CBIT Therapist Training for Tourette Syndrome

(CBIT-Trainer Trial)

Not currently recruiting at 1 trial location

Overseen By Michael Himle, PhD

Age: Any Age

Sex: Any

Trial Phase: Academic

Sponsor: University of Utah

Disqualifiers: Serious psychiatric, neurological conditions, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: 7

Duration: 10 weeks

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial aims to improve access to Comprehensive Behavioral Intervention for Tics (CBIT), a therapy that reduces tics in individuals with tic disorders, such as Tourette syndrome. The study will compare two therapist training methods: an in-person workshop and a new online program, to determine which is more effective for teaching CBIT. Therapists who have not been trained in CBIT and can treat patients with tic disorders are ideal candidates. Patients must have a tic disorder and experience daily tics to participate. As an unphased trial, this study allows patients to contribute to enhancing therapy access and effectiveness for tic disorders.

Do I need to stop my current medications to join the trial?

The trial information does not specify whether you need to stop taking your current medications. It focuses on a behavioral therapy for tics, so it's best to discuss your medications with the study team or your doctor.

What prior data suggests that these therapist training methods are safe for use in treating tic disorders?

Studies have shown that Comprehensive Behavioral Intervention for Tics (CBIT) safely and effectively reduces tics in both children and adults with tic disorders. Research indicates that most individuals can undergo CBIT without issues. In one study, 87% of participants who responded well to CBIT continued to benefit six months later.

CBIT is a type of behavior therapy, not a medication. It uses specific techniques to manage tics by changing behaviors, helping to avoid the side effects associated with drugs. Overall, evidence suggests that CBIT, whether learned in person or online, is a safe option for managing tic symptoms. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about this trial because it explores innovative ways to train therapists in Comprehensive Behavioral Intervention for Tics (CBIT), a leading non-drug treatment for Tourette Syndrome. Unlike traditional face-to-face training, this trial includes an online training option, making it potentially more accessible and convenient for therapists worldwide. This could lead to more widespread and efficient delivery of CBIT, ultimately helping more individuals with Tourette Syndrome manage their symptoms effectively. By comparing in-person and online training, the trial aims to determine if virtual learning can match the efficacy of traditional methods, which could revolutionize how behavioral therapies are taught and implemented.

What evidence suggests that this trial's training methods could be effective for Tourette Syndrome?

Studies have shown that Comprehensive Behavioral Intervention for Tics (CBIT) reduces tics more effectively than supportive therapy in both children and adults. Research indicates that 87% of those who responded well to CBIT continued to benefit six months after treatment. This treatment significantly reduces tic severity and improves overall functioning for individuals with tic disorders, including Tourette syndrome. In this trial, participants will receive CBIT therapist training either in-person or online. Both methods aim to lessen the problems caused by tics. Therefore, CBIT is recommended as the first choice for managing tic disorders. ^{1 6 7 8 9}

Who Is on the Research Team?

Michael Himle, PhD

Principal Investigator

University of Utah

Suzanne Mouton-Odum, PhD

Principal Investigator

PsycTech, LLC

Doug Woods, PhD

Principal Investigator

Marquette University

Are You a Good Fit for This Trial?

This trial is for licensed therapists with a Master's degree or higher in mental/behavioral health, medical, or related fields. They must be able to travel for training and find at least one patient with tic disorders to participate. Patients should have a diagnosed tic disorder, be 7 years old or older, speak English fluently, and have internet access.

Inclusion Criteria

Speaks fluent English

Access to a private computer with high-speed internet access

I am at least 7 years old. If under 18, I have a consenting adult.

Exclusion Criteria

Patient is a first, second, or third degree biological relative of the study-matched therapist or if the study-matched therapist is the patient's legal guardian

I cannot participate if a suitable therapist for me is not found.

You have a serious mental or neurological condition that needs urgent treatment or would make it hard for you to take part in the study, according to your doctor or the study team.

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2 weeks

Training

Therapists undergo either in-person or online training to deliver CBIT

2 weeks

1 visit (in-person) or self-paced online

Treatment

Therapists administer CBIT to patients, and outcomes are assessed

10 weeks

Regular sessions with patients

Follow-up

Participants are monitored for safety and effectiveness after treatment

14 weeks

Assessments at 6-month follow-up

What Are the Treatments Tested in This Trial?

Interventions

• Behavior Therapy Training Institute
• CBIT-Trainer

Trial Overview

The study compares traditional in-person CBIT therapist training to an online self-paced program called CBIT-Trainer. It evaluates the effectiveness of each method by assessing therapists' ability to administer CBIT and the resulting change in patients' tic severity.

How Is the Trial Designed?

Group I: Online Therapist Training Experimental Treatment 1 Intervention

Group II: In-Person Therapist Training Active Control 1 Intervention

Behavior Therapy Training Institute is already approved in United States, European Union for the following indications:

Approved in United States as Comprehensive Behavioral Intervention for Tics for:

• Tic disorders
• Tourette syndrome

Approved in European Union as Comprehensive Behavioral Intervention for Tics for:

• Tic disorders
• Tourette syndrome

Who Is Running the Clinical Trial?

University of Utah

Lead Sponsor

Trials

1,169

Recruited

1,623,000+

PsycTech, LLC

Collaborator

Trials

1

Recruited

230+

Marquette University

Collaborator

Trials

68

Recruited

202,000+

Published Research Related to This Trial

In a study involving 46 children with Tourette Syndrome or Chronic Tic Disorder, group Comprehensive Behavioral Intervention for Tics (CBIT) was found to be more effective than group Educational Intervention for Tics (EIT) in reducing motor tic severity, with improvements maintained at a 3-month follow-up.

