Efficacy of Habit Reversal Training in Children With Chronic Tic Disorders: A Within-Subject Analysis

Abstract

The aim of this study is to evaluate a cognitive-behavioral treatment for children and adolescents with tic disorder including habit reversal training (HRT) in a sample of children and adolescents ( n = 27). Multiple outcome measures were used to assess the effects of the treatment on tic symptoms. In addition, impairment/subjective burden ratings and the self-efficacy to control tics were assessed. A within-subject design with two phases (8 weeks diagnostic; 16 sessions treatment) was analyzed using multilevel modeling (MLM). During the treatment phase, significant improvements in tic symptoms, impairment, and self-efficacy to control tics were found on most outcome measures. Treatment effects were found on the clinical rating of tic symptoms ( Yale Global Tic Severity Scale [YGTSS]), the self-efficacy to control tics, and the video-observed motor tic frequency by comparing the improvements during treatment with the course of the outcome measures during the preceding diagnostic phase.

Implementation and Evaluation of Therapeutic Online Coaching Using Habit Reversal Training in Children With Tourette’s Disorder – A Pilot Study

“…In addition, only two patients had a relative improvement of more than 25% (categorized as a clinical success) at therapy end, while at the follow-up assessment four patients had an improvement of at least 25%. Earlier HRT trials using face-to-face interventions often reported a mean reduction of about 30% (e.g., Piacentini et al, 2010 ; Viefhaus et al, 2018 ), while the present online coaching study found a mean reduction of 13% at therapy end and of 43% at the follow-up assessment.…”

“…The efficacy of a similar German treatment program for children and adolescents with chronic tic disorders (Therapieprogramm für Kinder und Jugendliche mit Tic-Störungen, THICS; Woitecki and Döpfner, 2015 ) was evaluated in two studies using within-subject designs ( Woitecki and Döpfner, 2011 ; n = 16; Viefhaus et al, 2018 ; n = 27). The program was found to be effective in reducing tics and increasing the sense of controllability of tics.…”

European clinical guidelines for Tourette syndrome and other tic disorders—version 2.0. Part II: psychological interventions

“…Viefhaus et al examined the efficacy of a German BT program (similar to CBIT) including HRT, psychoeducation and additional behavioral interventions (e.g. functional interventions) for young people (8–16 years; N =27) with TS/CTD [ 20 ]. In a within-group design (8 weeks pre-treatment; 16 sessions treatment), significant improvements were found on tic severity (YGTSS-TTS, within-group effect size: 0.89) and tic-related impairment (YGTSS Impairment Score, within-group effect size: 0.31) at post-treatment.…”

Psychometric Properties of the Chinese Version of the Premonitory Urge for Tics Scale: A Preliminary Report

“…PU seemed to play a critical role in the expression of tic symptoms, but it can also be considered as an indicator of the severity of tic symptoms. Moreover, Habit Reversal Training (HRT) (Hwang et al, 2012;Piacentini and Chang, 2016;Viefhaus et al, 2020), as recommended by the American Academy of Neurology as the first-line therapy for TS (Pringsheim et al, 2019), notes that the most critical step of HRT is the awareness of PU (Seragni et al, 2018;Nissen et al, 2019b). Thus, we should pay more attention to PUs in the treatment research for tic disorders, especially for the assessments of PUs at the baseline and after HRT trials.…”