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Tourette SyndromePRISM-TSNCT07905898

Evaluating and Promoting Resilience in Adolescents With Tourette Syndrome

A study testing PRISM Intervention in people with Tourette Syndrome and Tic Disorders, run by Wake Forest University Health Sciences at 1 site in United States.

Not yet recruiting

Opening soon. The study is approved but enrolment has not started yet. Sites may already take enquiries.

Sites and contacts
Official record
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Trial summary

This study adapts and tests PRISM (Promoting Resilience in Stress Management), a short skills-based program that teaches resilience, for teens ages 12-18 with Tourette syndrome or persistent tic disorder. The study has three parts. Read more about this study

Who is it for?
Ages 12 to 18 years
What is being tested?
PRISM Intervention
Could I receive a placebo?
No, everyone receives an active treatment
How many people
95 participants
Where
1 siteUnited States
Study dates
Nov 2026to Jun 2031
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 12 to 18 years
  • All sexes
  • No healthy volunteers
  • Child, Adult

Who may be able to join

  • Age 12-18 years
  • Physician-confirmed diagnosis of Tourette syndrome or persistent (chronic) motor or vocal tic disorder per DSM-5-TR criteria
  • YGTSS Total Tic Severity ≥15 (Tourette syndrome) or Total Motor/Total Phonic score ≥10 (persistent motor or vocal tic disorder)
  • YGTSS Impairment ≥20
  • English fluency in reading and speaking, even as a second language
  • Able to understand and complete study procedures and measures

Who cannot join

  • An active diagnosis of functional neurological disorder
  • Beginning any new therapy within 8 weeks of study initiation

Trial locations and contacts

1 site in 1 country. Contact the study team or a site near you to ask about taking part.

TouretteAHWFB@Advocatehealth.org contact

United States1 site
  • Atrium Health Wake Forest Baptist

    Winston-Salem, North Carolina, 27157

    Carolina Burgos-Aguilar, MS, 336-713-2603, Carolina.Burgosaguilar@advocatehealth.org

    TouretteAHWFB@Advocatehealth.org

Other trials in United States

About this study

Official title: Adapting and Pilot Testing Promoting Resilience in Stress Management (PRISM) for Adolescents With Tourette Syndrome and Persistent Tic Disorders: A Mixed-Methods Feasibility Study and Pilot Randomized Controlled Trial

This study adapts and tests PRISM (Promoting Resilience in Stress Management), a short skills-based program that teaches resilience, for teens ages 12-18 with Tourette syndrome or persistent tic disorder. The study has three parts. First, a small group of teens and their caregivers try PRISM and give feedback to adapt it for teens with tics. Second, 15 teens complete the adapted program to see whether it is practical and acceptable. Third, 60 teens are randomly assigned to PRISM plus usual care or usual care alone, to see whether a larger trial is feasible and to get early information on resilience and other outcomes.

