Obsessive - Compulsive DisorderTORCHNCT07725926
Integrating Exposure and Response Prevention and Habit Reversal Techniques to Treat a Tourettic Subtype of Obsessive-Compulsive Disorder (Tourettic OCD)
A study testing Exposure and Response Prevention (ERP), Habit Reversal Training (HbRT and Psychoeducation and Supportive Intervention in people with Obsessive - Compulsive Disorder and Tic Disorder, Chronic Motor or Vocal, run by University College London Hospitals at 2 sites in United Kingdom.
Trial summary
Obsessive-Compulsive Disorder and Tic Disorders frequently co-occur, and a subgroup of patients - those with a Tourettic Subtype of OCD (TOCD) - present with concurrent obsessive-compulsive and tic symptoms. Existing psychological interventions typically target one condition or the other, but rarely both together. Read more about this study
- Who is it for?
- Ages 18 to 65 years
- Conditions the study is for
- Obsessive - Compulsive Disorder, Tic Disorder, Chronic Motor or Vocal, Tic Disorders
- What is being tested?
- Exposure and Response Prevention (ERP), Habit Reversal Training (HbRT and Psychoeducation and Supportive Intervention
- Type of treatment
- Lifestyle or therapy programme
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 40 participants
- Where
- 2 sitesUnited Kingdom
- Study dates
- 8 Jul 2026to 1 Feb 2030
- Phase
- Interventional
- Are there results?
- Not yet: the study is under way
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 18 to 65 years
- All sexes
- No healthy volunteers
- Adult, Older adult
Who may be able to join
- Age 18 years or older
- All genders
- Confirmation of a primary diagnosis of either:
- Tourettes Disorder / Tourette Syndrome b. Persistent Motor or Vocal Tic Disorder / Chronic Motor or Vocal Tic Disorder c. Provisional Tic Disorder / Transient Motor Tics d. Other Specified Tic Disorder e. Unspecified Tic Disorder f. Obsessive-Compulsive Disorder [d] Participants taking psychotropic medication are eligible provided medication type and dose remain stable throughout the intervention period [e] Ability to provide sustained informed consent [f] A minimum score of 16 on YBOCS [g] A minimum score of 5 on the Premonitory Urge for Tics Scale (PUTS)
Who cannot join
- Substance misuse
- Current diagnosis of a personality disorder
- Schizophrenia
- Bipolar disorder
- Contraindications to participation in a trial (i.e., active suicidal ideations and/or requirement of an interpreter)
- Any psychiatric or neurological condition that, in the opinion of the investigators, would interfere with participation or interpretation of study outcomes.
Trial locations and contacts
2 sites in 1 country. Contact the study team or a site near you to ask about taking part.
United Kingdom2 sites, 2 recruiting
- Recruiting
University College London Hospitals NHS Foundation Trust
London, London, WC1N 3BG
Dipesh Patel, MPhil / PhD, +44 (0)20 3456 7890, dipesh.patel.23@ucl.ac.uk
- Recruiting
University College London Queen Square Institute of Neurology
London, London, WC1N 3BG
Dipesh Patel, MPhil / PhD, +44 (0)20 3456 7890, dipesh.patel.23@ucl.ac.uk
Himanshu Tyagi, PhD
About this study
Obsessive-Compulsive Disorder and Tic Disorders frequently co-occur, and a subgroup of patients - those with a Tourettic Subtype of OCD (TOCD) - present with concurrent obsessive-compulsive and tic symptoms. Existing psychological interventions typically target one condition or the other, but rarely both together. This study aims to test whether a combined psychological therapy integrating Exposure and Response Prevention (ERP) and Habit Reversal (HbRT) is more effective at reducing symptoms than either therapy delivered alone, in adults with TOCD.
Read the detailed description
Participants are randomly allocated to one of four groups: (1) combined ERP and HbRT, (2) ERP alone, (3) HbRT alone, or (4) a supportive psychoeducation control. All participants receive 12 weekly one-to-one sessions (either in-person or remotely) of approximately fifty minutes. Symptoms will be assessed using the Yale Global Tic Severity Scale (YGTSS) and Yale-Brown Obsessive Compulsive Scale (Y-BOCS) by an independent clinician at the start of treatment, at Week 12, and again at Week 24.
