An interventional study of Behavior Therapy Training Institute and CBIT-Trainer in Tics, Tic Disorders and Tourette Syndrome, sponsored by University of Utah. Completed at 2 sites in United States. Open to participants aged 7 Years and older. Per ClinicalTrials.gov, last updated 2026-10-05.
Sponsored by University of Utah · Not applicable, Interventional, and Health services research
Tic disorders are a class of childhood-onset neuropsychiatric disorders that occur in 1-3% of the population. Studies have shown that a non-drug treatment known as Comprehensive Behavioral Intervention for Tics (CBIT) is more effective than supportive therapy for reducing tics in children and adults. Although CBIT is now recommended as a first-line intervention for tic disorders, many patients do not have access to CBIT, in part due to a lack of trained therapists. Currently, the only option available for training therapists in CBIT is an intensive, two day, in-person behavior therapy training institute (BTTI). This study will compare the traditional in-person training approach to a recently developed online, self-paced CBIT therapist training program called CBIT-Trainer with regard to (1) therapists' ability to accurately administer CBIT and (2) change in the severity of patients' tic symptoms after being treated by a CBIT-trained therapist.
Tic disorders are a class of childhood-onset neuropsychiatric disorders that occur in 1-3% of the population and often cause significant impairment in physical, social, academic, and interpersonal functioning and reduced quality of life. There is currently no cure for tic disorders, however large-scale randomized controlled trials have shown that a non-drug treatment known as Comprehensive Behavioral Intervention for Tics (CBIT) is more effective than supportive psychotherapy for reducing tics in both children and adults. Although CBIT is now recommended as a first-line intervention for tic disorders, many patients do not have access to CBIT, in part due to a lack of trained therapists. Given the need and desire for CBIT among individuals with tic disorders, high demand for therapist trainings, and the lack of therapists adequately trained in CBIT, there is a clear need for innovative ways to train more providers in this evidence-based treatment. To address this gap, the investigators recently developed an innovative online program for training therapists to deliver CBIT (called CBIT-Trainer). This study will test CBIT-Trainer against an intensive in-person therapist training program in a randomized controlled trial. This study will accomplish four aims: (1) to compare CBIT-Trainer to traditional in-person training on therapists' ability to administer CBIT with fidelity, (2) to compare CBIT-Trainer to in-person training on patient outcomes when patients are treated by a CBIT-trained therapist, (3) to identify therapist factors that might improve (or limit) adoption and use of CBIT-Trainer, and (4) to identify therapist factors likely to influence continued use of CBIT after training. These aims will be tested using an effectiveness-implementation hybrid randomized controlled trial comparing CBIT-Trainer (online therapist training) to the Tourette Association of America's Behavior Therapy Training Institute (in-person therapist training), which is the current gold-standard for training CBIT therapists. Therapist-patient dyads will be recruited to participate. The primary therapist outcome will be therapists' skill in delivering CBIT in a standardized role-play, which will be assessed at post-training (Week 0), after administering CBIT with a patient (Week 10), and at 6-month follow-up (Week 24). The primary patient outcome will be overall clinical improvement, which will be assessed at pre-treatment (Week 0), post-treatment (Week 10), and 6-month follow up (Week 24). Secondary therapist outcomes that will be assessed include changes in knowledge of tic disorders and CBIT; changes in comfort and self-efficacy in delivering CBIT; adherence to the CBIT protocol when treating a patient with tics; attitudes toward evidence-based practice and CBIT; and therapists' ratings of the acceptability, appropriateness, and feasibility of the training. Secondary patient outcomes that will be assessed include changes in motor and/or vocal tic severity; changes in overall psychological/behavioral, physical, and social functioning; and satisfaction with the treatment received.
65 studies on the registry are indexed under Tics; 11 are open to participants now.
This study's enrollment of 284 is above the median of 34 across 51 interventional studies indexed under Tics.
