Table 1: Tic Hierarchy with SUD Scores
The sessions were held weekly and the scale was also applied weekly. Only the sessions which show improvement have been reported in Table 1. Both the child and the parent-reported clinical improvement, including a decrease in the frequency of the tic episodes to once every 2-3 weeks, an improvement in the child’s quality of life, more significant social interaction at home and school, and an improvement in academic achievement. In April 2020, the YGTSS revealed a score of 12, suggesting improvement in both motor & vocal tics). A complete absent tic episode and a YGTSS score of 6, indicating a practically symptom-free condition, were seen after six months of weekly therapy sessions, which continued till July 2020.
The child’s academic performance had improved, as evidenced by her improved assessment exam grades, regular attendance in class, and compliance with school rules. CBiT was continued as a follow-up treatment for six months because the child showed good compliance and significant symptom improvement.
In August 2020, MSE revealed a reactive child with no worries, low mood, and improved social interaction, whose fundamental mental functions remained the same. In addition, she could effectively regulate stressors in terms of frequency, severity, and duration of a stress response.
The child is currently under follow-up monthly, planned for 12 months till February 2021. Before initiating the management, the therapist and the parents of the child during the therapeutic alliance entered into a contract to continue follow-ups till the child feels a complete resolution of her symptoms and improved psychosocial functioning. Thus 12 months period was taken to achieve the treatment goals but was not prefixed as such.