Updated: Jul 28
Behavioural therapy is used to teach people with Tourette's ways to manage their tics.
It is important to remember that this is not a cure for tics, however it has been proven to help reduce the number, severity and impact of tics for many people.
These Interventions can be taught both face to face and via Telehealth.
There are three main behaviour interventions currently available, some have been around longer than others however the newest treatment available (CBiT), has seen tremendous results. Let's look at them below:
Habit Reversal Therapy:
Habit Reversal Therapy (HRT) is the most researched validated behavioural therapy for Tourette's and tic disorders to date, the research stems back to the 1970's. HRT treats tics individually starting with the most problematic first. You will work on becoming more aware of how a certain tic is expressed, then you learn a suitable competing response. You do this by contracting a group of muscles that make it impossible for the tic to be actioned at the same time. You implement the competing response as soon as you feel the urge coming on. Eventually you learn to manage that 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 break through.
Despite HRT being hard work, it is proven to reduce tics by over 40%.
There are 5 rules when considering competing responses.
1) be able to be done anywhere
2) be done with no props
3) be actioned for more than 1 minute
4) be incompatible with the tic
5) be more socially acceptable.
Exposure Response Prevention:
Exposure Response Prevention (ERP) is where you learn to tolerate the urge that comes before a tic, by learning to tolerate the urge you are learning to suppress the tic. ERP works on all tics at the same time. This can also be hard work, and an uncomfortable sensation to begin with but with lots of practice it gets easier. By exposing your tics, you practice resisting the urge for longer and longer periods of time, until you are able to manage it in most situations. 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 in age. Tic reduction is the result.
Comprehensive Behaviour Intervention for Tics:
CBIT (pronounced see-bit) is made up of six strategic therapeutic components.
This therapy is usually offered in 8-12 weekly or fortnightly sessions (although fewer might be suitable for milder tics) but this can depend on the person with tics and the therapist.
The success of CBIT comes from the comprehensive combination of therapies used within treatment, these consist of Psychoeducation, Self-awareness training, Relaxation training, Establishing a tic hierarchy, selecting a target tic and reverse engineering it, Formulating a competing response to the target tic using habit reversal techniques, and Social support.
CBIT is now the first treatment offered to children diagnosed with Tourette's Syndrome and can even be delivered via skype.
Let's Look At CBiT A Little More.
Would you like to know more about therapy for tics?
Behavioural Therapy for tics, (CBiT) is recommended as the first line Intervention for tics, before medication by the American Academy of Neurology AAN. To learn more visit www.tictocktherapy.co.uk or
Sign up for a free zoom consultation via https://www.tictocktherapy.co.uk/book-online-1