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Compliance has been an overlooked area in occupational therapy practice and research. Compliance with progressive relaxation training for recurrent headache relief was determined for 10 children. A multiple baseline across subjects design was used. Baseline periods were assigned randomly and ranged from 7 to 25 days with treatment introduced in a time-staggered fashion. Subjects received a 6-week program that included weekly training sessions supplemented with daily home practice. Compliance was determined by the subject's correct recording of a password randomly placed on a cassette relaxation tape. Mean compliance across subjects was 84% (range: 36% to 100%). Noncompliance occurred 74% of the time when subjects reported being headache-free for that day. Eight of the subjects had a 2% to 30% (mean: 15%) increase in headache-free days. This study indicated that compliance with relaxation training does not result consistently in headache relief. Guidelines for the occupational therapist's assessment of patient compliance with treatment regimens are provided. Results and implications for future research also are discussed.

Headaches are one of the most common somatic complaints among adults and children. This study investigated the effects of thermal biofeedback-assisted relaxation training on adult and child tension, migraine, and mixed (migraine and tension) headache disorders. A multiple baseline design across three adult and four child participants was used and multiple outcomes were assessed including participants' records of headache duration and severity, medication intake, and downtime because of headaches. To corroborate participants' records of headache activity, family members independently recorded headache occurrences, and medication intake was corroborated by investigators' pill counts of headache medications. After treatment, reductions in headache duration and severity, downtime, and medication intake were noted for all participants, with four of seven participants headache-free at 1-year follow-up. The results are compared with previous studies and methodological issues are discussed, particularly the need to corroborate self-report measures in headache studies.