TY - JOUR AU - Lichtman, Jeremy D. PY - 2017/04/23 Y2 - 2024/03/29 TI - Mechanical/Algorithmic Versus Flexible/Creative Clinical Practice: How Underlying Principles Bridge the Gap JF - Pragmatic Case Studies in Psychotherapy JA - PCSP VL - 13 IS - 1 SE - Case Study DO - 10.14713/pcsp.v13i1.2002 UR - https://pcsp.nationalregister.org/index.php/pcsp/article/view/2002 SP - 73-81 AB - In the case of "Hiro" (Lichtman, 2017) I described the successful use of Comprehensive Behavioral Intervention for Tics (CBIT) in a young boy with Tourette Syndrome (TS). In three different commentaries on this case, authors noted important concepts regarding the use of manuals in treating TS; how an understanding of underlying principles is important in flexible use of manuals; and how training impacts the treatment of TS. In my response to these commentaries, I hope to continue the conversation of how to use manuals in psychotherapy in general as well as in the treatment of TS in particular. Specifically, I hope to address the seeming dichotomy between a mechanical, algorithmic approach to treatment versus a flexible, creative approach, and to ultimately show that an understanding of the underlying principles guiding manualized treatment provides room for ingenuity that proves this dichotomy false. ER -