Comprehensive Behavioural Intervention for Tics
Comprehensive Behavioural intervention for Tics (CBiT)
Firstly, what is CBiT? CBiT stands for Comprehensive Behaviour Intervention for Tics.
CBiT is a treatment for tics only and not for the co-occurring conditions that may be associated with Tourette’s.
CBiT is behavioural therapy, it is used to support people with Tourette’s to manage their tics. Behaviour therapy is not a cure for Tourette’s but aids in the reduction of tic severity and frequency.
CBiT is made up of 6 therapeutic components and is a clinically proven therapy in tic reduction.
These six components consist of:
Habit Reversal Therapy (HRT) Overview
Habit Reversal Therapy is the most researched validated behavioural therapy for Tourette's to date, the research stems back to the 1970s. HRT treats tics individually unlike other behavioural therapies used to treat tics. You will work on becoming more aware of how a certain tic is expressed, then you learn a competing response. You do this by contracting a group of muscles that make it impossible to do the tic at the same time, as soon as you feel the urge coming on, you need to do the competing response and keep doing it even after the urge passes. Eventually, you learn to take control of the tic.
This can be hard work, and an uncomfortable sensation to begin with but with lots of practice, it gets easier.
To learn how to do this, strategies are used to increase the need for you to tic, making the urge as strong as possible, and then you will work at implementing a competing response to make it hard for your tic to breakthrough.
HRT is hard work and takes time and practice however HRT has been proven to reduce tics by up to 40%
There are 5 rules when considering competing responses. The competing response must be able to be done anywhere, without props, can be actioned for more than 1 minute, must be incompatible with the tic, and should be more socially acceptable.
Exposure Response Prevention (ERP)
Exposure Response Prevention is also known as tic suppression. The main aim of ERP is for you to learn to tolerate the urge that comes before a tic, by learning to tolerate the urge you are learning to suppress the tic. This can be hard work, and an uncomfortable sensation to begin with but with practice, it gets easier. By exposing your tics, you practice resisting the urge for longer periods, until you can stop it in most situations for a period of time. Evidence suggests that ERP is as effective as Habit Reversal Therapy. ERP is best suited to individuals who have a range of troublesome tics or are young. Tic reduction is the result.