Intensive Behavior Therapy for Tics: Implications for Clinical Practice and Overcoming Barriers to Treatment

Abstract

This case study illustrates the treatment of an individual diagnosed with Tourette syndrome (TS) treated with a behavior therapy (BT) protocol adapted from Woods and colleagues (2008). The client was a 25 year old, male who traveled from his country of origin for 2 weeks of intensive treatment for complex tics. The tics included multiple body movements and vocalizations that were both distressing and impairing. BT for tics is typically implemented weekly over the course of 10 weeks, and the efficacy of this regimen with adults has been demonstrated in several clinical trials (e.g., Wilhelm et al. American Journal of Psychiatry 160:1175–1177, 2003). In this report, we outline the case of a treatment-seeking adult with TS for which practical considerations necessitated a consolidated, intensive BT protocol involving massed rather than traditional spacing of sessions. To our knowledge, this is the first report of intensive BT for an adult with TS. Specific modifications to the protocol, as well as the specific steps for intensive BT, are discussed within the context of this client’s unique circumstances. Clinical considerations for intensive treatment for TS are also discussed.