Online remote behavioural intervention for tics in 9- to 17-year-olds: the ORBIT RCT with embedded process and...

Area of Science:

• Clinical Psychology
• Child Psychiatry
• Health Economics

Background:

• Behavioral therapy for tics is challenging to access.
• Effectiveness of online delivery for tic disorders is not well understood.

Purpose of the Study:

• To assess the clinical and cost-effectiveness of an online, therapist- and parent-supported therapy for young people with tic disorders.

Main Methods:

• A single-blind, parallel-group, randomized controlled trial with 224 participants (aged 9-17) with Tourette syndrome or chronic tic disorder.
• Intervention: 10 weeks of online, remotely delivered, therapist-supported exposure and response prevention therapy.
• Control: Online psychoeducation. Outcomes assessed at 3, 6, 12, and 18 months post-randomization.

Main Results:

• The online therapy group showed a significant reduction in tic severity (Yale Global Tic Severity Scale) compared to the control group, with sustained effects up to 18 months.
• The intervention was found to be clinically effective (mean difference -2.29 at 3 months) and cost-effective (mean incremental cost per QALY gained £16,708).
• Parental engagement was linked to better child engagement and clinical outcomes.

Conclusions:

• Online, therapist-supported behavioral therapy is a clinically and cost-effective treatment for reducing tics in young people.
• The benefits of this online intervention are durable, lasting up to 18 months post-treatment.
• Further research should compare online to face-to-face therapy and explore clinical integration.