A randomised trial comparing Habit Reversal and psycho-education treatment groups for children with Tourette Syndrome

Abstract

The quality of life of children with Tourette Syndrome, a neurodevelopmental condition characterised by chronic tics, is impacted greatly by both the symptoms themselves and their social consequences. Habit Reversal Therapy, a behavioural therapy for tic management, has substantial empirical support in its individual form, but this approach has never been investigated in a group format. Group based delivery of Habit Reversal Therapy could increase access to therapy, improve the cost-effectiveness of treatments and potentially offer additional therapeutic benefits. This randomised controlled pilot study evaluated the feasibility and preliminary efficacy of Habit Reversal Therapy compared to psycho-educational groups for 33 children aged 9 to13 years with Tourette Syndrome and Chronic Tic Disorders. Outcomes of the groups were evaluated in terms of reductions in tic severity and improvements in quality of life. Good attendance rates in both groups suggested feasibility and acceptability of the interventions. Improvements in tic severity and quality of life were found in both groups, although to a lesser extent compared to previous studies of individual behavioural therapy for tics. Motor tic severity showed greater improvements in the Habit Reversal Therapy group on the main outcome measure (Yale Global Tic Severity Scale) but not on a direct observational measure of tic frequency. Given the potential for such groups to provide additional treatment options for families, further research is warranted. Clinical implications and suggestions for improvements to the current design for a larger study are outlined as well as indications for wider reaching future research.