Homework adherence predicts therapeutic improvement from behavior therapy in Tourette's disorder

Essoe, Joey K.-Y.; Ricketts, Emily J.; Ramsey, Kesley A.; Piacentini, John; Woods, Douglas W.; Peterson, Alan L.; Scahill, Lawrence David; Wilhelm, Sabine; Walkup, John T.; McGuire, Joseph F.

doi:10.1016/j.brat.2021.103844

Cited by 21 publications

(13 citation statements)

References 61 publications

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“…Taken together, the available studies suggest that PT for TS does not influence the treatment effects of BT. In another study, based on data from the same original RCTs as used in the Sukhodolsky et al study, Essoe et al concluded that adherence to homework assignments predicted tic reductions and treatment response [ 42 ].…”

Section: Resultsmentioning

confidence: 99%

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

Andrén

Jakubovski

Murphy

et al. 2021

Eur Child Adolesc Psychiatry

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Part II of the European clinical guidelines for Tourette syndrome and other tic disorders (ECAP journal, 2011) provides updated information and recommendations for psychological interventions for individuals with tic disorders, created by a working group of the European Society for the Study of Tourette Syndrome (ESSTS). A systematic literature search was conducted to obtain original studies of psychological interventions for tic disorders, published since the initial European clinical guidelines were issued. Relevant studies were identified using computerized searches of the MEDLINE and PsycINFO databases for the years 2011–2019 and a manual search for the years 2019–2021. Based on clinical consensus, psychoeducation is recommended as an initial intervention regardless of symptom severity. According to a systematic literature search, most evidence was found for Habit Reversal Training (HRT), primarily the expanded package Comprehensive Behavioral Intervention for Tics (CBIT). Evidence was also found for Exposure and Response Prevention (ERP), but to a lesser degree of certainty than HRT/CBIT due to fewer studies. Currently, cognitive interventions and third-wave interventions are not recommended as stand-alone treatments for tic disorders. Several novel treatment delivery formats are currently being evaluated, of which videoconference delivery of HRT/CBIT has the most evidence to date. To summarize, when psychoeducation alone is insufficient, both HRT/CBIT and ERP are recommended as first-line interventions for tic disorders. As part of the development of the clinical guidelines, a survey is reported from ESSTS members and other tic disorder experts on preference, use and availability of psychological interventions for tic disorders.

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Section: Resultsmentioning

confidence: 99%

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

Andrén

Jakubovski

Murphy

et al. 2021

Eur Child Adolesc Psychiatry

View full text Add to dashboard Cite

show abstract

“…Also based on previous RCTs of CBIT, 86 Essoe and colleagues 87 investigated the relation between homework adherence and treatment outcomes. The results showed that greater overall homework adherence predicted tic severity reductions and treatment response.…”

Section: Resultsmentioning

confidence: 99%

“…Despite limitations such as confounding TS/CTD interventions during the follow-up period and data loss, the study indicated good durability of the effects of BT. Also based on previous RCTs of CBIT, 86 Essoe and colleagues 87 investigated the relation between homework adherence and treatment outcomes. The results showed that greater overall homework adherence predicted tic severity reductions and treatment response.…”

Section: Psychological Interventionsmentioning

confidence: 99%

Tourette syndrome research highlights from 2021

et al. 2022

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“…Similar effects with decreased adherence and efficacy have also been shown in other mental disorders such as depression when using completely self-guided (internet-delivered) treatments [ 32 , 33 , 34 , 35 ]. Besides general support, reminder/request to complete homework assignments might play a crucial role in HRT/CBIT, since homework adherence has been found as a predictor for therapeutic response to CBIT [ 36 ]. Thus, we are convinced that our results did not reach significance, because in our sample size calculation, we neglected reduced treatment effects due to internet-delivered treatment (compared to f2f treatment).…”

Section: Discussionmentioning

confidence: 99%

ONLINE-TICS: Internet-Delivered Behavioral Treatment for Patients with Chronic Tic Disorders

Haas

Jakubovski

Kunert

et al. 2022

JCM

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Comprehensive Behavioral Intervention for Tics (CBIT) is considered a first-line therapy for tics. However, availability of CBIT is extremely limited due to a lack of qualified therapists. This study is a multicenter (n = 5), randomized, controlled, observer-blind trial including 161 adult patients with chronic tic disorders (CTD) to provide data on efficacy and safety of an internet-delivered, completely therapist-independent CBIT intervention (iCBIT Minddistrict®) in the treatment of tics compared to placebo and face-to-face (f2f) CBIT. Using a linear mixed model with the change to baseline of Yale Global Tic Severity Scale-Total Tic Score (YGTSS-TTS) as a dependent variable, we found a clear trend towards significance for superiority of iCBIT (n = 67) over placebo (n = 70) (−1.28 (−2.58; 0.01); p = 0.053). In addition, the difference in tic reduction between iCBIT and placebo increased, resulting in a significant difference 3 (−2.25 (−3.75; −0.75), p = 0.003) and 6 months (−2.71 (−4.27; −1.16), p < 0.001) after the end of treatment. Key secondary analysis indicated non-inferiority of iCBIT in comparison to f2f CBIT (n = 24). No safety signals were detected. Although the primary endpoint was narrowly missed, it is strongly suggested that iCBIT is superior compared to placebo. Remarkably, treatment effects of iCBIT even increased over time.

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Homework adherence predicts therapeutic improvement from behavior therapy in Tourette's disorder

Cited by 21 publications

References 61 publications

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

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

Tourette syndrome research highlights from 2021

ONLINE-TICS: Internet-Delivered Behavioral Treatment for Patients with Chronic Tic Disorders

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