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Evaluation ViewAttendees 4

Master Clinician Seminar - Ticketed

Tic and Impulse Control Disorders

Master Clinician Seminar 2 - Tackling Tics: A Behavioral Approach to Reducing Symptoms and Improving Functioning in Children and Adults with Tic Disorders

Friday, November 17, 2023
11:00 AM – 1:00 PM PST
Location: Queets (505), Level 5
Earn 2 Credit
Ticketed Session
Keywords: Tic Disorders, Habit Reversal, Behavior Analysis
Level of Familiarity: Basic to Moderate
Recommended Readings: Piacentini, J. C., Woods, D. W., Scahill, L. D., Wilhelm, S., Peterson, A., Chang, S., . . . Walkup, J. T. (2010). Behavior therapy for children with Tourette Syndrome: A randomized controlled trial. Journal of the American Medical Association, 303, 1929-1937.,   Wilhelm, S., Peterson, A. L., Piacentini, J., Woods, D.W., Deckersbach, T., Sukhodolsky, D. G., … Scahill, L. (2012). Randomized trial of behavior therapy for adults with Tourette syndrome. Archives of General Psychiatry, 69, 795-803.,   Pringsheim, T., Okun, M. S., Muller-Vahl, K., Martino, D., Jankovic, J., Cavanna, A. E., ... Piacentini, J. (2019). Practice guideline recommendations summary: Treatment of tics in people with Tourette syndrome and chronic tic disorders. Neurology, 92,896-906.,   Rizzo, R., Pellico, A., Silvestri, P. R., Chiarotti, F., & Cardona, F. (2018). A randomized controlled trial comparing behavioral, educational, and pharmacological treatments in youths with chronic tic disorder or Tourette syndrome. Frontiers in Psychiatry, 9, 1-9.,   Woods, D. W., Piacentini, J. C., Chang, S., Deckersbach, T., Ginsburg, G., Peterson, A. L., . . . Wilhelm, S. (2008). Managing Tourette’s Syndrome: A behavioral intervention for children and adults (therapist guide). New York: Oxford University Press.
Persistent tic disorders (PTDs), including Tourette Disorder, are a class of neurodevelopmental conditions characterized by sudden, recurrent, involuntary movements and vocalizations (i.e., motor and vocal tics). Over the past decade, there has been a growing body of evidence showing that tics can be effectively managed with a treatment package referred to as Comprehensive Behavioral Intervention for Tics (CBIT), which combines elements of habit reversal training with psychoeducation and function-based behavioral interventions to reduce the overall severity of tics and their impact on daily life. Despite now being recommended as a first-line intervention for PTD, few clinicians have been trained in CBIT. In this session, two of the developers of CBIT will describe and demonstrate the various components of the CBIT package and their application in the treatment of PTD. In addition to learning the general therapeutic techniques, attendees will learn about the biobehavioral model of TD and the theoretical and empirical rationale for CBIT. Various instructional technologies will be employed including didactic instructions, video demonstrations of primary treatment components, and experiential exercises. An overview of alternative/emerging treatment modalities (group, intensive, telehealth, online) will also be provided.

Outline:
• Overview of tics & tic disorders: Diagnosis, phenomenology, and clinical course
• Introduction to the biobehavioral model of tic disorders
• Understanding how internal and external antecedents and consequences influence the course and severity of tics
• Overview of the CBIT approach to conceptualizing and treating tic disorders
• Implementing the function-based assessment & intervention (FBAT) component of CBIT
• Implementing the habit reversal training (HRT) component of CBIT
• Discussion of ancillary therapeutic strategies for reducing tics and tic-related impairment
• Review of the evidence base supporting CBIT
• Overview of treatment delivery formats (tele-CBIT, group delivery, online formats)

Learning Objectives:

At the end of the session, the learner will be able to:
  • Recognize tic disorders and describe their key phenomenological features.
  • Explain the core elements of the biobehavioral model of tic disorders.
  • Identify the core components of the CBIT approach for treating tic disorders.
  • Describe the application of habit reversal training and the functional approach to managing tics.
  • Discuss the evidence base supporting the efficacy of behavior therapy for tic disorders.
  • Long-term Goals: Use the biobehavioral model to inform case conceptualization and clinical decision making when treating patients with tic disorders.
  • Long-term Goals: Help clients learn evidence-based tic management skills to reduce tic severity, tic-related impairment, and improve functioning.