What do those who know, know? Investigating providers' knowledge about Tourette's Syndrome and its treatment

Abstract

Physicians and possibly psychologists are likely to be at the center of clinical care for persons with Tourette's Syndrome (TS). To date, it is unclear (a) how much basic knowledge these health care providers possess about the disorder, (b) how much incorrect or untested information is believed about the disorder, (c) what the perceived role of a psychologist is in the treatment process, and (d) if physicians and psychologists are familiar with, or desire more information about, habit reversal, an effective nonpharmacological procedure used to reduce tics. To study these topics, a survey was sent to 443 physicians and psychologists. Of the 67 surveys returned, results showed that the health care professionals responded correctly to 77% of the general knowledge items about TS. No differences in TS-related knowledge were found between physicians and psychologists, but there was a trend toward those with experience treating TS being more knowledgeable than those without experience. Regarding beliefs about incorrect or empirically untested information about TS, few professionals believed that allergies or diets affected tics, but considerably more believed that persons with TS had the ability to suppress tics, and that doing so produced a “rebound” in tic occurrence. A large portion of the sample also believed that discussing tics with a person who had TS made the tics worse. There was some disagreement among professionals as to the role psychologists could play in the clinical management of TS. Psychologists, more so than physicians, believed the psychologist's role could involve treating tics, educating the patient about the disorder, and treating ADHD, depression, and family difficulties. A small percentage of both groups had heard of habit reversal, but up to 63% wanted to learn more. Implications of the findings and limitations to the study are discussed.