Read the detailed description
  1. Rationale Resilience, the ability to adapt positively to adversity, may improve the ability of adolescents to cope with psychosocial distress even when tics persist. Resilience is a modifiable protective factor that can mitigate negative outcomes while facilitating positive ones. Evidence-based resilience skills across several relevant populations - including ADHD, learning disabilities, and depression (all prevalent co-occurring conditions of TS) - associate resilience with better psychosocial adjustment, life satisfaction, hope and benefit finding, Quality of Life (QOL), coping, and mental health outcomes. No current therapies for TS systematically teach resilience. Thus, a skills-based intervention focusing on strengthening resilience may improve psychosocial distress and TS-related outcomes.
  2. The intervention Promoting Resilience in Stress Management (PRISM) is a brief, skills-based resilience intervention developed using the Transactional Model of Stress and Coping and the NIH ORBIT model. It teaches four skills (managing stress, catching thoughts, goal setting, and finding the positives) through six one-on-one sessions with a trained interventionist. An optional app supports skills practice. PRISM has been adapted for adolescents and young adults with cancer, type 1 diabetes, cystic fibrosis, chronic pain, and other conditions. It has not yet been adapted or tested for Tourette syndrome.
  3. Overall design This mixed-methods study enrolls 85 adolescents ages 12-18 with Tourette syndrome or persistent tic disorder at Wake Forest University School of Medicine/Atrium Health Wake Forest Baptist. It runs in three sequential phases. The intervention is adapted with input from teens and caregivers (Aim 1), tested in a single-arm open trial (Aim 2), and then evaluated in a pilot randomized controlled trial against usual care (Aim 3). The PRISM package is finalized before Aim 3 enrollment begins and does not change during the pilot trial.
  4. Aim 1: Co-adaptation Ten adolescents and their caregivers take part in five virtual focus group sessions. In Sessions 1-4, the PRISM team delivers one PRISM skill per session. Teens and caregivers then give feedback in separate semi-structured interviews, guided by the MODIFI adaptation framework. In Session 5, teens complete and give feedback on the proposed survey measures. The qualitative findings guide revisions to PRISM module names, manual text, examples, worksheets, and training materials. The core skills and the app are not changed.
  5. Aim 2: Open trial Fifteen adolescents receive the adapted PRISM: six sessions held every 1-2 weeks, in person or by video, followed by biweekly booster check-ins through week 16. The primary outcome is feasibility, defined in advance as at least 80% of participants completing all six sessions. Acceptability and appropriateness are measured with validated implementation measures (FIM, AIM, IAM), along with fidelity and app use. Post-intervention interviews with teens and caregivers explore barriers and facilitators. The findings are used to refine PRISM before Aim 3.
  6. Aim 3: Pilot randomized controlled trial Sixty adolescents are randomized 1:1 to PRISM plus usual care or usual care alone, stratified by YGTSS tic impairment. Usual-care participants receive study-team check-ins matched in number and timing to the PRISM sessions. Assessments occur at baseline, post-intervention (weeks 13-16), and week 26, and post-randomization clinician ratings are done by a blinded assessor. The primary outcome is feasibility: a mean FIM score of 4 or higher in the PRISM arm. Secondary outcomes include resilience (CD-RISC-10), tic severity and impairment, co-occurring symptoms, quality of life, stigma, illness identity, and automatic thoughts. Results will inform the design and sample size of a future fully powered efficacy trial.
Being tested
PRISM Intervention, Usual care intervention
Keywords
Tics, Resilience, Psychosocial Distress, Adolescents, Stigma, Quality of life, PRISM
Medical subject headings
Tourette Syndrome, Tic Disorders, Bronchiolitis Obliterans Syndrome, Tics, Social Stigma

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • PRISM InterventionBehavioural

    Also called PRISM, Promoting Resilience in Stress Management

    One-on-one resilience program: a 10-15 min introductory session, four 30-60 min skills sessions (managing stress, catching thoughts, goal setting, finding the positives), and a 15-45 min family session. Sessions are held every 1-2 weeks, in person or by secure video, with trained research assistants. Biweekly booster check-ins continue through week 16. An optional PRISM app (ages 13+) and worksheets are used for skills practice

  • Usual care interventionOther

    Psychoeducation, medication and/or behavioral therapy as directed by the treating clinician.

Study groups in NCT07905898
Study groupRoleWhat they receive
Aim 1: Co-adaptation focus group (n=10 + caregivers)OtherPRISM Skills 1-4 (delivered by the PRISM team), each followed by a feedback interview
Receives: Behavioral: PRISM Intervention
Aim 2: Open trial (n=15)ExperimentalAdapted PRISM
Receives: Behavioral: PRISM Intervention
Aim 3: PRISM + usual care (n=30)ExperimentalAdapted PRISM; Usual care
Receives: Behavioral: PRISM Intervention
Aim 3: Usual care (n=30)Active comparatorUsual care; study-team check-ins matched to the PRISM schedule
Receives: Other: Usual care intervention

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Feasibility: Proportion of Participants Completing All Six Core PRISM Sessions (Aim 2)

    Feasibility of the adapted PRISM intervention in the Aim 2 open trial, measured as the proportion of participants who complete all six core PRISM sessions (introductory session, four skills sessions, and family session), as recorded on the session attendance log. Feasibility is defined a priori as at least 80% of participants (12 or more of 15) completing all six sessions.

    Measured: Post-intervention (weeks 13-16, about 3-4 months)

  2. Feasibility of Intervention Measure (FIM) Mean Score (Aim 3 PRISM Arm)

    Adolescent-rated feasibility of PRISM, measured with the 4-item Feasibility of Intervention Measure (FIM). Each item is rated from 1 (completely disagree) to 5 (completely agree), and the score is the mean of the 4 items (range 1-5). Higher scores indicate greater perceived feasibility. Feasibility is defined a priori as a mean score of 4 or higher. Measured in the Aim 3 PRISM + usual care arm only.