- Conditions
- Obsessive - Compulsive Disorder, Tic Disorder, Chronic Motor or Vocal, Tic Disorders, Tic Disorder, Combined Vocal and Multiple Motor, Tourette Disease, Tourette Disorder
- Being tested
- Exposure and Response Prevention (ERP), Habit Reversal Training (HbRT, Psychoeducation and Supportive Intervention
- Keywords
- Obsessive-Compulsive Disorder, Tic Disorders, Tourette Syndrome, Tourettic Obsessive-Compulsive Disorder, Exposure and Response Prevention, Habit Reversal Training
- Medical subject headings
- Compulsive Personality Disorder, Tic Disorders, Tourette Syndrome, Obsessive-Compulsive Disorder
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Exposure and Response Prevention (ERP)Behavioural
Exposure and Response Prevention (ERP) is a behavioural intervention that involves gradual and systematic exposure to obsessional fears, distress, sensory discomfort, premonitory urges, and "not-just-right" experiences while refraining from compulsions, avoidance, reassurance seeking, and other safety behaviours. Treatment is delivered individually over 12 weekly 50-minute sessions, either face-to-face or remotely.
Habit Reversal Training (HbRTBehavioural
Habit Reversal Training (HbRT) is a behavioural intervention that includes awareness training, identification of premonitory urges and antecedents to tic expression, development and practice of competing responses, and strategies to generalise skills across settings. Treatment is delivered individually over 12 weekly 50-minute sessions, either face-to-face or remotely.
Psychoeducation and Supportive InterventionBehavioural
Psychoeducation and Supportive Therapy consists of structured education about obsessive-compulsive disorder, tic disorders, Tourettic obsessive-compulsive disorder, stress, and wellbeing, together with supportive discussion and general problem-solving. The intervention does not include Exposure and Response Prevention, Habit Reversal Training, or other targeted behavioural techniques. Treatment is delivered individually over 12 weekly 50-minute sessions, either face-to-face or remotely.
| Study group | Role | What they receive |
|---|---|---|
| Combined Exposure and Response Prevention and Habit Reversal | Experimental | Participants allocated to this arm will receive a 12-week individual psychological intervention integrating Exposure and Response Prevention (ERP) and Habit Reversal Training (HRT). ERP will involve planned exposure to obsessional fears, distress, sensory discomfort, premonitory urges, and "not-just-right" experiences while reducing compulsions, avoidance, reassurance seeking, and other safety behaviours. HRT will include awareness training, identification of premonitory urges and tic-related cues, development and practice of competing responses, and strategies to support generalisation. Sessions will last approximately 50 minutes and will be delivered face-to-face or remotely. Receives: Behavioral: Exposure and Response Prevention (ERP); Behavioral: Habit Reversal Training (HbRT |
| Standardised Exposure and Response Prevention | Active comparator | Participants allocated to this arm will receive a 12-week individual psychological intervention based on Exposure and Response Prevention (ERP). Treatment will involve gradual and systematic exposure to obsessional fears, distress, sensory discomfort, premonitory urges, and "not-just-right" experiences while refraining from compulsions, avoidance, reassurance seeking, and other safety behaviours. The intervention aims to reduce obsessive-compulsive symptoms by promoting inhibitory learning and increasing tolerance of uncertainty and internal experiences. Sessions will last approximately 50 minutes and will be delivered face-to-face or remotely. Receives: Behavioral: Exposure and Response Prevention (ERP) |
| Standardised Habit Reversal | Active comparator | Participants allocated to this arm will receive a 12-week individual psychological intervention based on Habit Reversal Training (HbRT). Treatment will include awareness training to improve recognition of tics and premonitory urges, identification of antecedents and contextual triggers, development and practice of competing responses, and strategies to promote generalisation of skills to everyday settings. The intervention aims to reduce tic severity and improve voluntary tic management. Sessions will last approximately 50 minutes and will be delivered face-to-face or remotely. Receives: Behavioral: Habit Reversal Training (HbRT |
| Psychoeducation / Supportive Intervention | Active comparator | Participants allocated to this arm will receive a 12-week individual psychological intervention consisting of psychoeducation and supportive therapy. Sessions will provide information about obsessive-compulsive disorder, tic disorders, Tourettic obsessive-compulsive disorder, stress, and wellbeing, together with supportive discussion and general problem-solving. This intervention will not include structured Exposure and Response Prevention, Habit Reversal Training, or other targeted behavioural techniques. Sessions will last approximately 50 minutes and will be delivered face-to-face or remotely. Receives: Behavioral: Psychoeducation and Supportive Intervention |
What is being measured
The primary outcome is the main question the study is designed to answer.
