European Child & Adolescent Psychiatry

, Volume 20, Issue 4, pp 197–207 | Cite as

European clinical guidelines for Tourette Syndrome and other tic disorders. Part III: behavioural and psychosocial interventions

  • Cara VerdellenEmail author
  • Jolande van de Griendt
  • Andreas Hartmann
  • Tara Murphy
  • the ESSTS Guidelines Group


This clinical guideline provides recommendations for the behavioural and psychosocial interventions (BPI) of children and adolescents with tic disorders prepared by a working group of the European Society for the Study of Tourette Syndrome (ESSTS). A systematic literature search was conducted to obtain an update on the efficacy of BPI for tics. Relevant studies were identified using computerised searches of the Medline and PsycINFO databases and the Cochrane Library for the years 1950–2010. The search identified no meta-analyses, yet twelve (systematic) reviews and eight randomised controlled trials provided evidence for the current review. Most evidence was found for habit reversal training (HRT) and the available but smaller evidence also supports the efficacy of exposure with response prevention (ERP). Both interventions are considered first line behavioural treatments for tics for both children and adults and should be offered to a patient, taking into account his preference. Treatments that are considered second line or add-on behavioural treatments are contingency management, function based interventions and relaxation training. Neurofeedback is still experimental. Almost no research was identified that examined the efficacy of psychosocial interventions, e.g., psychoeducation and group work. Based on clinical practice, this guideline recommends behavioural treatment as first line offer to patients in most cases. It should be embedded within a psychoeducational and supportive context and can be combined with drug treatment.


Tourette Tic disorders Guidelines Behavioural treatment Psychosocial interventions Literature review 


Conflict of interest

Commercial firms and governmental organisations did not play a role in, or fund, the development of these guidelines. Cara Verdellen, Jolande van de Griendt, Andreas Hartmann, Tara Murphy declare that they have no conflict of interest.


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Copyright information

© Springer-Verlag 2011

Authors and Affiliations

  • Cara Verdellen
    • 1
    Email author
  • Jolande van de Griendt
    • 1
  • Andreas Hartmann
    • 2
  • Tara Murphy
    • 3
  • the ESSTS Guidelines Group
  1. 1.HSK Group/Expertise Centre TicsDen BoschThe Netherlands
  2. 2.Centre de Référence National ‘Syndrome Gilles de la Tourette’, Pôle des Maladies du Système Nerveux, Groupe Hospitalier Pitié-Salpêtrière, Assistance Publique des Hôpitaux de ParisParisFrance
  3. 3.Tourette Syndrome ClinicGreat Ormond Street Hospital NHS TrustLondonUK

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