When It’s More Than “Just a Headache”: What Therapists Need to Know About Headaches and Migraines

ByNotBoringCEs

Let’s be real: Most of us have had a headache. But when your client says they’re having three a week, or describes losing vision or vomiting from the pain, it’s no longer something to gloss over with “drink some water and rest.” In this conversation with pediatric pain psychologist Dr. Emily Foxen-Craft, we dig into what every therapist should know about headaches—especially when they show up in the therapy room.

This blog is for any clinician who’s ever Googled “continuing education for counselors” or “CEs for therapists” and ended up in a swamp of vague webinars. We’ve got you. This one’s full of practical info, straight talk, and some surprising truths about pain, the brain, and how to help our clients feel less alone.

Why Headaches Matter More Than You Think

🧠 Up to 50% of people have some kind of headache condition.
📈 At any moment, 16% of the global population is dealing with a headache.

That’s a lot of your caseload.

As therapists, we can’t diagnose headaches, but we can hold space for the experience, help clients navigate the medical system, and avoid projecting our own “I just push through” mindset.

“Because headaches are so common, we sometimes don’t realize how deeply they affect functioning—and empathy can get clouded by assumption.”

Headache vs. Migraine: What’s the Difference?

Primary Headaches = the headache is the issue (like tension-type or migraines)
Secondary Headaches = the headache is a symptom of something else (like illness, concussion, or pressure in the brain)

Tension-Type Headache:

  • Feels like a band around the head
  • Usually mild to moderate
  • Often related to muscle tension or stress

Migraine:

  • Can include nausea, light/sound sensitivity, visual disturbances (auras)
  • Pain that worsens with movement
  • Often more disabling than a typical headache
  • Sometimes not head-pain centered (e.g., abdominal migraine)

👀 Red flags that deserve medical follow-up:

  • New or sudden-onset headaches
  • Changes in vision
  • Tingling or numbness
  • Loss of coordination
  • Headaches that wake someone up at night

When WebMD Says You’re Dying

We’ve all done it: You or a client Google symptoms and suddenly it’s brain cancer. Emily reassures us:

“If it’s been going on for a long time, it’s likely not something new and sinister—but always get checked.”

Therapists can coach clients to:

  • Keep a symptom log
  • Ask key questions at appointments
  • Communicate clearly with providers

Helping Clients Communicate About Their Pain

Clients may struggle to talk about their headaches with:

  • Partners
  • Kids
  • Teachers or school staff
  • Employers
  • Healthcare providers

Help them prepare:

  • A short script that includes their diagnosis, experience, and needs
  • Questions to ask their provider (“Why this medication?” “Do I need imaging?”)
  • Boundaries around what they share at work or school

Lifestyle Changes That Actually Help

Therapists often ask: “How much can I do with something that sounds medical?”
The answer: A lot.

Dr. Foxen-Craft recommends starting with four big lifestyle levers:

1. Sleep

  • Duration, quality, and consistency matter
  • Track it with a sleep log or wearables (like an Oura Ring)
  • Good sleep hygiene practices can be a game-changer

2. Hydration

  • Thirst = already dehydrated
  • Spread water intake throughout the day
  • Trendy water bottles work wonders (especially for kids)

3. Nutrition

  • Skipping meals can be a trigger
  • Beware of the myth that everyone has a food trigger
  • Don’t restrict whole food groups unless medically advised

4. Physical Activity

  • Tricky but helpful
  • Start small (e.g., walking, gentle stretching)
  • Exercise can prevent headaches long-term but may aggravate them in the short term

Myth-Busting Time

🚫 Migraine ≠ just a bad headache
🚫 It’s not “all in your head” emotionally
🚫 Avoid shaming or oversimplifying (“If you just drank more water…”)

Instead, offer validation, gentle education, and tools that empower clients to track patterns and experiment with small changes.

Therapists Already Have the Tools

You already know how to help people:

  • Communicate better
  • Make sustainable behavior changes
  • Manage stress and regulate their nervous system

All of that applies here.

Techniques like:

  • Cognitive restructuring
  • Motivational interviewing
  • Psychoeducation
  • ACT for pain
  • Mindfulness and relaxation work

…are all useful when supporting clients with headaches or migraines.

Wrap-Up: Supporting the Whole Human (Not Just the Headache)

Whether your client is a 10-year-old with chronic migraines or a parent stretched thin by pain and caregiving, you have a role. Not to diagnose. Not to fix. But to listen, validate, coach, and collaborate.

These are the kinds of nuanced, real-world insights we dig into at Not Boring CEs—where you can get all your required CEs for therapists, continuing education for counselors, and actually learn something useful (without fighting off a nap).

➡️ Ready for more? Check out our full CE course on the psychology of headaches with Dr. Emily Foxen-Craft at Not Boring CEs.

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