Change From Baseline in Yale-Brown Obsessive Compulsive Scale Total Score
Obsessive-compulsive symptom severity will be assessed using the Yale-Brown Obsessive Compulsive Scale (Y-BOCS). Total scores range from 0 to 40, with higher scores indicating greater obsessive-compulsive symptom severity. Change from baseline will be assessed at Week 12 and Week 24.
Measured: Baseline, Week 12 and Week 24
Change From Baseline in Yale Global Tic Severity Scale Total Tic Severity Score
Tic symptom severity will be assessed using the Yale Global Tic Severity Scale (YGTSS) Total Tic Severity Score. Scores range from 0 to 50, with higher scores indicating greater tic symptom severity. Change from baseline will be assessed at Week 12 and Week 24.
Measured: Baseline, Week 12 and Week 24
Secondary outcomes (1)
Change From Baseline in Yale Global Tic Severity Scale Global Severity Score
Overall tic symptom severity and tic-related impairment will be assessed using the Yale Global Tic Severity Scale (YGTSS) Total Score. The Global Score is calculated by summing the Total Tic Severity Score (0-50) and the Impairment Score (0-50), resulting in a global score ranging from 0 to 100. Higher scores indicate greater overall tic severity and impairment. Change from baseline will be assessed at Week 12 and Week 24.
Measured: Baseline, Week 12 and Week 24
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted24 Jul 2026
- Study start8 Jul 2026
- Primary completion1 Aug 2027 (estimated)
- Study completion1 Feb 2030 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Other trials for Obsessive - Compulsive DisorderStudies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase N/A
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Model description
- Participants are randomly allocated to one of four groups: (1) combined ERP and HbRT, (2) ERP alone, (3) HbRT alone, or (4) a supportive psychoeducation control.
- Masking
- Single blind
- Who is masked
- Outcomes assessor
- Enrolment
- 40 participants (estimated)
Sponsor and investigators
- Lead sponsor
- University College London Hospitals
- Sponsor type
- University, hospital or other
- Collaborators
- University College, London
- Responsible party
- Principal investigator, Dipesh Patel, University College London Hospitals
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT07725926
- Sponsor's protocol ID
- ERP/HR TOCD RTC - 177187
- Acronym
- TORCH
- Status last verified
- Jul 2026
- First submitted
- 21 Jul 2026
- Last updated
- 27 Jul 2026
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- Undecided
Study at a glance
From the registry record, last updated by the sponsor on 27 Jul 2026. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Integrating Exposure and Response Prevention and Habit Reversal Techniques to Treat a Tourettic Subtype of Obsessive-Compulsive Disorder (Tourettic OCD)
- ClinicalTrials.gov ID
- NCT07725926
- Acronym / sponsor ID
- TORCH / ERP/HR TOCD RTC - 177187
- Conditions
- Obsessive - Compulsive Disorder, Tic Disorder, Chronic Motor or Vocal, Tic Disorders, Tic Disorder, Combined Vocal and Multiple Motor, Tourette Disease, Tourette Disorder
- Keywords
- Obsessive-Compulsive Disorder, Tic Disorders, Tourette Syndrome, Tourettic Obsessive-Compulsive Disorder, Exposure and Response Prevention, Habit Reversal Training
- Study type
- Interventional
- Recruitment status
- Recruiting
- Enrolment
- 40 participants (estimated)
- Lead sponsor
- University College London HospitalsUniversity, hospital or other
- Collaborators
- University College, London
- Study start
- 8 Jul 2026 (actual)
- Primary completion
- 1 Aug 2027 (estimated)
- Study completion
- 1 Feb 2030 (estimated)
- First posted
- 24 Jul 2026 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
Obsessive-Compulsive Disorder and Tic Disorders frequently co-occur, and a subgroup of patients - those with a Tourettic Subtype of OCD (TOCD) - present with concurrent obsessive-compulsive and tic symptoms. Existing psychological interventions typically target one condition or the other, but rarely both together. This study aims to test whether a combined psychological therapy integrating Exposure and Response Prevention (ERP) and Habit Reversal (HbRT) is more effective at reducing symptoms than either therapy delivered alone, in adults with TOCD.
