Behavioral therapy is just as effective as medication for Tourette syndrome. This is the finding of doctoral research conducted by clinical psychologist Jolande van de Griendt, who will receive her Ph.D. from Radboud University on July 3, 2026. "Medication is still often the first step in treating a tic disorder. But for many people, it's a great relief to be able to do something about their symptoms without taking pills."
During behavioral therapy, people with Tourette syndrome learn to perform competing movements to counteract their tics, or they learn to suppress their tics for increasingly longer periods. This latter form of treatment is called Exposure and Response Prevention (ERP).
Behavioral therapy
In ERP, patients practice suppressing their tics for as long as possible. Many patients feel a strong urge to perform a tic and initially delay it for only a few seconds. Over time, they progress to a minute and, after a few sessions, perhaps even 15 minutes. "In treatment, we focus on that feeling," says Van de Griendt. "We make it harder by, for example, talking about the tic—then that tic really wants to come out."
Van de Griendt observed that, for most people, the urge to perform a tic grew stronger during the first 15 minutes of the treatment session and then stabilized rather than subsided. "The trick is to delay the tics for longer and longer periods when that urge is strongest," she explains. "That way, you get used to the feeling, just like when you jump into cold water. At first it's unpleasant, but your body gradually learns to tolerate the cold. Once you're used to it, you can still swim just fine. In the same way, you can learn to tolerate the urge, and by practicing every day, the tics often become less frequent."
