Internet-based guided self-help comprehensive behavioral intervention for tics (ICBIT) for youth with tic disorders: a f
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ORIGINAL CONTRIBUTION
Internet‑based guided self‑help comprehensive behavioral intervention for tics (ICBIT) for youth with tic disorders: a feasibility and effectiveness study with 6 month‑follow‑up Lilach Rachamim1,2 · Sharon Zimmerman‑Brenner1,3 · Osnat Rachamim4 · Hila Mualem1,2 · Netanel Zingboim1 · Michael Rotstein4 Received: 27 August 2020 / Accepted: 11 November 2020 © Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract Practice guidelines endorse comprehensive behavioral intervention for tics (CBIT) as first-line treatment for tic disorders (TD) in youth. Nevertheless, CBIT is rarely available due to various barriers. This study evaluated the feasibility and potential effectiveness of an Internet-based, self-help CBIT program (ICBIT) guided by parents with minimal therapist support delivered via telepsychotherapy. Forty-one youths, aged 7–18 years, were randomly assigned to receive either ICBIT (n = 25) or a wait-list (WL) condition (n = 16) in a crossover design. ICBIT was feasible to implement and at post-treatment, 64% of the participants have improved significantly. Results demonstrated clinically meaningful reductions in tic severity and improved youth global impairment and functioning. Gains were maintained over a 6-month follow-up period. The effect size for the primary outcome measure (Yale Global Tic Severity Scale) ranged between large effect size (Cohen”s d = 0.91) at post-intervention to very large effect size (Cohen’s d = 2.25) 6 months after the end of the acute intervention. These were comparable to face-to-face delivery treatment trials for TD. Participants rated the intervention as highly acceptable and satisfactory. Youth receiving ICBIT experienced improvement in self-esteem and comorbidity. Finally, during the COVID19 pandemic, the ICBIT program enabled the delivery of the intervention consecutively without interruption. The results observed provide preliminary evidence of the feasibility and effectiveness of this innovative modality to assist youth with TD and remove various barriers to treatment, including those during a public crisis, such as the COVID-19 pandemic. Larger studies with an active control group are warranted. Trial registration URL: http://clinicaltrials.gov, ClinicalTrials.gov Identifier: NCT04087616. Keywords Child tic disorders · Comprehensive behavioral intervention for tics · Internet-based CBIT · Guided self-help · COVID-19 pandemic
* Lilach Rachamim [email protected]
1
School of Psychology, Interdisciplinary Center Herzliya, Herzliya, Israel
Sharon Zimmerman‑Brenner [email protected]
2
Donald J. Cohen & Irving B. Harris Resilience Center, Association for Children at Risk, Tel‑Aviv, Israel
Osnat Rachamim [email protected]
3
Tourette Syndrome Association in Israel (TSAI), Ra′anana, Israel
Hila Mualem [email protected]
4
Pediatric Movement Disorders Clinic, Pediatric Neurology Unit, Dana-Dwek Children’s Hospital - Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
Netanel Zingboim [email protected] Michael Rots
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