Abstract

Behavioral and psychological therapies for Tourette syndrome and tic disorders: their place in treatment and history

Author(s): Mary M Robertson,Uttom Chowdhury

In the past, only psychological therapies were used for Tourette syndrome (TS), thereafter medications were the mainstay for many years. There has been a recent increase in the literature on evidence-based behavioral therapies for TS, but there seems to be little evidence-based treatment of psychological therapies for tic disorders. This article reviews the management of TS, highlighting the controlled studies examining behavioral and cognitive therapies for TS and tic disorders. There have been numerous case reports and small case series on the subject of cognitive-behavioral treatments of TS and tic disorders. There have been ten published studies that used controls as part of the design. There is evidence that habit reversal training and exposure response prevention therapy may have some effect on reducing tics, but, to date, long-term follow-up has not been established. Recent studies using habit reversal training, in particular, have been promising. There are no evidence-based studies showing that other forms of psychological therapies such as psychoanalysis are effective. Further clinical research is needed to establish the effectiveness of several behavioral therapies. Developmental considerations should be considered when looking at its application to children. Suggestions for future studies are discussed.