Responding With Evidence and Access for Childhood Headaches (REACH) study: A comparative effectiveness trial of cognitive behavioral therapy monotherapy versus combined cognitive behavioral therapy-pharmacotherapy with amitriptyline for the prevention of childhood migraine-The study protocol.

Migraine is a common health issue for children and teens. It causes significant disability and often continues into adulthood. Current recommendations suggest using both medication and cognitive behavioral therapy (CBT) for treatment. However, no studies have compared these methods directly. The REACH study aims to fill this gap. It will compare CBT alone to a combined treatment of CBT and medication. The study will involve young people aged 10 to 17 with migraines. Participants will be randomly assigned to either the combined treatment group or the CBT-only group. Researchers will also focus on improving access to CBT through teletherapy. This approach could make it easier for families to receive care, especially in underserved areas. The study will take place at 15 sites across the United States, providing valuable insights into effective migraine prevention strategies for youth. Clinical relevance: This research may help identify the best treatment approach for childhood migraines, improving outcomes for young patients and their families.