By Douglas W Woods; et al
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Extra resources for Managing Tourette syndrome : a behavioral intervention for children and adults : therapist guide
4. When entering situations that are not easily modiﬁable, the patient should learn strategies to minimize her own reactions that may contribute to tics. For example, if anxiety makes tics worse, it will likely be difﬁcult to prevent all anxiety-producing events from occurring. In such a case, interventions may focus on teaching the patient ways to modify her anxious response to such situations. Examples of such interventions could include challenging and replacing anxiogenic cognitions and teaching the child to relax in such situations.
Throughout the rest of the session, I’ll be checking to see if you’re doing your exercises correctly. If you miss an opportunity to use them, I’ll remind you, but I want you to try very hard to use them every time you tic. Notes on Using the Competing Response As you start to do HRT, you may encounter a number of potentially confusing or frustrating issues. We attempt to predict and clarify these issues in the following sections. Patient Loss of Enthusiasm Occasionally, as patients improve, they become less vigilant in doing the CRs for the tics that remain.
28 Ask about the speciﬁc consequences listed on the FAF and put the number (1, 2, 3 . . ) of each relevant antecedent under the consequences that are present for that antecedent. After reviewing with the patient the consequences listed, ask whether there are any other things that happen or that people do or say during or after the patient tics in this situation. If the description is sufﬁciently different from what has already been checked, write down a description of the new consequence in one of the “other” boxes and assign the appropriate number (1, 2, 3 .