Browse Tics studies →University of Utah is the lead sponsor of 994 studies on the registry; 175 are open to participants now.
Of its 114 completed or terminated interventional studies of FDA-regulated products, 69 (61%) have results posted.
Counted across the registry records on this site, refreshed daily.
This study will recruit therapist-patient dyads who meet the criteria below:
Therapist Inclusion Criteria:
Therapist Exclusion Criteria:
(1) Therapist is a first, second, or third degree biological relative, stepparent, or legal guardian of the study-matched patient.
Patient Inclusion Criteria:
Patient Exclusion Criteria:
Behavioral: Behavior Therapy Training Institute
Behavioral: CBIT-Trainer
In-person therapist training will follow the Tourette Association of America's established Behavior Therapy Training Institute procedures and will consist of 12 hours of in-person training conducted over the course of 2 days. Day 1 will involve standardized didactic lectures on tic disorders and video demonstrations of therapeutic techniques. Day 2 will involve break-out groups and role-play practice of CBIT techniques. Participants (therapists) will receive up to three, 30-minute follow-up consultations with a training instructor while providing CBIT to a study-enrolled patient.
In the online therapist training condition participants will be provided with access to the CBIT-Trainer program and asked to complete the training over the course of 4 weeks. CBIT-Trainer is designed for the average user to complete in approximately 12 hours. Participants (therapists) will receive up to three, 30-minute follow-up consultations with a CBIT expert while providing CBIT to a study-enrolled patient.
Therapist scores on the CBIT Fidelity Checklist and Rating Scale at post-training
The CBIT Fidelity Checklist and Rating Scale measures therapists' accuracy in administering 12 core components of CBIT during a standardized role-play. Items are rated using a series of 5-point Likert-type ratings ranging from "poor" to "excellent." Item ratings are aggregated to provide an overall fidelity rating ranging from 0-48. Higher ratings indicate better performance.
Time frame: up to 2 weeks post-training
Therapist scores on the CBIT Fidelity Checklist and Rating Scale at post-treatment
The CBIT Fidelity Checklist and Rating Scale measures therapists' accuracy in administering 12 core components of CBIT during a standardized role-play. Items are rated using a series of 5-point Likert-type ratings ranging from "poor" to "excellent." Item ratings are aggregated to provide an overall fidelity rating ranging from 0-48. Higher ratings indicate better performance.
Time frame: 10-12 weeks post-training
Therapist scores on the CBIT Fidelity Checklist & Rating Scale at 6-month follow-up
The CBIT Fidelity Checklist and Rating Scale measures therapists' accuracy in administering 12 core components of CBIT during a standardized role-play. Items are rated using a series of 5-point Likert-type ratings ranging from "poor" to "excellent." Item ratings are aggregated to provide an overall fidelity rating ranging from 0-48. Higher ratings indicate better performance.
Time frame: 24-26 weeks post-training
Proportion of treatment responders at post-treatment on the Clinical Global Impression Improvement Scale (CGI-I)
The CGI-I is a single-item clinical rating of symptom improvement relative to baseline. Ratings on the CGI-I range from 1 (very much improved) to 7 (very much worse). CGI-I ratings of 1 (very much improved) or 2 (much improved) indicate positive treatment response. Higher scores are related to worse treatment response.
Time frame: 10-12 weeks from the start of treatment (post-treatment)
Proportion of treatment responders at follow-up on the Clinical Global Impression Improvement Scale (CGI-I)
The CGI-I is a single-item clinical rating of symptom improvement relative to baseline. Ratings on the CGI-I range from 1 (very much improved) to 7 (very much worse). CGI-I ratings of 1 (very much improved) or 2 (much improved) indicate positive treatment response. Higher scores are related to worse treatment response.