Detailed description
Participants are randomly allocated to one of four groups: (1) combined ERP and HbRT, (2) ERP alone, (3) HbRT alone, or (4) a supportive psychoeducation control. All participants receive 12 weekly one-to-one sessions (either in-person or remotely) of approximately fifty minutes. Symptoms will be assessed using the Yale Global Tic Severity Scale (YGTSS) and Yale-Brown Obsessive Compulsive Scale (Y-BOCS) by an independent clinician at the start of treatment, at Week 12, and again at Week 24.
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Single blind (outcomes assessor)
- Number of arms
- 4
- Model description
- Participants are randomly allocated to one of four groups: (1) combined ERP and HbRT, (2) ERP alone, (3) HbRT alone, or (4) a supportive psychoeducation control.
| Arm | Type | Receives |
|---|---|---|
| Combined Exposure and Response Prevention and Habit Reversal | Experimental | Behavioral: Exposure and Response Prevention (ERP), Behavioral: Habit Reversal Training (HbRTParticipants allocated to this arm will receive a 12-week individual psychological intervention integrating Exposure and Response Prevention (ERP) and Habit Reversal Training (HRT). ERP will involve planned exposure to obsessional fears, distress, sensory discomfort, premonitory urges, and "not-just-right" experiences while reducing compulsions, avoidance, reassurance seeking, and other safety behaviours. HRT will include awareness training, identification of premonitory urges and tic-related cues, development and practice of competing responses, and strategies to support generalisation. Sessions will last approximately 50 minutes and will be delivered face-to-face or remotely. |
| Standardised Exposure and Response Prevention | Active comparator | Behavioral: Exposure and Response Prevention (ERP)Participants allocated to this arm will receive a 12-week individual psychological intervention based on Exposure and Response Prevention (ERP). Treatment will involve gradual and systematic exposure to obsessional fears, distress, sensory discomfort, premonitory urges, and "not-just-right" experiences while refraining from compulsions, avoidance, reassurance seeking, and other safety behaviours. The intervention aims to reduce obsessive-compulsive symptoms by promoting inhibitory learning and increasing tolerance of uncertainty and internal experiences. Sessions will last approximately 50 minutes and will be delivered face-to-face or remotely. |
| Standardised Habit Reversal | Active comparator | Behavioral: Habit Reversal Training (HbRTParticipants allocated to this arm will receive a 12-week individual psychological intervention based on Habit Reversal Training (HbRT). Treatment will include awareness training to improve recognition of tics and premonitory urges, identification of antecedents and contextual triggers, development and practice of competing responses, and strategies to promote generalisation of skills to everyday settings. The intervention aims to reduce tic severity and improve voluntary tic management. Sessions will last approximately 50 minutes and will be delivered face-to-face or remotely. |
| Psychoeducation / Supportive Intervention | Active comparator | Behavioral: Psychoeducation and Supportive InterventionParticipants allocated to this arm will receive a 12-week individual psychological intervention consisting of psychoeducation and supportive therapy. Sessions will provide information about obsessive-compulsive disorder, tic disorders, Tourettic obsessive-compulsive disorder, stress, and wellbeing, together with supportive discussion and general problem-solving. This intervention will not include structured Exposure and Response Prevention, Habit Reversal Training, or other targeted behavioural techniques. Sessions will last approximately 50 minutes and will be delivered face-to-face or remotely. |
Who may qualify
- Ages
- 18 to 65 years
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (4 listed)
- Age 18 years or older
- All genders
- Confirmation of a primary diagnosis of either:
- Tourettes Disorder / Tourette Syndrome b. Persistent Motor or Vocal Tic Disorder / Chronic Motor or Vocal Tic Disorder c. Provisional Tic Disorder / Transient Motor Tics d. Other Specified Tic Disorder e. Unspecified Tic Disorder f. Obsessive-Compulsive Disorder [d] Participants taking psychotropic medication are eligible provided medication type and dose remain stable throughout the intervention period [e] Ability to provide sustained informed consent [f] A minimum score of 16 on YBOCS [g] A minimum score of 5 on the Premonitory Urge for Tics Scale (PUTS)
