Modified comprehensive behavioral intervention for Tics: treating children with Tic disorders, co-occurring ADHD, and psychosocial impairment
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OBJECTIVE: To evaluate the feasibility and acceptability, and preliminary efficacy of Modified Comprehensive Behavioral Intervention for Tics (MCBIT) therapy for patients with persistent chronic tic disorders (CTD) and co-occurring attention deficit hyperactivity disorder (ADHD). METHOD: Seventeen child and adolescent patients aged 10-17 with CTD and co-occurring ADHD were randomly assigned to the MCBIT group (n=9) or to a control group, where they received traditional Comprehensive Behavioral Intervention for Tics (CBIT) therapy (n=8). Both groups received ten fifty-five-minute weekly treatment sessions, and two fifty-five-minute biweekly relapse prevention sessions. RESULTS: Sixteen of the seventeen participants completed the study, and acceptability ratings in both treatment groups were high with no significant differences in expectation of improvement. The MCBIT and CBIT groups in combination showed significant improvement in measures of tic severity, ADHD symptom severity, and tic impairment and group differences were not statistically significant. CONCLUSION: The results indicate that MCBIT treatment is feasible and acceptable for youth with CTD and ADHD, and the findings demonstrate preliminary support for the modified CBIT treatment’s efficacy in reducing tic and ADHD symptoms and improving tic-related quality of life. Additional studies with more participants are warranted to further examine the role of a modular behavioral treatment approach in targeting commonly co-occurring disorders simultaneously and successfully.