Comprehensive Behavioral Intervention for Tics

Comprehensive Behavioral Intervention for Tics (CBIT) is an alternative to medication for tics.  

CBIT is a non-drug treatment consisting of three important components:

• Training the patient to be more aware of tics
• Training patients to do competing behavior when they feel the urge to tic
• Making changes to day to day activities in ways that can be helpful in reducing tics.

WHAT DOES TREATMENT LOOK LIKE.

CBIT is a highly structured therapy that typically takes place in a therapist’s office on a weekly basis. The standard treatment is 8 sessions over 10 weeks, but can be longer or shorter depending on the needs of the patient and his or her family. 

 - Step one in CBIT is to teach the patient to become more aware of his or her tics and the urge to tic. 

 -  Step two; the patient is taught to perform a specific behavior that makes the tic more difficult to do, as soon as the tic or urge appears. This “competing response” helps to reduce, and in some cases, even eliminate the tic. For example, a youngster with a frequent throat clearing tic would be taught to engage in slow rhythmic breathing whenever he felt the urge to clear his throat. A competing response chosen for a head-shaking tic might be gently tensing the head or neck muscles. Consistent and repeated practice of a carefully chosen competing response done at the appropriate time is necessary for the treatment to be effective.

 - The final step of CBIT, the functional intervention (FI), is based on the fact that certain situations or reactions to tics can make them worse than they might otherwise be. The goal of FI is to identify these situations and have the patient and family attempt to change them so the tics aren’t made worse unnecessarily. For example, someone whose tics get worse when doing homework or before a presentation at work would be taught to manage their stress before and during these situations.

How Long Does This Method Take?

 CBIT is a highly structured therapy that typically takes place in a therapist’s office on a weekly basis. The standard treatment is 8 sessions over 10 weeks, but can be longer or shorter depending on the needs of the patient and his or her family.