Cara Verdellen, Jolande van de Griendt, Sanne Kriens, Ilse van Oostrum
'Tics' is a protocol for treating children from 7-13 years with tics and Gilles de la Tourette syndrome.
The protocol consists of a set, containing the Therapist Manual and the Workbook for Children. The Therapist Manual provides therapists with step by step information and enables them to make notes of each session. The Workbook for Parents can be ordered free of charge (PDF document).
Two behavioral treatment methods are described in this protocol:
• Exposure and response prevention: two practice sessions followed by ten exposure sessions
• Habit reversal: ten sessions
Exposure and response prevention targets all the tics at once. By suppressing tics for a substantial amount of time, a child is given the opportunity to get used to the unpleasant premonitory sensory phenomena (tic-alerts), which often precede a tic and subside once a tic has been expressed. This method can be applied when there are many different tics (Gilles de la Tourette syndrome).
During the sessions of habit reversal, each tic is tackled separately by becoming aware of the tic and then learning a competing response that prevents the tic. Habit reversal is often used when a child has only one or few different tics.
The protocol includes homework; the Workbook for Children is illustrated. Parents are involved in the treatment: they record tics daily, practice together with their child and help improve the child’s awareness. Additional interventions include developing strategies to manage remaining tics. The therapist makes a relapse prevention plan according to the child’s needs. On completing the treatment, the child will receive the tic certificate.