Investigating Changes in Premonitory Urges During Habit Reversal Training for Tics

Inclusion Criteria: Participants who meet criteria for a DSM-5-TR diagnosis of a TD will be recruited to participate in this study. Participants will be eligible for the study if they 1. present with at least three motor and/or vocal tics and are interested in receiving treatment, 2. report experiencing a PU for each of their target tics with a minimum rating of a 4/8 on a subjective rating (i.e., the Urge Thermometer; Silverman \& Albano, 1996) for each tic, 3. the targeted tics occur, on average, at least once per minute during a 10-minute direct observation, 4. are between the ages of 8 and 17 5. the patient has no planned changes in medication initiation or dosage during their study participation period. Exclusion Criteria: 1. the presence of any comorbid conditions that are considered a primary treatment concern and/or could interfere with study participation or treatment (i.e., unmanaged ADHD, OCD, anxiety), 2. have previously engaged in CBIT or HRT for more than 2 sessions, 3. a Yale Global Tic Severity Score of 40+ (or 20+ if they present with a primary motor or vocal tic disorder), 4. suspected (based on clinical presentation) that the tics are better attributed to functional neurological symptom disorder per DSM-5-TR criteria (APA, 2022).