Time frame: 24-26 weeks from the start of treatment (6-month follow-up)
Patient changes in overall symptom severity on the Clinical Global Impression Severity Scale (CGI-S)
The CGI-S is a single-item clinical rating of the participant's illness at the time of the assessment. Ratings on the CGI-S range from 1 (slight psychiatric illness) to 7 (extremely severe psychiatric illness). Higher scores indicate greater symptom severity.
Time frame: Up to 2 weeks prior to starting treatment (baseline), 10-12 weeks from the start of treatment (post-treatment), 24-26 weeks from the start of treatment (6-month follow-up)
Therapist change scores on the Tic Disorder & CBIT Knowledge Test
The Tic Disorder \& CBIT Knowledge Test is a 20-item pre-post multiple choice test that assesses therapists' knowledge of several essential concepts taught during the psychoeducation component of CBIT. Scores are based on the percentage of items answered correctly. Higher scores indicate greater understanding and mastery of the material.
Time frame: Up to 2 weeks pre-training and up to 2 weeks post training
Therapist changes in self-efficacy to treat tic disorders as measured by the Therapist Self-Assessment & Rating Form
The Therapist Self-Assessment \& Rating Form is a therapist self-rating form developed for this study. It is a face-valid measure designed to assess therapists' self-efficacy regarding to their ability to competently and effectively treat tic disorders using CBIT and intent to use CBIT to treat tic disorders in the future. Ten self-statements are each rated on a 5-point Likert-type scale ranging from "Strongly Disagree" to "Strongly Agree." Higher scores indicate higher self-efficacy on each item.
Time frame: Up to 2 weeks pre-training, up to 2 weeks post-training, 10-12 weeks from the start of treatment delivery with a patient, 24-26 weeks from the start of treatment delivery with a patient
Patient changes in tic severity as measured by the Yale Global Tic Severity Scale (YGTSS) Total Tic Score
The YGTSS is a clinician-rated interview assessing motor and vocal tics symptom severity during the past week. Motor and vocal tics are rated separately across 5 domains: number (0-5), frequency (0-5), intensity (0-5), complexity (0-5), and interference (0-5). The ratings for each motor and vocal tic domain are then summed to produce an overall total tic score ranging from 0-50 with higher scores indicating greater severity.
Time frame: Up to 2 weeks prior to starting treatment (baseline), 10-12 weeks from the start of treatment (post-treatment), 24-26 weeks from the start of treatment (6-month follow-up)
Patient changes in tic-related impairment as measured by the Yale Global Tic Severity Scale (YGTSS) Overall Tic Related Impairment Scores
The YGTSS Overall Tic Related Impairment Score is a single-item clinician rating of overall impairment caused by tics. Impairment is rated on a 0-50 scale with higher scores indicating greater impairment.
Time frame: Up to 2 weeks prior to starting treatment (baseline), 10-12 weeks from the start of treatment (post-treatment), 24-26 weeks from the start of treatment (6-month follow-up)
Patient treatment satisfaction scores on the Treatment Satisfaction Questionnaire (TSQ) at post-treatment
The TSQ is a brief 10-item self-report measure that assesses patients' satisfaction with their therapist and the treatment that they received. Each item is rated on a 4-point Likert-type scale. Scores range from 0-40 with higher scores indicating greater overall treatment satisfaction.
Time frame: 10-12 weeks from the start of treatment (post-treatment)
Patient treatment satisfaction on the Treatment Satisfaction Questionnaire (TSQ) at follow-up
The TSQ is a brief 10-item self-report measure that assesses patients' satisfaction with their therapist and the treatment that they received. Each item is rated on a 4-point Likert-type scale. Scores range from 0-40 with higher scores indicating greater overall treatment satisfaction.
