Hollis C, Hall CL, Jones R, et al. - According to this multicentre, parallel group, single-blind, randomised controlled trial, Exposure and Response Prevention (ERP) is a successful behavioural therapy for tics. Remotely delivered, online ERP with little therapist interaction time offers an effective public mental health strategy for increasing access to behavioural therapy for tics in children and adolescents.

• The authors evaluated 445 individuals for participation in the research between May 8, 2018, and September 30, 2019.

• Two hundred twenty-one potential candidates were ruled out (90 did not meet inclusion criteria, 84 declined to participate, and 47 were unable to contact family).

• A total of 224 people were enrolled and randomly assigned to either ERP (n = 112) or psychoeducation (n = 112).

• The majority of the patients enrolled were male (n = 177; 79% ) and of White ethnicity (n = 195; 87%).

• Three months following randomization, 11 patients in the ERP group were lost to follow-up, compared with 12 patients in the psychoeducation group.

• At 3 months following randomization, the ERP group had a mean YGTSS-TTSS of 23·9 (SD 8·2) while the psychoeducation group had a mean YGTSS-TTSS of 26·8 (7·3).

• At 3 months, the mean total decrease in YGTSS-TTSS in the ERP group was 4·5 (16%, SD 1·1) vs 1·6 (6%, 1·0) in the psychoeducation group.

• The estimated mean difference in YGTSS-TTSS change across groups adjusted for baseline and site was –2·29 points in favour of ERP, with an effect size of –0·31.

• Two major adverse events (one collapse and one tic attack) occurred in the psychoeducation group, and neither was connected to study treatment.