Tic suppression in the treatment of Tourette's syndrome with exposure therapy: The rebound phenomenon reconsidered

Exposure and response prevention (ER), a behavioral treatment program consisting of exposure to premonitory sensory experiences during prolonged tic suppression, was shown to be a promising new treatment for tics in Tourette's syndrome (TS). In this study, the commonly reported paradoxical increase in tic frequency following voluntary tic suppression, i.e., rebound phenomenon, was examined. Tic frequency was rated in 20 TS patients during 15-minute videotaped conversations taken both before and following 10 ER sessions. In addition, tic frequency was obtained at home by family members of the patients during 15-minute daily tic frequency registrations. Ratings following ER sessions were compared with ratings obtained before the sessions. Neither the ratings at the institute nor the ratings at home supported a rebound effect following ER tic suppression.