This thesis focuses on the behavioural therapy treatment of tics and Gilles de la Tourette syndrome. Various forms of behavioural therapy and the European guidelines for the treatment of tics and Tourette’s syndrome are described. The study then focuses on exposure and response prevention, a form of treatment in which patients practise controlling their tics for increasingly longer periods, whilst focusing on the unpleasant sensation that often precedes them. An open-label trial investigated whether intensive two-hour sessions are necessary, or whether one-hour sessions are sufficient. Shorter sessions proved to be equally effective, meaning that twice as many patients can be treated in the same amount of time — an important consideration given the shortage of practitioners. In addition, the potential mechanisms of action of exposure and response prevention were investigated. It is striking that the urge to perform tics during sessions does not diminish, whilst the tics themselves do decrease. Finally, behavioural therapy was compared with medication in a randomised trial. Whereas medication used to be the standard treatment, this research suggests that behavioural therapy can be at least as effective. Taken together, these studies demonstrate how behavioural therapy can be further optimised and used more widely for tics and Tourette’s syndrome.
Jolande van de Griendt (1975) studied Psychology at Radboud University Nijmegen. After graduating in 1999, she worked for many years as a clinician and researcher at HSK, where she began her PhD research into behavioural therapy for tics and Gilles de la Tourette’s syndrome. Since 2016, she has been working as an independent clinical psychologist and behavioural therapist at TicXperts, her own practice specialising in diagnosis and behavioural therapy for children, young people and adults with tics and Tourette’s syndrome. She also delivers workshops and training courses on this subject both nationally and internationally.