Exposure and Response Prevention for Children and Adolescents with Tourette Syndrome Delivered via Web-Based Videoconference versus Face-to-Face Method

Abstract

Chronic tic disorders, such as Tourette Syndrome, are characterized by motor and vocal tics. Tics present a considerable burden for some patients, and therefore effective treatment is important. One evidence-based treatment option is a behavioral therapy called Exposure and Response Prevention (ERP). Despite its effectiveness, access to ERP remains limited due to a lack of treatment sites. Web-based videoconferences can connect patients at home with a therapist located in the hospital, allowing for treatment delivery over a wide geographic area. The primary aim of this study was to compare the development of tics during and one year after ERP delivered respectively via web-based videoconferences and traditional face-to-face methods in a naturalistic setting. 116 patients treated using either the face-to-face method (n = 72) or web-based videoconferences (n = 44) were included. The primary outcome measure was tic severity. In both training modalities, tic severity decreased during ERP and the effect lasted in the follow-up period. No statistically significant differences in tic severity between the training modalities were found at baseline, last training session or at follow-up. Our results suggest that ERP delivered via web-based videoconferences is a good alternative to the traditional face-to-face method.

Tourette syndrome research highlights from 2022

“…In this study by Sørensen and colleagues ( Sørensen et al . 2023a , 2023b ), 116 youth received ERP (either face-to-face [n = 72] or via videoconference [n = 44]) and were followed up one-year post-treatment. The study showed significant short- and long-term tic severity reductions (YGTSS-TTS) in both groups, with no significant between-group differences.…”

Internet-Delivered Exposure and Response Prevention for Pediatric Tourette Syndrome

“…Both treatments are typically delivered in person, and thus, their availability is limited . To make BT more accessible, several studies have investigated ways to deliver BT remotely . In a large UK randomized clinical trial (RCT)—the Online Remote Behavioural Intervention for Tics (ORBIT) trial—224 young individuals with TS or CTD were randomized to 1 of two 10-week therapist-supported, internet-delivered interventions: ERP and psychoeducation.…”

“… 6 , 7 To make BT more accessible, several studies have investigated ways to deliver BT remotely. 8 , 9 , 10 , 11 In a large UK randomized clinical trial (RCT)—the Online Remote Behavioural Intervention for Tics (ORBIT) trial 12 —224 young individuals with TS or CTD were randomized to 1 of two 10-week therapist-supported, internet-delivered interventions: ERP and psychoeducation. At the primary end point (posttreatment), internet-delivered ERP was superior to psychoeducation in reducing tic severity, requiring only minimal therapist resources.…”

Exposure and Response Prevention: Evaluation of Tic Severity Over Time for Children and Adolescents with Tourette Syndrome and Chronic Tic Disorders

“…Further information about the web-based videoconferencing approach is described in another article by the same author group. 31 In the ERP treatment sessions, the patients systematically learned to suppress their tics for a prolonged period. If a tic occurred, the patient was asked to start over again, encouraged by the therapist to improve the performance.…”