Dissemination of Comprehensive Behavioral Intervention for Tics (CBIT) to Occupational Therapists: A Feasibility Study
Condition: Tourette Disorder; Chronic Tic Disorder
MeSH terms: Tics; Tic Disorders; Tourette Syndrome
Study type: Interventional

Summary: 
      Comprehensive Behavioral Intervention for Tics (CBIT) is an evidence based intervention for
      tic disorders. A recent scientific review of research priorities completed by the Tourette
      Syndrome Association recommended widespread dissemination of CBIT as an important next step
      in services delivery research. Given early evidence that occupational therapists can deliver
      CBIT effectively, a dissemination strategy using occupational therapists may improve
      accessibility to this treatment, at lower cost and with decreased stigma. Thus the goal of
      this study is to develop and test a training and dissemination model with occupational
      therapists (OTs) using an expert, multi-disciplinary team at Weill Cornell/New York
      Presbyterian Hospital (WC/NYPH) and University of Alabama at Birmingham (UAB). The
      investigators have adapted CBIT, the gold-standard behavioral intervention program for
      children with tic disorders (Woods et al, 2008a,b), for eventual use in OT programs across
      the country.
    

Detailed description: 
      CBIT training materials designed by the study team have been used to train occupational
      therapists (OTs) at WC/NYPH and UAB to deliver CBIT, and data has been collected to measure
      training acceptability.

      OTs will be supervised in the practice of CBIT with youth in the New York City and Birmingham
      areas. Pre- and post-treatment assessment measures will be collected from 16 families (8 from
      each site) to evaluate intervention acceptability, feasibility, and fidelity. Patient and
      parent satisfaction of CBIT-OT will also be documented. The investigators will look within
      subjects to ascertain change in reported tic severity.

      This study is designed to determine the feasibility and acceptability of treatment,
      feasibility of research design, as well as demonstrate the ability to disseminate the study
      protocol to a new care discipline in methodologically rigorous fashion across multiple sites.
    

Intervention name(s): OTs Trained and Deliver CBIT
Intervention type(s): Behavioral
Intervention description(s): CBIT is a highly structured therapy that typically takes place on a weekly basis. The patient is taught to perform a specific behavior that makes the tic more difficult to do, as soon as the tic or urge appears. This "competing response" helps to reduce, and in some cases, even eliminate the tic. The functional intervention (FI), is based on the fact that certain situations or reactions to tics can make them worse than they might otherwise be. The goal of FI is to identify these situations and have the patient and family attempt to change them so the tics aren't made worse unnecessarily.
Other intervention name(s): CBIT
Intervention model: Single Group Assignment
Masking: None (Open Label)
Primary purpose: Treatment
Keywords: Tourette's; Tic Disorder; CBIT; Dissemination; Occupational Therapist