Long-term Outcomes of Behavior Therapy for Youth With Tourette Disorder

Flint M. Espil, Douglas W. Woods, Matthew W. Specht, Shannon M. Bennett, John T. Walkup, Emily J. Ricketts, Joseph F. McGuire, Jordan T. Stiede, Jennifer S. Schild, Susanna W. Chang, Alan L. Peterson, Lawrence Scahill, Sabine Wilhelm, John C. Piacentini

Research output: Contribution to journalArticlepeer-review

10 Scopus citations


Objective: To determine the long-term durability of behavior therapy for tics among youth with Tourette disorder and persistent (chronic) motor or vocal tic disorders. Method: Of the 126 youth who participated in a randomized controlled trial of behavior therapy 11 years prior, 80 were recruited for this longitudinal follow-up. Consenting participants were interviewed in person or remotely (Web-based video) by trained evaluators to determine the course of tics, current tic severity, and tic-related impairment. Recruitment and data collection occurred between 2014 and 2019, with an average follow-up duration of 11.2 years. Results: Treatment responders to both conditions in the original trial achieved partial, but not full, tic remission. Tic severity also decreased significantly across the sample, with 40% reporting partial remission. Behavior therapy responders (n = 21) in the original trial were more likely (67%) to achieve remission at follow-up (Total Tic Score = 12.52, SD = 10.75) compared to psychoeducation/supportive therapy responders (n = 6, 0%) at follow-up (Total Tic Score = 20.67, SD = 6.92) on the Yale Global Tic Severity Scale. Tic-related impairment decreased across the sample, with no significant differences between treatment groups or responders. Conclusion: Despite limitations of unmeasured variables and veracity of self-report at follow-up, this study supports guidelines recommending behavior therapy as the first-line intervention for tics. Further investigation of behavior therapy as an early preventive intervention also merits attention.

Original languageEnglish (US)
Pages (from-to)764-771
Number of pages8
JournalJournal of the American Academy of Child and Adolescent Psychiatry
Issue number6
StatePublished - Jun 2022


  • long-term follow up
  • tics
  • Tourette
  • youth

ASJC Scopus subject areas

  • Developmental and Educational Psychology
  • Psychiatry and Mental health


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