RELAXaHEAD for Headache Patients (Phase III)

Inclusion Criteria:

• English speaking. (At this time, the validated app is only available in English.)

• ≥16 years of age

• Meets International Classification of Headache Disorder (ICHD)-3 migraine criteriabased on Information in the Study Manual

• Headaches for ≥1 year with a stable pattern for the past >3 months

• Agreement to not make any preventive medication changes for the 3 months before thestart of the trial and then the 6 weeks of the intervention part of the study

• 4-29 headache days a month (so that we include those in whom we typically offerpreventive treatment (>4 headache days/month and those with more frequent migrainesincluding chronic migraine but exclude those with continuous headaches (30days/month))

• MSQv2 score <75 for role restrictive function to ensure participants have sufficientreduced quality of life to potentially benefit from the intervention (see if thereis a positive effect of the intervention)

Exclusion Criteria:

• Patients who have had CBT, Biofeedback, or other Relaxation Therapy for migraine inthe past year

• Alcohol or other substance abuse as determined by self-report or prior documentationin the medical record

• Diagnosis of medication overuse headache and/or opioid or barbiturate use

• PHQ-8 scores greater than 15, indicate a conservative score of moderately severedepressive symptoms based on the PHQ-9 12-14 (in those with PHQ-8 scores >15, moreintense intervention targeted to the depression may be needed, as depression is asignificant predictor of migraine chronification and people with migraine andcomorbid depression are more likely to be refractory to migraine treatments and tosuffer from medication overuse)

• Unable or unwilling to follow a treatment program that relies on written andaudio-taped materials

• Not having a smartphone (we do not believe this exclusion criterion will adverselyaffect equitable subject selection because the subject population specific to ourresearch question would only be able to access this application via smartphone if itwere to become publicly available, including subjects without smartphones would notbe pertinent to our research question and overall study goals).

• Pregnant (because hormonal fluctuations in pregnancy can affect migraine outcomes)