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However, concerns have been expressed about the negative effects of behavioral interventions, such as tic worsening, tic substitution, and excessive effort. This study explored perceived negative effects of tic management strategies in adults with TDs and predictors of these experiences. Participants ( N\u2009=\u200972) completed semi-structured interviews 11\u2009years after receiving behavior therapy or supportive therapy in a randomized clinical trial. We examined responses to interview questions about managing tics and predictors of reported negative effects. Most participants did not experience tic worsening (84%) or tic substitution (75%) from tic management strategies. The majority felt they could manage tics while participating in their environment (87%) and did not report life interference from tic management (77%). About half (45%) felt less present when managing tics. Treatment non-responders in the original trial were more likely to report negative effects of tic management strategies. No differences in reported negative consequences were found between those who received behavior therapy versus supportive therapy, suggesting that behavior therapy specifically does not lead to such adverse effects. These findings could reduce misconceptions about behavior therapy for TDs and enhance its acceptability and utilization.<\/jats:p>","DOI":"10.1177\/01454455241236446","type":"journal-article","created":{"date-parts":[[2024,4,1]],"date-time":"2024-04-01T07:25:45Z","timestamp":1711956345000},"page":"449-470","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":7,"title":["Perceived Negative Effects of Tic Management Strategies in Adults With Tic Disorders"],"prefix":"10.1177","volume":"48","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6359-8845","authenticated-orcid":false,"given":"Kathryn E.","family":"Barber","sequence":"first","affiliation":[{"name":"Marquette University, Milwaukee, WI, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Brandon X.","family":"Pitts","sequence":"additional","affiliation":[{"name":"Marquette University, Milwaukee, WI, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jordan T.","family":"Stiede","sequence":"additional","affiliation":[{"name":"Baylor College of Medicine, Houston, TX, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Flint M.","family":"Espil","sequence":"additional","affiliation":[{"name":"Stanford University, Stanford, CA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Douglas W.","family":"Woods","sequence":"additional","affiliation":[{"name":"Marquette University, Milwaukee, WI, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Matthew W.","family":"Specht","sequence":"additional","affiliation":[{"name":"Connecticut OCD, Anxiety, and Tic, Greenwich, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shannon M.","family":"Bennett","sequence":"additional","affiliation":[{"name":"Cornell University, Ithaca, NY, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John T.","family":"Walkup","sequence":"additional","affiliation":[{"name":"Ann and Robert H. 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