxation techniques, and problem-solving. The study includes specific procedures for telemedicine encounters to ensure participant safety and engagement. Throughout the study, participants will complete assessments on headache-related disability using the Headache Impact Test-6 HIT-6, headache diaries, and measures of depression, anxiety, and PTSD at baseline and at 3-month follow-up. Weekly monitoring calls will be conducted for the TAU group to check for adverse events. The total involvement spans the treatment period plus follow-up, with data collected to understand treatment outcomes and participant experiences in a randomized, double-blind design.

Multisite Advancement of Research on Chronic Posttraumatic Headache