Group work for children with Tourette syndrome: A pilot randomised controlled trial evaluating tic severity and neuropsychological outcomes

This thesis consists of three major components: A literature review, an empirical paper and a critical appraisal. The literature review outlines a wide-ranging systematic search, describing and evaluating the effectiveness of psychosocial group-delivered treatments for children aged 5 – 18 years with ADHD. Studies included child-only groups as well as those that involved parents, multimodal treatment, or a comparison of these different approaches. Twenty-two studies were described, in which cognitive-behavioural approaches dominated. The methodological quality of nineteen studies was assessed, finding that child-only groups and dual interventions had the poorest methodological quality. Treatment effectiveness findings for ten of these studies were mixed, providing most support for multicomponent approaches. The empirical paper reports the findings of a pilot randomised controlled trial, which aimed to evaluate tic severity and neuropsychological outcomes following group work for children with Tourette syndrome. The two group-delivered interventions were a Comprehensive Behavioural Intervention for Tics (CBIT) compared with a psycho-educational group. Preliminary evidence indicated both interventions to be feasible and effective, in terms of improving tic severity and inhibitory processes of neuropsychological functioning. CBIT was superior in reducing motor tic severity. Study design, recruitment, testing and data entry was carried out jointly with Rachel Yates, a Trainee Clinical Psychologist from Royal Holloway, University of London. Finally, the critical appraisal offers reflections on the challenges encountered throughout the process of conducting a moderately-sized pilot RCT, from the early design and recruitment stages through to data collection and analysis. This is combined with a further discussion of the strengths and weaknesses of this study