Both interventions effectively reduced tic impairment and comorbid symptoms, but only group-CBIT showed significant and lasting reductions in total and motor tic severity, highlighting the benefits of a tic-focused treatment approach.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Group behavioral interventions for tics and comorbid symptoms in children with chronic tic disorders. Zimmerman-Brenner, S., Pilowsky-Peleg, T., Rachamim, L., et al.[2022]

In a study involving 30 children with chronic tic disorders, group-based Comprehensive Behavioral Intervention for Tics (group-CBIT) significantly reduced tic severity and associated impairment compared to a control group.

The intervention led to notable improvements in motor tic interference and overall severity scores, demonstrating its efficacy as a treatment for tic disorders.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Effects of Group Comprehensive Behavioral Intervention for Tics in Children With Tourette's Disorder and Chronic Tic Disorder. Kang, NR., Kim, HJ., Moon, DS., et al.[2022]

Habit reversal training (HRT) is an effective behavioral intervention for reducing tic severity in children and adolescents with chronic tic disorders, based on a review of studies since 2000.

Recent multisite trials indicate that adding functional analysis to traditional HRT may further improve its effectiveness in treating tic disorders.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Habit reversal training for children with tourette syndrome: update and review. Hwang, GC., Tillberg, CS., Scahill, L.[2018]

Comprehensive behavioral intervention for tics (CBIT) is a safe and effective treatment for Tourette syndrome, supported by evidence from two large multisite trials that demonstrate its efficacy and long-term benefits.

Recent guidelines recommend CBIT as a first-line treatment for tic disorders, indicating its importance in managing tics compared to traditional medications, and there is a growing effort to train more providers in the U.S. to deliver this intervention.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Current controversies on the role of behavior therapy in Tourette syndrome. Scahill, L., Woods, DW., Himle, MB., et al.[2021]

In a small case series of 14 youth with Tourette disorder, an abbreviated version of the Comprehensive Behavioral Intervention for Tics (CBIT) showed a significant reduction in tic severity and tic-related impairment after treatment, indicating its efficacy in a clinical setting.

The study found that 56% of participants were classified as treatment responders, and both satisfaction and therapeutic alliance ratings were high, suggesting that the modified CBIT protocol is acceptable and feasible for use in child neurology and developmental pediatrics clinics.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Pilot Testing Behavior Therapy for Chronic Tic Disorders in Neurology and Developmental Pediatrics Clinics. Ricketts, EJ., Gilbert, DL., Zinner, SH., et al.[2016]

The comprehensive behavioral intervention for tics (CBIT) significantly reduced tic severity and the number of tics in 30 children with tic disorder after completing an eight-session program.

Participants also reported lower distress levels and improved self-perception regarding their ability to perform everyday activities, indicating enhanced occupational performance.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Comprehensive behavioral intervention to improve occupational performance in children with Tourette disorder. Rowe, J., Yuen, HK., Dure, LS.[2013]

A meta-analysis of 10 randomized controlled trials involving 586 patients found that habit reversal training (HRT) is effective in reducing tic symptoms, with a small to medium effect size (SMD of -0.43).

The efficacy of HRT was influenced by the type of behavioral therapy used in the control group, indicating that different comparison conditions can affect treatment outcomes.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The therapeutic effect of habit reversal training for Tourette syndrome: a meta-analysis of randomized control trials. Yu, L., Li, Y., Zhang, J., et al.[2021]

Citations

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pmc.ncbi.nlm.nih.gov

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Effects of Group Comprehensive Behavioral Intervention ...

The group-CBIT showed an improvement in tic symptoms, especially in reducing the level of interference and impairment of tics.

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tourette.org

tourette.org/research-medical/cbit-overview/

Comprehensive Behavioral Intervention for Tics (CBIT)

A recent study showed that 87% of participants who thrived with CBIT continued to do well six months after treatment. Remember CBIT is not a cure; it is a ...

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sciencedirect.com

sciencedirect.com/science/article/pii/S258997912400009X

Comparison of cognitive-behavioral treatments for tics and ...

In conclusion, CoPs and CBIT effectively reduce tic severity and improve global functioning in children and adults with tic disorders and Tourette syndrome.

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medrxiv.org

medrxiv.org/content/10.1101/2025.09.11.25335505v1.full-text

Habit Reversal Training for Tic Disorders

Evaluating the feasibility, acceptability, and preliminary effectiveness of tele-comprehensive behavior therapy for tics (teleCBIT) for Tourette ...

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pmc.ncbi.nlm.nih.gov

pmc.ncbi.nlm.nih.gov/articles/PMC3812724/

The effectiveness of habit reversal therapy in the treatment ...

Our main finding was that HRT can significantly reduce tic severity in both adults and children with TS and other CTDs.

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pmc.ncbi.nlm.nih.gov

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Behavior Therapy for Children with Tourette Disorder

A comprehensive behavioral intervention based on habit reversal training was effective in reducing tics and tic-related impairment in youth with Tourette or ...

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Comprehensive Behavioral Intervention for Tics

Subsequent studies, including randomized controlled trials, reported excellent outcomes for HRT vs most other behavioral therapy with sustained ...

8.

frontiersin.org

frontiersin.org/journals/psychiatry/articles/10.3389/fpsyt.2022.997174/full

A preliminary study of comprehensive behavioral ...

Conclusion: CBIT is probably effective in reducing tic severity in Chinese children with tic disorders. CBIT + PT may not be superior to CBIT ...

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clinicaltrials.gov

clinicaltrials.gov/study/NCT02413216

Study Details | NCT02413216 | TicHelper: A Computerized ...

Effective non-pharmacological treatment options such as comprehensive behavioral intervention for tics (CBIT) have been shown to be effective for reducing tics ...