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.