Behavioral Treatment of Tourette Syndrome: Past, Present, and Future

Cook and Blacher (2007) provide the most comprehensive review to date of psychosocial treatments for patients with tic disorders and are to be congratulated for their fine effort. The authors’ conclusion that habit reversal treatment warrants designation as well established based on the American Psychological Association's Division 12 Task Force criteria should spur increased clinical and research interest in this treatment. However, to fully realize the promise of Cook and Blacher's findings, it is first necessary to understand the broad historical context surrounding the conceptualization and treatment of Tourette syndrome (TS), including fluctuating perceptions within the TS community about the efficacy and utility of psychosocial interventions. In related fashion, this commentary also addresses several barriers, some methodological and others based on historical misconceptions about psychological treatments, that have constrained greater acceptance of such interventions in the past. Finally, we present a model approach for the development and dissemination of evidence-based psychosocial treatments designed to facilitate maximal understanding and acceptance of these interventions by the TS treatment community.

库克和布拉彻（2007年）对抽动障碍患者的心理社会治疗进行了迄今为止最全面的综述，他们的出色工作值得称赞。作者根据美国心理学会第12分会工作组的标准得出习惯逆转治疗理应被认定为成熟疗法的结论，这应会激发对该治疗在临床和研究方面更大的兴趣。然而，要充分实现库克和布拉彻研究结果的预期，首先有必要了解围绕图雷特综合征（TS）的概念化和治疗的广泛历史背景，包括TS群体内部对心理社会干预的有效性和实用性的看法波动。同样，本评论还涉及一些障碍，一些是方法上的，另一些是基于对心理治疗的历史误解，这些障碍在过去限制了此类干预措施得到更广泛的接受。最后，我们提出了一种开发和传播基于证据的心理社会治疗的示范方法，旨在促进TS治疗群体对这些干预措施的最大理解和接受。