Integrated cognitive behavioral intervention for functional tics (I-CBiT): case reports and treatment formulation

Area of Science:

• Neurology
• Psychiatry
• Behavioral Science

Background:

• The COVID-19 pandemic led to a rise in functional tic-like behaviors (FTLBs), distinct from primary tic disorders.
• FTLBs emerge from environmental and personal factors, impacting the stress-arousal system with sudden onset.
• Standard tic disorder interventions are often ineffective for FTLBs.

Observation:

• This study evaluated an Integrated Cognitive Behavioral Intervention for Functional Tics (I-CBiT) in eight young individuals with new-onset FTLBs.
• The I-CBiT program integrated traditional tic therapies with third-wave cognitive behavioral approaches.
• Intervention components included psychoeducation, exposure and response prevention with urge acceptance, sensory grounding, and stress-arousal system management.

Findings:

• All participants experienced a significant decrease in tic severity after completing I-CBiT.
• Improved overall daily living function was observed in all cases post-intervention.
• Urge acceptance proved crucial for managing tic urges and the stress-arousal system, facilitating lasting change.

Implications:

• I-CBiT demonstrates efficacy in managing FTLBs.
• Addressing underlying stress and anxiety is vital for treating FTLBs.
• Multidisciplinary collaboration is essential for comprehensive FTLB management, encompassing cognitive, emotional, sensory, and stress-related aspects.