Current controversies on the role of behavior therapy in Tourette syndrome


  • Full financial disclosures and author roles may be found in the online version of this article.

  • Funding agencies: This work was supported by grants from the National Institute of Mental Health (NIMH) to Lawrence Scahill (R01MH069874), Sabine Wilhelm (5R01MH069877), Alan L. Peterson (RO1MH069875), and John C. Piacentini (R01MH070802).

  • Relevant conflicts of interest/financial disclosures: Douglas W. Woods, Sabine Wilhelm, Alan L. Peterson, John C. Piacentini, John T. Walkup, and Lawrence Scahill report receiving royalties from Oxford University Press for treatment manuals on tic disorders. Sabine Wilhelm, Alan L. Peterson, John C. Piacentini, Douglas W. Woods, John T. Walkup, Lawrence Scahill, and Michael B. Himle report receiving honoraria for continuing education presentations from the Tourette Syndrome Association. John C. Piacentini, Douglas W. Woods, and John T. Walkup receive royalties from Guilford Press for a book on Tourette disorder.

Correspondence to: Dr. Lawrence Scahill, Marcus Center, Emory University School of Medicine, 1920 Briarcliff Road, Atlanta, GA 30329, USA;


Comprehensive behavioral intervention for tics (CBIT) is a safe and effective treatment for managing the tics of Tourette syndrome (TS). In contrast to most current medications used for the treatment of tics, the efficacy of CBIT has been demonstrated in 2 relatively large, multisite trials. It also shows durability of benefit over time. Similar to psychopharmacological intervention, skilled practitioners are required to implement the intervention. Despite concerns about the effort required to participate in CBIT, patients with TS and parents of children with TS appear willing to meet the requirements of the CBIT program. Efforts are under way to increase the number of trained CBIT providers in the United States. Based on available evidence, recent published guidelines suggest that CBIT can be considered a first-line treatment for persons with tic disorders. © 2013 Movement Disorder Society