Managing Tourette Syndrome

Book excerpt: In 2002, the Tourette Syndrome Association formed the TS Behavioral Sciences Consortium (BSC). The charge of the BSC was to develop and test nonpharmacological treatment options for individuals, both children and adults with Tourette Syndrome. This manual is the result of their work, and represents the most scientifically effective behavioral treatment for Tourette Syndrome available today. The treatment program uses Habit Reversal Training (HRT) for children and adults with chronic tic disorder. Individual treatment is based at its core on awareness training, the development of a specific competing response for each tic, and the use of functionally-based strategies for the elimination of tic-exacerbating antecedent and consequent variables. In addition, individual treatment includes techniques designed to enhance patient compliance, including social support and an inconvenience review, as well as scheduled time for the therapist and client to discuss areas of functioning that individuals with TS may find difficult, such as social/familial difficulties and disruptive anger/rage behavior. Each week, clients are given homework assignments, to be done 4-5 times per week, consisting of 20 to 30 minutes of awareness and competing response training to tics addressed in session. The client will be encouraged to keep tally marks to monitor tic behavior. Home-based monitoring and competing response training are reviewed at each session. All homework assignments will be available in this companion workbook.