Self-monitoring and reciprocal inhibition in the modification of multiple tics of Gilles de la Tourette's syndrome

Abstract

An 18-year-old male with multiple tics, including a bark-like vocalization and jerking neck movements, as components of the syndrome of Gilles de la Tourette, was treated using an empirically based practice procedure in an investigation that employed a modified multiple-baseline design. In the assessment, instigating and inhibiting stimulus conditions were identified by collecting observational data on the tics in many life situations in and outside of the rehabilitation unit where the therapy was undertaken. Self-monitoring was found to be tic-inhibiting and when it was introduced in the modification for the vocal tic, the rate dropped immediately and dramatically on the first day. Self-monitoring and reciprocal inhibition procedures were subsequently associated with gradual reduction to nearly zero of a newly emerged minor vocal sound and of the neck tic. Evidence also suggested that the haloperidol the patient had taken previous to treatment and took throughout all but 1 week of the treatment period may have helped to reduce the tics.