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A small, uncontrolled open trial of mindfulness-based stress reduction was provided to 18 individuals who were at least 16 years old \citep{25149879}. Treatment consisted of 8 weekly 2-hour group classes and one four hour retreat. Participants were taught a tic-specific meditation exercise that involved noticing any urges to tic while maintaining a focus on one's breathing rather than trying to change or eliminate the urge to tic. Only one subject dropped out and overall tic severity was decreased by 20% for the participants who completed the program. Ten subjects were rated as "much improved" or "very much improved" and thus considered treatment responders. The gains for the treatment responders were maintained at a one month follow-up visit suggesting that improvements reflected more than just the waxing and waning pattern commonly associated with tic severity.  An open-label trial of psychotherapy using a cognitive psychophysiological model of tic behavior, behavior  was conducted with 102 adults who had TS or chronic tic disorder \citep{26250742}. Ten weeks of individual psychotherapy involved a variety of components including increasing awareness of tics, muscle discrimination, decreasing muscle tension and an overactive style of action, identifying low and high risk activities in terms of tic probability, highlighting the differences in behaviors, thoughts and feelings, and decreasing perfectionistic beliefs linked to tension and relapse prevention. These psychotherapy components were chosen because of that group's prior research suggesting that some TS subjects have perfectionist beliefs when they plan actions and this leads to an impulsive overactive style resulting in frustration, tension and tics. Large effect sizes were seen for both treatment groups (TS, CTD) compared to the waiting list controls. 65% of the chronic tic disorder group and 74% of the TS group had reductions of more than 35% on the Tourette Syndrome Global Scale. At the end of treatment 78 of 85 completers were rated as having no more than mild symptoms, regardless of the starting severity, while the other 7 were considered to have moderate symptoms. Large effect sizes were seen whether tics were simple or complex, and similar results were seen for various tic locations (eyes, face, head, neck and shoulder, trunk and abdomen, or phonic). \citet{26022060} examined the effects of this psychotherapy approach on event-related potentials and lateralized readiness potentials (LRPs). EEGs were recorded for 20 TS subjects and 20 control subjects matched for age, sex and intelligence, while performing a stimulus-response compatibility inhibition task. During the No-Go condition, the TS group exhibited a delayed and overactivated frontal late positive component. The authors interpreted this result as evidence that this frontal activation may be an adaptive mechanism that allows patients to perform similarly to the control subjects in terms of their behavioral performances. TS subjects exhibited delayed stimulus-locked LRP (sLRP) onset. TS subjects also displayed larger response-locked LRP (rLRP) peak amplitudes, which are associated with the execution of the motor program for the correct response. The authors suggest that the larger amplitudes may reflect overactivation of the premotor and motor cortex in TS patients. Although sLRP onset and rLRP peak normalized after psychotherapy, the larger sLRP amplitude did not. Given the high rate of OCD comorbidity among TS patients, it is encouraging that more research is examining similarities and differences between OCD patients with and without tics. Tic status was evaluated using the YGTSS in a psychotherapeutic study of 124 children and adolescents with OCD who had shown a partial response to a serotonin reuptake inhibitor \citep{26126872}. Tics were identified in 53% of the study participants, but these subjects did not differ significantly from tic-free participants in terms of age, sex, family history, or OCD impairment or severity. The high rate of tics in this sample is partially explained by the inclusion of subjects with tics for less than one year. Cognitive-behavioral therapy resulted in similar OCD symptom improvement in both groups. In another study, 12 children and adolescents with tics whose OCD symptoms had not improved after 14 weeks of cognitive-behavioral therapy received either 16 weeks of sertraline treatment or 10 additional sessions of CBT \citep{26091197}. Externalizing disorders were more common in the tic patients (50%) than in the non-tic patients (5.3%), while internalizing disorders were more common in the non-tic patients. The tic patients showed more improvement when switched to sertraline rather than additional CBT, while the non-tic patients showed similar improvement with either treatment. The authors suggested that the dopaminergic action of sertraline might have helped the OCD patients with tics; alternatively one might conclude simply that pediatric OCD patients with tics respond differently to treatment than do those without tics.