Key exclusion criteria (6 listed)
- Substance misuse
- Current diagnosis of a personality disorder
- Schizophrenia
- Bipolar disorder
- Contraindications to participation in a trial (i.e., active suicidal ideations and/or requirement of an interpreter)
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Exposure and Response Prevention (ERP)Exposure and Response Prevention (ERP) is a behavioural intervention that involves gradual and systematic exposure to obsessional fears, distress, sensory discomfort, premonitory urges, and "not-just-right" experiences while refraining from compulsions, avoidance, reassurance seeking, and other safety behaviours. Treatment is delivered individually over 12 weekly 50-minute sessions, either face-to-face or remotely. | Behavioural | Combined Exposure and Response Prevention and Habit Reversal, Standardised Exposure and Response Prevention |
| Habit Reversal Training (HbRTHabit Reversal Training (HbRT) is a behavioural intervention that includes awareness training, identification of premonitory urges and antecedents to tic expression, development and practice of competing responses, and strategies to generalise skills across settings. Treatment is delivered individually over 12 weekly 50-minute sessions, either face-to-face or remotely. | Behavioural | Combined Exposure and Response Prevention and Habit Reversal, Standardised Habit Reversal |
| Psychoeducation and Supportive InterventionPsychoeducation and Supportive Therapy consists of structured education about obsessive-compulsive disorder, tic disorders, Tourettic obsessive-compulsive disorder, stress, and wellbeing, together with supportive discussion and general problem-solving. The intervention does not include Exposure and Response Prevention, Habit Reversal Training, or other targeted behavioural techniques. Treatment is delivered individually over 12 weekly 50-minute sessions, either face-to-face or remotely. | Behavioural | Psychoeducation / Supportive Intervention |
Primary outcome
Change From Baseline in Yale-Brown Obsessive Compulsive Scale Total Score
Time frame: Baseline, Week 12 and Week 24
Obsessive-compulsive symptom severity will be assessed using the Yale-Brown Obsessive Compulsive Scale (Y-BOCS). Total scores range from 0 to 40, with higher scores indicating greater obsessive-compulsive symptom severity. Change from baseline will be assessed at Week 12 and Week 24.
Change From Baseline in Yale Global Tic Severity Scale Total Tic Severity Score
Time frame: Baseline, Week 12 and Week 24
Tic symptom severity will be assessed using the Yale Global Tic Severity Scale (YGTSS) Total Tic Severity Score. Scores range from 0 to 50, with higher scores indicating greater tic symptom severity. Change from baseline will be assessed at Week 12 and Week 24.
1 secondary outcome
Change From Baseline in Yale Global Tic Severity Scale Global Severity Score
Time frame: Baseline, Week 12 and Week 24
Results and safety
This study is still under way. Results are not available in the source record yet.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 27 Jul 2026.
- Individual participant dataSharing planned: Undecided
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part.
2 sites in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing Exposure and Response Prevention (ERP), Habit Reversal Training (HbRT and Psychoeducation and Supportive Intervention in people with Obsessive - Compulsive Disorder and Tic Disorder, Chronic Motor or Vocal, run by University College London Hospitals at 2 sites in United Kingdom.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 4 inclusion and 6 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: looking for participants now, as of the sponsor's last update on 27 Jul 2026. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 2 sites in United Kingdom. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
This study is still under way. Results are not available in the source record yet.
How can a doctor refer a patient or contact the research team?
Contact Dipesh Patel, MPhil / PhD (+44 (0)20 3456 7890, dipesh.patel.23@ucl.ac.uk), or a site near the patient. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Change From Baseline in Yale-Brown Obsessive Compulsive Scale Total Score (time frame: Baseline, Week 12 and Week 24). The study lists 2 primary outcomes in all. It is what the study was designed to measure, not a finding.
Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 27 Jul 2026.