Comprehensive Behavioral Intervention for Tics (CBIT) is a new evidence-based treatment for chronic tics and Tourette’s Disorder. CBIT has been shown to be effective in reducing tic symptoms and tic-related impairment in children and adults. The components of CBIT are psycho-education about tics, relaxation techniques, function-based behavior interventions and habit reversal training.
In functional intervention, the first step of CBIT, the therapist will work with your child to better understand the types of tics that are predominant and to understand the situations that maintain the tics. This intervention is used to help identify environments and situations that make the tics worse or better. The therapist will then work with your child to help them understand what usually happens before and after a bout of tics. This may include examining reactions, feelings or thoughts that happen in specific places or in certain situations. Your therapist will also review how others respond to your child when they tic and work to modify or decrease the most challenging situations.
The next step will be teaching your child how to monitor when a tic is about to occur. Your child is then taught how to replace the tic with a competing, voluntary movement. This movement is specifically designed to be physically incompatible with the tic. The child then practices this new behavior. Each time your child performs a competing response instead of the tic, this makes the tic weaker.
For example, a child who has a motor tic that involves flinging his arm out might be taught to put his hands on his knees and push gently on his leg until the urge to tic passes. This competing movement disrupts the tic cycle and decreases the tic behavior.
Parents are also included in the CBIT training. You will be taught how to cope with your own reactions to your child’s tics and learn how to best support your child in learning and practicing the new behavioral techniques.
More information about tics, Tourette’s Disorder and CBIT can be found by visiting www.tourette.org/research-medical/cbit-overview.