Biofeedback and Self-Regulation, Vol. 16, No. 2, 1991 Muscular Response to the Therapist and Symptomatic Improvement During Biofeedback for Tension Headache 1 Francois Borgeat 2 and Robert Elie University of Montreal Louis Georges Castonguay State University of New York at Stony Brook The relationship between muscular response to the therapist's presence and symptomatic improvement was studied during biofeedback. Thirty-two patients suffering from tension headaches received muscular biofeedback training of six sessions plus a follow-up session two months later. Patients' electro-myographic frontal response was measured prior to treatment both with and without the therapist present. A relationship was found between symptomatic improvement at follow-up and muscular response to the therapist's presence before treatment: patients showing a decrease of at least 10% in muscular tension response to the presence of their future therapist improved more regarding headache intensity than the patients showing in- crease or smaller variation of their EMG. A significant correlation of .59 was found between the frontal EMG response to therapist presence during the evaluation session and headache improvement at follow-up. The results sug- gest that the decrease of muscular tension .during the first contact with the therapist could be an indicator of good prognosis, possibly because of an immediate positive therapeutic relationship and~or favorable expectancies con- 1The authors thank Mrs. G. Paris6 for her assistance during the experimentation, Ms. M. Newman for her editorial corrections, and Ms. A. Khan for her secretarial work. 2Address all correspondence to Dr. F. Borgeat, Department of Psychiatry, University of Montreal, 3100 Ellendale, Montr6al (Qu6bec) Canada H3S 1W3. 147 0363-3586/91/0600-0147506.50/0 © 1991 Plenum Publishing Corporation