Transporting Behavior Therapy to neurology Clinics: Adaptation, Development and Feasibility

Grant Type
Grant Year
Institution Location
Institution Organization Name
University of Wisconson
Investigators Name
Woods, Douglas, PhD

Habit Reversal Treatment (HRT) has been classified as the only well-established non-pharmacological treatment for Chronic Tic Disorder. HRT is a behavioral intervention that involves awareness training, competing response training, and social support. Awareness training consists of teaching individuals with TS to become more aware of both occurrences of the tic as well as urges that precede a tic. The person is then trained to perform a specific behavior chosen because it prevents the tic from occurring. This is called a competing response. Each time a tic or an urge begins, the competing response is performed. The competing response is used for 1 minute or until the urge to tic diminishes. The person with TS is encouraged and reminded to use this procedure through social support, where a significant other praises the person for correctly using the procedure and reminds him/her to employ the procedure when the other person observes tics but the patient does not use a competing response. There is now a large body of research that demonstrates the effectiveness of HRT for children. A TSA-sponsored group known as the Behavioral Sciences Consortium has developed and tested a Comprehensive Behavioral Intervention for Tics (CBIT) in children. This intervention is based on HRT. One of the greatest barriers to receiving this treatment and other behavioral interventions for tics is the lack of healthcare professionals trained in these treatments. Given that a large percentage of children with Tourette Syndrome are treated by pediatric neurologists, it is thought that effective interventions should be available in such settings. In the current study, neurologists and nurse practitioners at three large Tourette Syndrome neurology clinics will help us create a version of CBIT that can be readily used in the clinic. The resulting manual (CBIT-N) will be pilot tested in these locations. Future research could involve a large scale test of the effectiveness of CBIT-N in neurology clinics. Douglas Woods, Ph.D., University of Wisconsin Milwaukee, WI Leon Dure, M.D., Children’s Hospital Birmingham, AL Donald Gilbert, M.D., Cincinnati Children’s Hospital Cincinnati, OH Jonathan Mink, M.D., Ph.D., University of Rochester Medical Center Rochester, NY John Piacentini, Ph.D., University of California, Los Angeles, CA John Walkup, M.D., New York Presbyterian Hospital, New York, NY Award: $49,280 Commentary: Comprehensive Behavioral Intervention for Tics (CBIT) has been shown to be an effective therapy for some children with TS. However, this treatment method is not yet widely available. In this study, members of the TSA Behavioral Sciences Consortium have partnered with neurologists and nurse practitioners at three large TS neurology clinics to adapt and test a new version of CBIT that would be more suitable for this environment. If this approach proves to be successful, CBIT could be implemented across the country and become more widely available to people with TS Tourette Association of America Inc. – Research Grant Award 2009-2010