Comparing Similar and Dissimilar Competing Responses for Tic Management

Competing-response training is an important component of Habit-Reversal Therapy. Competing responses are recommended to be incompatible with tics. However, research on the efficacy of non-incompatible (“dissimilar”) competing responses is scant. We conducted two experiments with individuals with tics who had at least one established incompatible (“similar”) competing response and completed Habit-Reversal Therapy previously. In Experiment 1, we compared similar and dissimilar competing responses in terms of tics reduction and interference with ongoing activities. In Experiment 2, we assessed the maintained effectiveness of dissimilar competing responses over multiple exposures, preference among competing response types, and the effects of similar and dissimilar competing responses on non-targeted tics. Across both experiments, we observed similar tic reduction and disruption of ongoing activity when participants used either competing response type. Engagement was generally greater in dissimilar competing responses. We discuss potential implications for clinicians and areas of future research.