Abstract
Objectives This pilot study aimed to investigate the efficacy of a combined behavioural intervention to improve severity of tic symptoms in adults with Tourette Syndrome. The treatment protocol combined elements of Habit Reversal Therapy (HRT) and Acceptance and Commitment Therapy (ACT). HRT is a behavioural approach to the treatment of tics and other habit disorders (Woods, 2001). The current study combined HRT with ACT, an empirically based psychological intervention and useful adjunct to HRT given its focus on acceptance, rather than avoidance, of internal experiences (such as urges to tic). It was hypothesised that the treatment would result in reduced tic severity.
Methods Tic symptoms were assessed at baseline, post-intervention, and at 6- and 12-months follow-up on 11 participants. The primary outcome measure was the Yale Global Tic Severity Scale (YGTSS) and validated using a video assessment. Intervention consisted of eight, 1-hour weekly individual treatment sessions.
Results Using mixed-effects regression, results indicated that compared to pre-treatment scores, participants experienced an average significant reduction in tic severity (YGTSS) at post-treatment (b=-10.36, p=.002), maintained at six- (b=-8.19, p=.012) and 12-month follow up (b=-8.82, p=.009). Results of the video assessment demonstrated a similar significant treatment effect that was maintained at 6- and 12-month follow-up.
Conclusion Results suggest that the combined HRT/ACT treatment protocol is effective in reducing tic severity in adults with Tourette Syndrome, with maintained improvements up to 12 months post-intervention. These results have provided data for a future comprehensive randomised-controlled trial to determine the efficacy of combined HRT/ACT versus HRT alone.