    Measured: Post-intervention (weeks 13-16, about 3-4 months)

Secondary outcomes (14)
  1. Feasibility of Intervention Measure (FIM) Mean Score (Aim 2)

    Adolescent-rated feasibility of PRISM in the Aim 2 open trial, measured with the 4-item Feasibility of Intervention Measure (FIM). Each item is rated from 1 (completely disagree) to 5 (completely agree), and the score is the mean of the 4 items (range 1-5). Higher scores indicate greater perceived feasibility.

    Measured: Post-intervention (weeks 13-16, about 3-4 months)

  2. Acceptability of Intervention Measure (AIM) Score

    Adolescent-rated acceptability of PRISM, measured with the 4-item Acceptability of Intervention Measure (AIM). Each item is rated from 1 (completely disagree) to 5 (completely agree), and the score is the mean of the 4 items (range 1-5). Higher scores indicate greater acceptability. Measured in participants who receive PRISM (Aim 2 and the Aim 3 PRISM + usual care arm).

    Measured: Post-intervention (weeks 13-16, about 3-4 months)

  3. Intervention Appropriateness Measure (IAM) Mean Score

    Adolescent-rated appropriateness (perceived fit and relevance) of PRISM, measured with the 4-item Intervention Appropriateness Measure (IAM). Each item is rated from 1 (completely disagree) to 5 (completely agree), and the score is the mean of the 4 items (range 1-5). Higher scores indicate greater appropriateness. Measured in participants who receive PRISM (Aim 2 and the Aim 3 PRISM + usual care arm).

    Measured: Post-intervention (weeks 13-16, about 3-4 months)

  4. Recruitment: Proportion of Eligible Participants Who Consent

    Number of participants who provide informed consent (and assent, if applicable) divided by the number who screen eligible, as recorded on the screening log and enrollment tracker. Reported separately for each Aim.

    Measured: At the end of enrollment for each Aim

  5. Data Completeness: Proportion of Participants Completing All Study Questionnaires

    Proportion of enrolled participants who complete all scheduled self-report questionnaires and clinician-rated assessments at each assessment timepoint.

    Measured: Baseline, post-intervention (weeks 13-16, about 3-4 months), and week 26 (about 6 months; Aim 3 only)

  6. Intervention Fidelity: Percentage of PRISM Session Components Delivered

    Audio-recorded PRISM sessions are scored by the PRISM team using PRISM's standardized session fidelity checklists, which rate each required session component as covered or not covered. The first 3 sessions and then 1 in 3 randomly selected sessions per interventionist are reviewed. Reported as the mean percentage of checklist components covered across reviewed sessions.

    Measured: Throughout the intervention period (weeks 1-16, about 4 months)

  7. Resilience: Connor-Davidson Resilience Scale-10 (CD-RISC-10) Total Score

    10-item adolescent self-report measure of resilience over the past month. Items are rated from 0 (not true at all) to 4 (true nearly all the time) and summed for a total score of 0-40. Higher scores indicate greater resilience. In Aim 3, the between-group difference (PRISM + usual care vs. usual care alone) in change from baseline will be estimated.

    Measured: Baseline, post-intervention (weeks 13-16, about 3-4 months), and week 26 (about 6 months; Aim 3 only)

  8. Tic Severity: Yale Global Tic Severity Scale (YGTSS) Total Tic Severity Score

    Clinician-rated, semi-structured interview of tic symptoms over the past week, completed with the adolescent and, for ages 12-17, a parent/caregiver. Motor and phonic tics are each rated on number, frequency, intensity, complexity, and interference (0-5 each), giving a Total Motor score (0-25) and Total Phonic score (0-25), which are summed for a Total Tic Severity score (0-50). Higher scores indicate more severe tics. For participants with persistent motor or vocal tic disorder, the score is capped at 25, and Total Motor and Total Phonic scores are also reported separately. In Aim 3, post-randomization ratings are completed by a blinded assessor.

