Improving Symptom Trajectories of Tic Disorders and Co-occurring Diagnoses: The Role of Integrative Intensive Intervention
Condition: Tic Disorder, Childhood; Comorbidities and Coexisting Conditions
MeSH terms: Tics; Tic Disorders
Study type: Interventional

Summary: 
      The purpose to the current study was to examine the efficacy of a telehealth, group-based,
      combined and intensive intervention for youth with tic disorders (TDs) and common
      co-occurring diagnoses. Families seeking treatment for TDs and common co-occurring diagnoses
      will be randomly assigned to receive treatment immediate (enrollment in the next group) or
      remain on a 1-month waitlist, and then receive treatment. Outcomes will be assessed across
      the treatment phase, immediately following treatment (post), as well as 1-month following the
      end of treatment.
    

Detailed description: 
      Over 1,000,000 children in the U.S. have a tic disorder (TD). TDs can substantially impact
      daily child functioning across numerous domains leading to a significant public health impact
      of TDs. Additionally, an overwhelming majority of children with a TD have at least one
      co-occurring disorder. Over 60% also meet criteria for attention deficit/hyperactivity
      disorder (ADHD), half struggle with anxiety and at least a third have clinically elevated
      Obsessive Compulsive-spectrum symptoms.

      Comprehensive Behavioral Intervention for Tics (CBIT) is a first-line treatment for youth
      with TDs. It has been shown to be effective in reducing the frequency, duration, and severity
      of tics in children and adolescents. Nonetheless, access to trained CBIT providers remains
      limited, and common comorbid conditions are not addressed in standard CBIT. Thus, there is a
      desperate need for interventions that can simultaneously increase CBIT access and incorporate
      treatment strategies for comorbidities.

      Intensive, group-based interventions are well-established for the treatment of comorbid
      disorders and have been shown to be a cost-efficient modality for delivering multimodal
      interventions. Intensive formats provide the opportunity for families to gain access to
      treatment for a limited time without the extended burden often associated with weekly
      treatment sessions. Further, intensive group-based treatments can simultaneously treat
      comorbidities.

      To address the critical need for increasing access to CBIT and simultaneously treating common
      comorbidities, a week-long group-based intensive intervention for children with TDs and
      common co-occurring diagnoses (Taming Tics Together) has been developed and will be
      evaluated. Participants will be randomly assigned to immediate treatment or a 1-month
      waitlist control. Assessments will take place pre-treatment, daily throughout the
      intervention, as well as at 1-month post treatment.

      The primary aims of the current study are to evaluate symptom reduction in tic severity and
      co-occurring condition symptom severity. Importantly, the investigators seek to learn more
      about the effectiveness of an intensive-format for tics and co-occurring diagnoses, which may
      lead to mechanisms to improve access to care for families who often are not able to access
      effective treatment.
    

Intervention name(s): Combination of Comprehensive Behavioral Intervention for Tics (CBIT) and Evidence-based interventions for co-occurring diagnoses (i.e., Cognitive Behavioral Therapy, Behavioral Parent Training)
Intervention type(s): Behavioral
Intervention description(s): Families assigned to the immediate treatment group will receive the telehealth-based Taming Tics Together protocol(created using well-established, evidence-based treatment protocols), which includes group (parent/caregiver-only, child/teen-only) and individualized one-to-one sessions to address tics and co-occurring diagnoses.
Allocation: Randomized
Intervention model: Parallel Assignment
Intervention model description: Eligible families will be randomly assigned to an immediate treatment group or a 1-month waitlist.
Masking: Single (Outcomes Assessor)
Primary purpose: Treatment