Rapid-response behavioral triage for tics (RRBTT): A 2-week clinical case series.

Abstract

Traditional behavioral treatments for tic disorders in youth require 8 sessions delivered over 10 weeks. Treatment duration represents a major barrier for patients and families, hinders direct comparisons between behavioral treatment and front line medication, and may motivate front line pharmacotherapy in place of behavioral interventions. The current case series describes an accelerated rapid-response behavioral triage for tics (RRBTT) and treatment outcomes. A retrospective chart review was conducted on clinically referred patients (n ϭ 10). The RRBTT consisted of 8 sessions delivered over 2 weeks, with a 1-month booster and evaluation session. Primary outcome measures were completed by the therapist conjointly with the parent and child at baseline, 1 and 2 weeks after beginning treatment, and 1 month after completing treatment. On average, youth experienced significant reductions (17.9%) in the Yale Global Tic Severity Scale after 1 week of treatment and (40.8%) by the 2-week posttreatment assessment (effect size ϭ .76). Posttreatment improvements in outcomes maintained at the 1-month follow-up with no additional treatment. Half of the patients (n ϭ 5) were rated as treatment responders, with 4 additional patients rated as receiving some benefit. The current findings highlight the flexible administration of an accelerated behavioral treatment, suggesting that the RRBTT may be effective in treating children and adolescents with tic disorders. These preliminary findings suggest the need for large-scale randomized controlled trials of RRBTT.

Behavioral Interventions for Children and Adults with Tic Disorder

“…Results showed that four out of five patients reported significant reductions in YGTSS scores, and two of the five patients were clinical responders as measured by the CGI-I. Similarly, Kennedy et al (2016) administered CBIT to 10 patients with TD or CTD in eight sessions conducted over a 2-week period. Results showed that the YGTSS scores were reduced 41%, and half of the participants were classified as clinical responders on the CGI-I.…”

Treating Tourette Together: An Agenda for Patient-Centered Research Focused on Comprehensive Behavior Therapy for Tics

“…Dissemination efforts have included adaptations of CBIT for use in pediatrics and neurology practices (Ricketts, Gilbert, et al, 2016), and for utilization by occupational therapists (Rowe et al, 2013). Brief and intensive forms of CBIT have been developed (Blount et al, 2014(Blount et al, , 2018Kennedy et al, 2016), as well as self-help online (PsycTech Ltd, n.d.) and video adaptations (Specht et al, 2017) to be used at home. Despite efforts to make CBIT more available, a large portion of affected individuals with chronic tic disorders do not have access to CBIT trained providers.…”