Psychology Chartered

Case Studies

Saturday 7th January 2017

Sam’s Tourette’s syndrome & psychological treatment

Sam, aged 29, lives in Portsmouth and was diagnosed with Tourette’s syndrome in early childhood (https://www.tourettes-action.org.uk). The separation of his parents during adolescence caused significant emotional difficulties for Sam and whilst remaining dependent on his family, he experiences communication with his parents extremely stressful. In the past, Sam has refused to take his medication, which has led to a deterioration in his symptoms. Sam recently suffered from a significant episode of depression and took a deliberate overdose of anti-depressants.

Due to Sam’s Tourette syndrome, he has experienced associated problems such as, social isolation and low self-esteem. He reports severe social anxiety, anger outbursts and has reported occasional auditory hallucinations. Sam rarely leaves the home unaccompanied, lacks motivation and has a disturbed sleep pattern causing him fatigue in the day.

A referral was made to the Clinical Neuropsychologist here at Psychology Chartered by a Psychiatrist in an attempt to improve some of Sam’s symptoms through psychological approaches. Sam had previously responded positively to psychological treatment in his childhood.

Psychological assessment & formulation identified how Sam’s Tourette’s had impacted upon his personal development, reducing opportunities for normal peer relationships, limiting his range of interpersonal skills and generating heightened self-consciousness and low confidence.  Family conflict also contributed significantly to Sam’s anxiety difficulties. Psychological intervention therefore focused on:

  • providing Sam’s family with information about his condition and increasing their understanding of the importance of their communication and behavior to Sam’s condition.
  • identifying and supporting realistic social goals.  Behavioural experiments (http://www.clinpsy.org.uk/forum/viewtopic.php?f=25&t=11585) allowed Sam to test out his expectations regarding social rejection and gradually build confidence and increase his ability to build supportive relationships and reduce his emotional dependence on his immediate family.
  • Cognitive-behavioural approaches provided Sam with effective ways of monitoring his own mood, responding to periods of high stress and implement an ‘early intervention’ plan when his symptoms worsened.
  • ‘Joining up’ this psychological treatment with a specialist occupational therapist (http://www.everydaylivingtherapy.co.uk) meant that Sam was eventually able to identify a voluntary work placement.  This provided structure to his week and an increased sense of meaning and purpose.

Sam has maintained these psychological, social and vocational gains over the last 18 months and is now being reviewed by a neuropsychologist every 3 months.