Internet-based Cognitive Behavioral Therapy for Chronic Tic Disorder and Tourette's Disorder: a Feasibility Trial

Summary

Tic disorders, including Tourette's Disorder (TD) and Chronic Motor or Vocal Tic Disorder (CTD), are neurodevelopmental motor disorders characterised by motor and/or vocal tics. TD/CTD are impairing conditions with onset during childhood that often persist into adulthood. Behaviour therapy (BT) is an effective treatment for TD/CTD and is recommended as a first-line intervention in both in children and in adults. However, most adults with TD/CTD do not have access to BT due to a lack of trained professionals and geographical barriers. The objective of the study is to adapt and extend existing face-to-face BT treatment protocols for adults with TD/CTD to an internet-delivered format and evaluate its feasibility and preliminary efficacy. A total of 30 adult TD/CTD adult patients deemed eligible for the study through the recruitment process involving both psychologist and physician assessment will be enrolled in the project. The 8-modues treatment program, mainly based on exposure with response prevention with addition of other techniques will be made available for the participants in a secure treatment platform. The participants will keep in touch with a therapist using two-ways written communication in the same platform. The therapist's role will be to introduce the treatment and its modules, give feedback on the homework assignments and open the new modules as well as monitor the participants psychiatric symptoms and activity in the plattform. The measures will include tic severity secifically and disease severity in general, anxiety and depression symptoms, quality of life, treatment credibility and therapeutic alliance. The measures will be administrated at baseline, min- and post-tretment, as well at 3 and 12 months follow-up. Upon completion, this project will be the first crucial step towards the implementation of internet-delivered behaviour therapy (I-BT) for adults with TD/CTD in regular health care.

Conditions

• Chronic Tic Disorder
• Tourette Syndrome

Interventions

BEHAVIORAL

Internet-delivered Cognitive Behavior Therapy for Chronic Tic Dosorder/Tourette Disorder

The treatment will be provided through a secure internet platform designed for internet-administered treatments (BASS-4). In the treatment, the patient works through modules of self-help material, each ending in a short quiz with questions about the material. The treatment is supported by a therapist through text-based communication via the platform as well as occasional phone calls when needed. The central component in the treatment is exposure and response prevention (ERP). In ERP, the patient exposes her/himself to situations that trigger premonitory urges (a type of bodily sensation that precede the tic) while practicing to resist the tic. By doing this systematically and repeatedly, the patient gradually learns how to tolerate the premonitory urges and increase the ability to control and resist doing tics. Beyond ERP the treatment consists of other components such as applied relaxation, counter-movements and interventions to decrease stressors in the patient's everyday life.

Sponsors & Collaborators

• Region Stockholm

  collaborator OTHER_GOV

• Karolinska Institutet

  lead OTHER

Study Design

Allocation

NA

Purpose

TREATMENT

Masking

NONE

Model

SINGLE_GROUP

Eligibility

Min Age

18 Years

Sex

ALL

Healthy Volunteers

No

Timeline & Regulatory

Start

2021-04-15

Primary Completion

2023-06-23

Completion

2023-08-23

Countries

• Sweden

Study Locations