Tourettic OCD: Incorporating the TOCD Framework into OCD Treatment

This presentation was originally reviewed on  October 15, 2025, and in person and live streamed online on October 17, 2025, from 9:10 am- 10:10 am ET.

The views and opinions expressed by this presenter in this lecture are their own, and do not represent the views of Sheppard Pratt.

Since the presenter introduced TOCD into the professional literature in 2007 the conceptual framework has been welcomed as a clarification of the interaction between OCD and chronic tic disorders. Recently, (Katz et. al., 2022), in a review of 15 years of clinical, genetic, environmental, neurodevelopmental and neurocircuit-based research, examined the major tenets of TOCD and found that they are substantially supported by a decade and a half of diverse research. As the presenter did, they concluded that TOCD is a distinct intermediary neuropsychiatric disorder distinct from either OCD or Tourette Syndrome alone. In this presentation the distinguishing features of TOCD will be described, its advantages for case conceptualization over related concepts (e.g. Just Right OCD, Tic-Related OCD, Perfection OCD, Sensory OCD) will be discussed. The implications of TOCD for modifying standard CBT and pharmacological treatment in such cases will be emphasized.

Target Audience

This activity is intended for physicians, nurses, psychologists, social workers and other mental health professionals. 

Learning Objectives

At the conclusion of this activity, attendees will be able to:

  1. Describe some similarities and differences in standard treatments for OCD and tic disorders.
  2. Discuss the clinical characteristics of TOCD.
  3. Identify the kinds of modifications to standard OCD treatment warranted in cases of TOCD.

 

 

Course summary
Available credit: 
  • 1.25 ACEP NBCC clock hours
  • 1.25 AMA PRA Category 1 Credit™
  • 1.25 Category II credits for Social Workers
  • 1.25 Psychologists
  • 1.25 MNA Contact Hours for Nurses
  • 1.25 Participation
Course opens: 
12/03/2025
Course expires: 
12/01/2027

There is no commercial support for this activity.

About the speaker

Dr. Charles Mansueto is founder and director of the Behavior Therapy Center of Greater Washington, a leading center for the treatment of obsessive-compulsive and related disorders. He has over 40 years of experience in the application of cognitive behavior therapy to a broad range of clinical problems.  Dr. Mansueto has written extensively and has presented nationally and internationally on OCD and related disorders.  He currently serves on the Scientific and Clinical Advisory Board of the International Obsessive Compulsive Disorder Foundation and is on the faculty of the IOCDF Behavior Therapy Training Institute. He is a member of the Executive Board of OCD Mid-Atlantic—an IOCDF affiliate and serves on the Scientific Advisory Board of the TLC Foundation for Body Focused Repetitive Behaviors, where he also heads the TLC Professional Training Institute.

Disclosure Statements

Sheppard Pratt holds the standard that its continuing medical education programs should be free of commercial bias and conflict of interest. In accord with Sheppard Pratt's Disclosure Policy, as well as standards of the Accreditation Council for Continuing Medical Education (ACCME) and the American Medical Association (AMA), all planners, reviewers, speakers and persons in control of content have been asked to disclose any relationship he /she has with any entity producing, marketing, selling, re-selling, or distributing health care goods or services consumed by, or used on, patients, during the past 24 months. All planners, reviewers and speakers have also been asked to disclose any payments accepted for this lecture from any entity besides Sheppard Pratt, and if there will be discussion of any products, services, or off-label uses of product(s) during this presentation.

Charles S. Mansueto, PhD, reports receiving royalties from New Harbinger and Cambridge University Press during the past 24 months. He will not discuss any products, services, or off-label uses in this presentation. All relationships have been mitigated through review.

Event Planners/Reviewers Disclosures: The following event planners and/or reviewers are reported as having no financial interest, arrangement or affiliation with any entity producing, marketing, selling, re-selling, or distributing health care goods or services consumed by, or used on, patients, during the past 24 months: Jon Hershfield, LCMFT, Todd Peters, MD, Michael C. Hann, MD, MBA, Ronald Means, MD, Rajeev Krishna, MD, PhD, MBA, Louis Marino, MD, Devi Bhuyan, PsyD, Manan Shah, MD, Vittoria DeLucia, MD, Chad J. Lennon, MD, Faith Dickerson, PhD, Carrie Etheridge, LCSW-C, Tom Flis, LCPC, Paula Bostwick, MSN, RN, CENP, Alfredo Sagisi, DNP, MS, RN, FACHE, Maggie O'Neill MSN, RN, PMH-BC, Lisa Illum, MLIS, MEd, and Jennifer Tornabene.

Physician Statement: This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint providership of Sheppard Pratt and OCD Mid-Atlantic. Sheppard Pratt is accredited by the ACCME to provide continuing medical education for physicians. Sheppard Pratt takes responsibility for the content, quality, and scientific integrity of this CME activity.  Sheppard Pratt designates this enduring activity for a maximum of 1.25 AMA PRA Category 1 Credit(s)™.  Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Nurse Statement: Sheppard Pratt is approved as a provider of nursing continuing professional development by the Maryland Nurses Association, an accredited approver by the American Nurses Credentialing Center’s Commission on Accreditation. Sheppard Pratt takes responsibility for the content, quality, and scientific integrity of this CME activity. This activity provides 1.25 contact hour for nurses.

Psychologist Statement: Sheppard Pratt is authorized by the State Board of Examiners of Psychologists as a sponsor of continuing education. Sheppard Pratt takes responsibility for the content, quality, and scientific integrity of this CE activity.  Sheppard Pratt designates this educational activity for a maximum of 1.25 contact hour for Psychologists.

Social Worker Statement: Sheppard Pratt is authorized by the Board of Social Work Examiners of Maryland to offer continuing education for Social Workers.  Sheppard Pratt takes responsibility for the content, quality, and scientific integrity of this CE activity. This activity is approved for 1.25 contact hour in Category II credits for Social Workers.

Counselor Statement:  Sheppard Pratt has been approved by NBCC as an Approved Continuing Education Provider, ACEP No. 5098.  Programs that do not qualify for NBCC credit are clearly identified.  Sheppard Pratt is solely responsible for all aspects of the program.  This activity is available for 1.25 NBCC clock hours.

Available Credit

  • 1.25 ACEP NBCC clock hours
  • 1.25 AMA PRA Category 1 Credit™
  • 1.25 Category II credits for Social Workers
  • 1.25 Psychologists
  • 1.25 MNA Contact Hours for Nurses
  • 1.25 Participation
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ON DEMAND WEBINAR: FOR BEST RESULTS WATCH USING GOOGLE CHROME

Tourettic OCD: Incorporating the TOCD Framework Into OCD Treatment

Charles S. Mansueto, PhD

Founder/Director, Behavioral Therapy Center of Greater Washington

Silver Spring, MD

Originally reviewed on October 15, 2025.
Originally broadcast live October 17, 2025, from 9:10 - 10:25 am ET.
Enduring Activity Credit Expiration Date: December 1, 2027.

Activity Time: One hour fifteen minute recorded webinar lecture with a 15-minute evaluation process. Total Time: 1:30.

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