Mechanisms Underlying Behavior Therapy for Tourette’s Disorder

Joey Ka Yee Essoe, Kesley A. Ramsey, Harvey S. Singer, Marco Grados, Joseph F. McGuire

Research output: Contribution to journalReview articlepeer-review


Purpose of Review: Behavior therapy is the recommended first-line treatment for Tourette’s disorder and other tic disorders (TD). Despite its therapeutic benefit, not all patients exhibit a positive treatment response. Understanding the mechanisms underlying behavior therapy for TD (i.e., how behavior therapy reduces symptoms) can help identify strategies to optimize treatment outcomes. This review examines evidence for three proposed mechanisms—habituation, associative learning, and cognitive control—across laboratory studies and clinical trials. Recent Findings: Evidence shows that mechanisms likely differ in youth and adults. The most promising evidence points to interactions between associative learning and cognitive control as mechanisms, with nuanced differences between youth and adults with TD. Habituation may also be a mechanism for adults with TD, but not for youth with TD. Summary: As multiple mechanisms are implicated and several promising ones remain unexamined, future mechanistic research is essential to identify approaches that could optimize behavior therapy outcomes.

Original languageEnglish (US)
Pages (from-to)161-174
Number of pages14
JournalCurrent Developmental Disorders Reports
Issue number3
StatePublished - Sep 2021


  • Associative learning
  • Behavior therapy
  • Cognitive control
  • Habituation
  • Mechanism
  • Tourette’s syndrome

ASJC Scopus subject areas

  • Developmental and Educational Psychology
  • Developmental Neuroscience
  • Psychiatry and Mental health


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