We have one in our office that we put on a shelf above eye height when we're all working. It seems to be okay just kind of shining down on us. It's usually on the whole day but we're only in for a few hours at a time, we all have meetings and appointments with other people so pop in and out of the office.
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I also work remote and have a SAD lamp mounted just an couple of inches above my employer-issued work laptop. (I custom designed and 3d printed a mount for it, in fact.) Basically exactly above and as close to my screen as possible.
It's quite bright (obviously) and does make seeing the screen a little harder, but I crank the monitor brightness up all the way. I don't know specifically that it's given me headaches, but I am prone to headaches. I'll have to pay more attention and see if there is any correlation between headaches and SAD lamp usage for me.
I leave it on at the brightest and whitest setting from 9:00am to 5:00pm (with a break for lunch.)
I will say it's not quite enough. This time of year, even with the SAD lamp, my (self-diagnosed, mild-ish) SAD benefits from sitting out in the sun for 10 minutes or so in the morning before work. But a SAD lamp and no sun is a lot better than no SAD lamp and no sun. I think even when it's overcast (which it is pretty much all the time where I am as well of late) I get benefit from sitting out and getting a little ambient, cloud-filtered light.
This is the specific model of SAD lamp I use. (I've got two of that same model, in fact. One of the AC adapters crapped out not long ago and I ordered a replacement AC adapter from Verilux for way more than what I'd consider reasonable. Works fine again now.) The one I have mounted over my work laptop is mounted in "landscape mode." (Sideways.) I figured that would be better than upright.
Hopefully this is all at least a little bit helpful. I have no idea if you have access to any 3d printers, but if you're interested in my SAD lamp mount models, I'm happy to share.