Tic Therapy with Heather Neville CBIT | Habit Reversal Therapy

Paediatric Tic and Anxiety Therapy with Heather Neville

CBiT for children and young people | Anxiety support | Parent guidance

If your child is struggling with tics, anxiety, or a combination of both, Heather offers calm, practical and compassionate support tailored to their age, needs and personality.

Heather is a Registered Mental Health Nurse with more than 30 years' experience across health, education, child and adolescent mental health and safeguarding services. She is also trained in Comprehensive Behavioral Intervention for Tics (CBIT) and works specifically with children and young people experiencing tic disorders or Tourette Syndrome.

Heather understands that a child is much more than a list of symptoms. Her approach considers the whole picture, including anxiety, confidence, school, family life, sensory needs and the situations in which tics become more difficult. She works collaboratively with parents and carers while ensuring the young person feels listened to, safe and involved.

All sessions are delivered online, allowing children and families to access specialist support from the comfort of home.

Is Heather's service right for your child?

Heather may be a good fit if your child or young person:

Has motor or vocal tics that are uncomfortable, painful, upsetting or disruptive
Has diagnosed Tourette Syndrome or a tic disorder
Is experiencing tics but is still waiting for assessment or diagnosis
Wants to understand their tics and feel more in control of the most troublesome ones
Experiences anxiety, worry, overwhelm or reduced confidence alongside their tics
Finds that tics increase during stress, uncertainty, tiredness or emotional overload
Is worried about school, friendships, being noticed or other people's reactions
Would benefit from a gentle, structured and child-centred approach
Needs their parent or carer to understand how best to support them

A formal diagnosis is not always required before support can begin. We work from the symptoms and difficulties your child is currently experiencing and consider whether therapy is appropriate for their age, awareness and readiness.

CBIT is most helpful when the young person wants support with their tics and is able to take part in noticing urges, exploring patterns and practising strategies between sessions. Therapy is never about forcing a child to suppress every tic or making them feel that their tics are wrong.

Tic management with Heather

What is CBiT?

CBIT stands for Comprehensive Behavioral Intervention for Tics. It is an evidence-based behavioural therapy designed to help people understand and manage tics.

CBIT is not a cure for Tourette Syndrome and it does not aim to remove every tic. Instead, it helps the young person become more aware of how their tics work, recognise the sensations or urges that may come before a tic and learn practical strategies for the tics that cause the greatest difficulty.

Treatment is personalised. Heather will not ask your child to work on every tic at once. Together, they will identify which tics are most uncomfortable, painful, disruptive or important to the young person and begin there.

What can CBiT include?

Psychoeducation

Understanding what tics are, why they change and what can influence them can reduce fear and confusion. Heather helps children and parents separate tics from behaviour and understand why attention, stress, excitement, tiredness, sensory overload or changes in routine may affect tic frequency.

Awareness training

The young person learns to notice how a tic begins, which muscles are involved and whether there is a sensation or premonitory urge beforehand. This awareness is developed gradually and without constantly drawing attention to the child.

Tic mapping and functional assessment

Heather explores when and where tics are more or less likely to happen. This is not about blaming the child or family. It helps identify patterns and environmental factors that may be changed or supported.

Habit Reversal Therapy

For an individual tic, Heather may help the young person develop a competing response: a safe action that is physically incompatible with the tic. The child practises using it when they notice the urge, with the aim of increasing choice and reducing the impact of that tic.

Exposure and Response Prevention

Where appropriate, the young person may practise noticing and tolerating tic urges for gradually longer periods before releasing or responding to them. This can help build confidence in coping with uncomfortable urges.

Relaxation and regulation

CBIT is not simply about competing responses. Sessions may also include breathing, relaxation, sensory or nervous-system regulation strategies and practical changes that reduce the overall pressure on the child.

Parent and environmental support

Parents are helped to respond in ways that reduce shame, pressure and unnecessary attention. Heather may also discuss routines, family responses, school situations and practical accommodations that support the young person outside therapy.

Anxiety support for children and young people

Anxiety and tics can interact. Worry or emotional pressure may increase tic frequency, while the experience of having tics can create additional anxiety about school, friendships, sleep, public situations or being judged by others.

Heather draws on her extensive mental health and education experience to help children and young people understand anxiety and build manageable coping strategies.

Support may include:

Understanding the body's response to anxiety
Recognising worries, triggers and patterns
Breathing, grounding and regulation strategies
Managing uncertainty and anticipatory anxiety
Building confidence and emotional awareness
Breaking overwhelming situations into smaller steps
Developing helpful routines and coping plans
Supporting school-related anxiety
Helping parents respond calmly and consistently
Reducing the cycle in which anxiety about tics creates further pressure

The work is tailored to the individual. Some children need structured tic therapy with anxiety strategies alongside it. Others may need to focus first on feeling safe, regulated and confident enough to engage.

What happens in sessions?

Step 1 - Complete the child or teen intake form (optional)

The intake form gives us an overview of your child's current tics, anxiety, wider needs and the impact on everyday life. We review this information before recommending the most appropriate clinician and starting point.

Step 2 - Initial consultation with Sarah (compulsary)

The initial appointment explores your child's history, current symptoms, goals and readiness for therapy. Parent or carer input is important, but Sarah will also make space for the young person's views and priorities in the second half of the assessment.

Step 3 - Individual therapy programme

Sessions are structured around your child's goals. For tic work, this may include awareness training, tic mapping, competing responses, urge-tolerance work, relaxation and changes within the environment. Anxiety-focused sessions may include psychoeducation, regulation tools, confidence-building and practical coping strategies.

Step 4 - Practice between sessions

CBIT works best when skills are practised regularly outside appointments. Practice should be short, manageable and agreed with the young person. Parents may be asked to support practice without repeatedly reminding, correcting or placing pressure on the child.

Step 5 - Review and future plan

Heather will review progress with the family, consider which strategies have been most useful and agree whether further sessions, a period of independent practice or other support would be appropriate.

Sessions take place online. A parent or responsible adult should be available as agreed, particularly for younger children.

Child Intake form

Child Initial Assessment Booking