Adaptation of Behavioral Treatment for Youth with Tourette’s Syndrome and Complex Comorbidity

Purpose of Review Comorbidity complicates behavioral treatment for youth with Tourette’s syndrome (TS). The Comprehensive Behavioral Intervention for Tic (CBIT) is a first-line intervention, and several clinical guidelines exist to assist clinicians in developing effective treatment plans for youth with TS. Unfortunately, there is currently little guidance on how to alter CBIT and similar evidence-based behavioral interventions in complex cases of TS with comorbidity. We present potential treatment adaptations for youth with TS and comorbidities and discuss factors that may impact clinical decision-making. Recent Findings Behavioral treatments have produced favorable tic-related outcomes (e.g., reducing the severity and functional impact of tics); however, less consideration has been given to the sequelae of comorbidity, including the accompanying behaviors and underlying emotional distress that may interfere with treatment such as emotional dysregulation, poor distress tolerance, attention/executive functioning deficits, low motivation, impulsivity, avoidance, and oppositional behaviors. Summary Current understanding of adaptations for behavioral treatment suggests beginning with a comprehensive assessment, followed by detailed treatment planning with the collaboration of the patient, caregivers, and healthcare team. Future research is needed to further examine best practices for youth with TS and comorbid conditions.