Tackle your tics Optimising behavioural therapy for children and adolescents with tics

Tics can have a serious impact on the quality of life of children and their families. Behavioural therapy is an evidence-based first line treatment for tic disorders. The main aim of this thesis was to investigate whether we can improve existing psychosocial treatments for young people with tics. We did this by studying the feasibility and efficacy of a brief, condensed group-based programme for children with tics. ‘Tackle your Tics’ is a four-day group treatment, including exposure and response prevention and supporting components, delivered by therapists and experts by experience. In a pilot study, described in chapter 2, we examined the feasibility, treatment satisfaction and indications for improvement of tic severity and quality of life. We highlight the unique and active role of patient representatives in the development and execution of the programme and research in chapter 3. In a randomised controlled trial (N=106), we compared a direct treatment group (N=52) with a waiting list group (N=54) at baseline, directly post-treatment, and at three- and six-months follow-up. Outcomes measures included tic severity, quality of life, tic-related cognitions, emotional/behavioural functioning, family functioning and treatment satisfaction. In chapter 4 and 5, the design and results of this study will be presented. A scoping review in Chapter 6 provides a first overview of existing data on the effect of psychosocial treatments on the quality of life and the impairment of tics in daily life. Findings, clinical implications, remaining questions, and propose directions for future research are discussed in chapter 7, the general discussion.