    Measured: Baseline, post-intervention (weeks 13-16, about 3-4 months), and week 26 (about 6 months; Aim 3 only)

  9. Tic-Related Impairment: Yale Global Tic Severity Scale (YGTSS) Impairment Score

    Single clinician rating of overall tic-related impairment over the past week (effects on self-esteem, family life, social acceptance, and school functioning), scored from 0 (none) to 50 (severe) in increments of 10. Higher scores indicate greater impairment. In Aim 3, post-randomization ratings are completed by a blinded assessor.

    Measured: Baseline, post-intervention (weeks 13-16, about 3-4 months), and week 26 (about 6 months; Aim 3 only)

  10. Anxiety: PROMIS Pediatric Anxiety Short Form 8a v3.0 Score

    8-item adolescent self-report measure of anxiety symptoms over the past 7 days. Items are rated from 1 (never) to 5 (almost always) and summed for a raw score of 8-40. Higher scores indicate more anxiety symptoms.

    Measured: Baseline, post-intervention (weeks 13-16, about 3-4 months), and week 26 (about 6 months; Aim 3 only)

  11. Depressive Symptoms: PROMIS Pediatric Depressive Symptoms Short Form 8a v3.0 Score

    8-item adolescent self-report measure of depressive symptoms over the past 7 days. Items are rated from 1 (never) to 5 (almost always) and summed for a raw score of 8-40. Higher scores indicate more depressive symptoms.

    Measured: Baseline, post-intervention (weeks 13-16, about 3-4 months), and week 26 (about 6 months; Aim 3 only)

  12. Obsessive-Compulsive Symptoms: Children's Florida Obsessive-Compulsive Inventory (C-FOCI) Severity Score

    Adolescent self-report measure of obsessive-compulsive symptoms over the past month. Part A is a 17-item yes/no symptom checklist. Part B has 5 severity items (time occupied, distress, difficulty controlling, avoidance, and interference), each rated 0-4 and summed for a severity score of 0-20. Higher scores indicate more severe obsessive-compulsive symptoms.

    Measured: Baseline, post-intervention (weeks 13-16, about 3-4 months), and week 26 (about 6 months; Aim 3 only)

  13. ADHD Symptoms: Conners 4 ADHD Index Score

    Adolescent self-report of ADHD symptoms over the past month using the Conners 4 Short Self-Report; items are rated from 0 (not true at all) to 3 (completely true). The ADHD Index is scored according to the Conners 4 manual using age- and sex-based norms. Higher scores indicate a greater likelihood of clinically significant ADHD symptoms

    Measured: Baseline, post-intervention (weeks 13-16, about 3-4 months), and week 26 (about 6 months; Aim 3 only)

  14. Suicide Risk: Number of Participants With a Positive Columbia-Suicide Severity Rating Scale (C-SSRS) Screener

    Number of participants with any positive response on the C-SSRS Screener (suicidal ideation items 1-5 or the suicidal behavior item), administered by a trained, certified study team member. Positive screens are also categorized by risk level (low, moderate, high, imminent) under the study's safety triage protocol.

    Measured: Baseline, post-intervention (weeks 13-16, about 3-4 months), and week 26 (about 6 months; Aim 3 only)

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted30 Oct 2026
  2. Study startNov 2026 (estimated)
  3. Primary completionMar 2031 (estimated)
  4. Study completionJun 2031 (estimated)

Resources

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
Supportive care
Allocation
Randomised
Intervention model
Parallel groups
Masking
Single blind
Who is masked
Outcomes assessor
Enrolment
95 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT07905898
Sponsor's protocol ID
IRB00158033
Other IDs
1K23MH141319-01A1
Acronym
PRISM-TS
Status last verified
Oct 2026
First submitted
23 Oct 2026
Last updated
30 Oct 2026
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
Yes: De-identified individual level data will be shared with the NIMH Data Archive (NDA).

Questions about this trial

What is this clinical trial studying?

A study testing PRISM Intervention in people with Tourette Syndrome and Tic Disorders, run by Wake Forest University Health Sciences at 1 site in United States.

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 6 inclusion and 2 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: opening soon, as of the sponsor's last update on 30 Oct 2026. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in United States. 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 Carolina Burgos-Aguilar, MS (336.713.2603, Carolina.Burgosaguilar@advocatehealth.org), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Feasibility: Proportion of Participants Completing All Six Core PRISM Sessions (Aim 2) (time frame: Post-intervention (weeks 13-16, about 3-4 months)). 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 30 Oct 2026.

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