Time frame: 24-26 weeks from the start of treatment (6-month follow-up)
Changes in psychological/behavioral symptoms and adaptive functioning as indicated by change scores on the Patient-Reported Outcomes Measurement Information System (PROMIS) Pediatric/Parent Proxy Profile 25 (for child patients & caregivers only)
The PROMIS Pediatric/Parent Proxy Profile 25 contains a collection of 25 caregiver and child-report items assessing psychological/behavioral symptoms in children in the following domains: anxiety, depressive symptoms, fatigue, pain interference, physical function-mobility, and peer relationships. Each item is rated on a 1-5 scale with higher scores indicate more severe symptoms or poorer adaptive functioning.
Time frame: Up to 2 weeks prior to starting treatment (baseline), 10-12 weeks from the start of treatment (post-treatment), 24-26 weeks from the start of treatment (6-month follow-up)
Changes in psychological/behavioral symptoms and adaptive functioning as indicated by change scores on the Patient-Reported Outcomes Measurement Information System (PROMIS) 29 Profile (for adult patients only)
The PROMIS-29 Profile contains a collection of 29 patient-report items assessing psychological/behavioral symptoms in adults in the following domains: anxiety, depression, fatigue, pain interference, physical function, and ability to participate in social roles and activities. Each item is rated on a 1-5 scale with higher scores indicate more severe symptoms or poorer adaptive functioning. Higher scores indicate more severe symptoms or poorer adaptive functioning.
Time frame: Up to 2 weeks prior to starting treatment (baseline), 10-12 weeks from the start of treatment (post-treatment), 24-26 weeks from the start of treatment (6-month follow-up)
Therapist change scores on the Evidence-Based Practice and Attitudes Scale (EBPAS)
The EBPAS is a measure of providers' attitudes toward the adoption evidence-based interventions and has been shown to predict implementation outcomes such as initiation and sustained use of evidence-based interventions. It contains 15 items regarding the respondent's feelings about using new types of therapy, interventions, or treatments. Respondents rate the extent to which they agree with each item using a 5-point Likert-type scale ranging from "Not at all" to "To a Very Great Extent." Scores range from 0-75 with higher scores indicating more positive attitudes toward evidence-based practice.
Time frame: Immediately pre- and post-training, 10-12 weeks from the start of treatment delivery with a patient, 24-26 weeks from the start of treatment delivery with a patient
Therapist scores on the Acceptability of Intervention Measure (AIM) at post-training
The Acceptability of Intervention Measure (AIM) is a psychometrically validated measure of an intervention's acceptability. It contains 4 items that are rated on a 1-5 scale ranging from "Completely Disagree" to "Completely Agree." Items are averaged to produce an overall score ranging from 1-5 with higher scores indicating greater acceptability of the intervention.
Time frame: Immediately post-training
Therapist scores on the Acceptability of Intervention Measure (AIM) at post-treatment
The Acceptability of Intervention Measure (AIM) is a psychometrically validated measure of an intervention's acceptability. It contains 4 items that are rated on a 1-5 scale ranging from "Completely Disagree" to "Completely Agree." Items are averaged to produce an overall score ranging from 1-5 with higher scores indicating greater acceptability of the intervention.
Time frame: 10-12 weeks from the start of treatment delivery with a patient
Therapist scores on the Acceptability of Intervention Measure (AIM) at follow-up
The Acceptability of Intervention Measure (AIM) is a psychometrically validated measure of an intervention's acceptability. It contains 4 items that are rated on a 1-5 scale ranging from "Completely Disagree" to "Completely Agree." Items are averaged to produce an overall score ranging from 1-5 with higher scores indicating greater acceptability of the intervention.
Time frame: 24-26 weeks from the start of treatment delivery with a patient
Therapist scores on the Intervention Appropriateness Measure (IAM) at post-training
The Intervention Appropriateness Measure (IAM) is a psychometrically validated measure of an intervention's appropriateness for addressing a clinical problem or disorder. It contains 4 items that are rated on a 1-5 scale ranging from "Completely Disagree" to "Completely Agree." Items are averaged to produce an overall score ranging from 1-5 with higher scores indicating greater appropriateness of the intervention.
