Wake Forest University Health Sciences
This study adapts and tests PRISM (Promoting Resilience in Stress Management), a short skills-based program that teaches resilience, for teens ages 12-18 with Tourette syndrome or persistent tic disorder. The study has three parts. First, a small group of teens and their caregivers try PRISM and give feedback to adapt it for teens with tics. Second, 15 teens complete the adapted program to see whether it is practical and acceptable. Third, 60 teens are randomly assigned to PRISM plus usual care or usual care alone, to see whether a larger trial is feasible and to get early information on resilience and other outcomes.
1. Rationale Resilience, the ability to adapt positively to adversity, may improve the ability of adolescents to cope with psychosocial distress even when tics persist. Resilience is a modifiable protective factor that can mitigate negative outcomes while facilitating positive ones. Evidence-based resilience skills across several relevant populations - including ADHD, learning disabilities, and depression (all prevalent co-occurring conditions of TS) - associate resilience with better psychosocial adjustment, life satisfaction, hope and benefit finding, Quality of Life (QOL), coping, and menta…
Inclusion Criteria: * Age 12-18 years * Physician-confirmed diagnosis of Tourette syndrome or persistent (chronic) motor or vocal tic disorder per DSM-5-TR criteria * YGTSS Total Tic Severity ≥15 (Tourette syndrome) or Total Motor/Total Phonic score ≥10 (persistent motor or vocal tic disorder) * YGTSS Impairment ≥20 * English fluency in reading and speaking, even as a second language * Able to understand and complete study procedures and measures Exclusion Criteria: * An active diagnosis of functional neurological disorder * Beginning any new therapy within 8 weeks of study initiation
One-on-one resilience program: a 10-15 min introductory session, four 30-60 min skills sessions (managing stress, catching thoughts, goal setting, finding the positives), and a 15-45 min family session. Sessions are held every 1-2 weeks, in person or by secure video, with trained research assistants. Biweekly booster check-ins continue through week 16. An optional PRISM app (ages 13+) and worksheets are used for skills practice
Psychoeducation, medication and/or behavioral therapy as directed by the treating clinician.
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