Therapist-guided, mobile app-assisted behavioural treatment for children and adolescents with chronic tic disorders: a pilot randomised controlled trial.

To evaluate the feasibility and acceptability of a therapist-guided, mobile app-assisted behavioural treatment for children and adolescents with chronic tic disorders, compared to videoconference-delivered behaviour therapy for tics. Pilot, single-blind, two-arm randomised controlled trial (RCT). A specialist tic disorder clinic for children and adolescents in Denmark. 30 participants with Tourette syndrome or chronic tic disorder aged 9 to 17 years (inclusive) and their parents. Participants were randomised to 8 sessions of either mobile app-assisted behavioural therapy (n = 14) or videoconference-delivered behaviour therapy (n = 16) for tics. The primary outcomes were measures of feasibility, acceptability, adherence and safety. Secondary measures of tic severity (Yale Global Tic Severity Scale; YGTSS) were administered at baseline, post-treatment and 2-month follow-up. Both interventions were deemed feasible and acceptable by the families. Both groups experienced meaningful tic severity reductions on the Total Tic Severity Score of the YGTSS (app group: -9.25 (-13.10 to -5.41; Cohen d = 1.17); videoconference group: -7.43 (-10.93 to -3.93; Cohen d = 0.94). Participants in both groups experienced further tic severity improvements during the 2-month follow-up (app group: -5.75 (-9.16 to - 2.34; Cohen d = 0.96); videoconference group: -5.00 (-8.16 to -1.84; Cohen d = 0.64). A therapist-guided mobile app-assisted behavioural intervention was found to be acceptable and potentially efficacious in the treatment of tics in a naturalistic clinical setting. The findings are promising but preliminary, given the limited sample size. The efficacy should be evaluated in a larger RCT.