None listed
Conditions
Brief summary
Tourette Syndrome (TS) is characterised by sudden, rapid and recurrent motor and vocal tics that cause significant disruptions in social and occupational functioning. Habit Reversal Training (HRT) is a behavioural treatment for tics that has received substantial empirical support for tic reduction in individuals with diagnosed Tourette Syndrome (Dutta & Cavanna, 2013). HRT focuses on increasing an individual’s awareness of tics, followed by training in performing a physically competing response (Woods, 2001). Recent research on related habit disorders, however, has indicated that treatments targeting experiential avoidance, referred to as “psychological inflexibility”, might be useful adjuncts to HRT (Franklin, Best, Wilson, Loew & Compton, 2011). Acceptance and Commitment Therapy (ACT) targets experiential avoidance by aiming to modify an individual’s attempts to control unwanted private experiences and therefore focuses on promoting acceptance of unpleasant thoughts, feelings and urges. For this reason, ACT may serve as a useful addition to HRT protocols, particularly in addressing tic-related urges and the associated unpleasant thoughts and feelings that may not be remediated by HRT. The current pilot study aims to investigate the effectiveness of a combined HRT/ACT protocol in the treatment of tics in adults. It is hypothesised that this treatment will not only reduce tic symptoms but result in positive improvements in quality of life (QoL), work/social adjustment, mood, stress and anxiety. Participants will receive ten weekly sessions of therapy in accordance with a combined HRT/ACT protocol. Two booster sessions will be provided at 1 and 2 months following completion of the eight-week treatment program. Assessments will be completed before and immediately after the eight-week course of treatment, and again at 3, 6, 9 and 12-months post-treatment to assess for any maintained improvements.
Interventions
This study uses a behavioural intervention for the treatment of tics combining Habit Reversal Therapy, an established and evidence-based treatment for tics, with Acceptance and Commitment Therapy, an empirically-based psychological intervention that uses acceptance and mindfulness strategies to increase psychological flexibility. HRT is a behavioural approach to the treatment of tics and other habit disorders. The treatment model is based on the rationale that tic reduction is possible through t
This study uses a behavioural intervention for the treatment of tics combining Habit Reversal Therapy, an established and evidence-based treatment for tics, with Acceptance and Commitment Therapy, an empirically-based psychological intervention that uses acceptance and mindfulness strategies to increase psychological flexibility. HRT is a behavioural approach to the treatment of tics and other habit disorders. The treatment model is based on the rationale that tic reduction is possible through tic awareness and training in performing a physically competing response, in order to prevent or interrupt the occurrence of tics. It involves several therapeutic components including a function-based assessment, awareness training, relaxation training and competing response training. ACT is a modern, empirically-based psychological intervention grouped under the “third wave of cognitive behavioural therapy”. The model employs six core processes that assist in developing increased psychological flexibility. Treatment sessions will incorporate the core ACT processes, such as mindfulness and defusion, with the overarching aim of fostering acceptance of tic urges and helping patients deal more effectively with the unpleasant emotional states. Participants will be encouraged to complete homework and exercises between sessions which consists of completing self-monitoring worksheets (counting tics) once a day for 30-60 minutes and doing 2-5 minute relaxation exercises daily. This combined behavioural intervention will be administered by a trained psychologist over eight, weekly, 1-hour sessions. The sessions will be conducted individually and face-to-face at the Perron Institute clinic in Nedlands, WA. Two 1-hour booster sessions will be provided at 1 and 2 months following completion of the eight-week treatment program. Booster sessions will involve a review and consolidation of learned techniques.
Sponsors
Perron Institute
Study design
Allocation
Non-randomised trial
Intervention model
Single group
Primary purpose
Treatment
Masking
Open (masking not used)
Eligibility
Sex/Gender
All
Age
16 Years to No maximum
Healthy volunteers
No
Inclusion criteria
• Adults aged 16 years and over • Diagnosis of Tourette Syndrome or another Chronic Tic Disorder • Comorbidities such as obsessive-compulsive disorder (OCD), anxiety disorders and Attention-Deficit Hyperactivity Disorder (ADHD) will be permitted providing that the tics are the primary concern for the participant and the co-occurring disorder is stable.
Exclusion criteria
Moderate to severe cognitive dysfunction • Severe psychiatric condition (such as severe depression, psychosis, suicidality or substance abuse) • Other medical or neurological comorbidities that may interfere with treatment • History of 4 or more sessions of a similar behavioural therapy for tics (to ensure the participant is naïve to the treatment techniques)
Outcome results
None listed