Time frame: Immediately post-training
Therapist scores on the Intervention Appropriateness Measure (IAM) at post-treatment
The Intervention Appropriateness Measure (IAM) is a psychometrically validated measure of an intervention's appropriateness for addressing a clinical problem or disorder. It contains 4 items that are rated on a 1-5 scale ranging from "Completely Disagree" to "Completely Agree." Items are averaged to produce an overall score ranging from 1-5 with higher scores indicating greater appropriateness of the intervention.
Time frame: 10-12 weeks from the start of treatment delivery with a patient
Therapist scores on the Intervention Appropriateness Measure (IAM) at follow-up
The Intervention Appropriateness Measure (IAM) is a psychometrically validated measure of an intervention's appropriateness for addressing a clinical problem or disorder. It contains 4 items that are rated on a 1-5 scale ranging from "Completely Disagree" to "Completely Agree." Items are averaged to produce an overall score ranging from 1-5 with higher scores indicating greater appropriateness of the intervention.
Time frame: 24-26 weeks from the start of treatment delivery with a patient
Therapist scores on the Feasibility of Intervention Measure (FIM) at post-training
The Feasibility of Intervention Measure (FIM) is a psychometrically validated measure of an intervention's feasibility for implementation. It contains 4 items that are rated on a 1-5 scale ranging from "Completely Disagree" to "Completely Agree." Items are averaged to produce an overall score ranging from 1-5 with higher scores indicating greater feasibility of the intervention.
Time frame: Immediately post-training
Therapist scores on the Feasibility of Intervention Measure (FIM) at post-treatment
The Feasibility of Intervention Measure (FIM) is a psychometrically validated measure of an intervention's feasibility for implementation. It contains 4 items that are rated on a 1-5 scale ranging from "Completely Disagree" to "Completely Agree." Items are averaged to produce an overall score ranging from 1-5 with higher scores indicating greater feasibility of the intervention.
Time frame: 10-12 weeks from the start of treatment delivery with a patient
Therapist scores on the Feasibility of Intervention Measure (FIM) at follow-up
The Feasibility of Intervention Measure (FIM) is a psychometrically validated measure of an intervention's feasibility for implementation. It contains 4 items that are rated on a 1-5 scale ranging from "Completely Disagree" to "Completely Agree." Items are averaged to produce an overall score ranging from 1-5 with higher scores indicating greater feasibility of the intervention.
Time frame: 24-26 weeks from the start of treatment delivery with a patient
Number of patients reporting adverse events
All health complaints, recent illness or injury, or need for medical consultation occurring since the baseline assessment will be recorded via a patient interview at post-treatment and follow-up.
Time frame: Post-treatment (week 10) & 6-month follow-up (week 24)
Plan to share: Yes — Individual participant data that underlie results in any publication(s) may be provided to qualified researchers with academic interests in tic disorders and related conditions and expertise in the scoring and interpretation of the outcome measures administered. All data shared will be coded with no identifying information included. Approval of the request by the study primary investigators and execution of all applicable data sharing agreements are prerequisites to the sharing of data with the requesting party.
Ran from Jun 2023 to primary completion in Aug 2025, 26 months.
Of 22 interventional studies with no phase under Tics, half reached primary completion within 36 months of starting (the median), counting those still running; a quarter within 23 and three quarters within 43. This study's 26 months is below that.
Since we started tracking on Sep 25, 2026, the dates moved once, on Oct 5, 2026: primary completion Dec 2024 → Aug 2025 and completion Jun 2025 → Aug 2025.
Earlier changes are on the record history on ClinicalTrials.gov ↗
How these figures are worked out, and which studies are left out of them.
From the registry record's own update history. This site started tracking changes on Sep 25, 2026; for anything earlier, see the record history on ClinicalTrials.gov ↗
This study is completed, as verified in Oct 2026. You cannot join it, but the record below documents what was studied.
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