What is Behaviour Therapy for tics?
A brief overview of behaviour intervention for Tourette's Syndrome
Behavioural therapy is used to teach people with Tourette's ways to manage their tics. However its important to remember that it is not a cure for tics, that said it has been proven to help reduce the number, severity and impact of tics.
" It is important to understand that even though behavioural therapies might help reduce the severity of tics, this does not mean that tics are just psychological or that anyone with tics should be able to control them" (Tourette's Action)
There are three main behaviour interventions currently available, some have been around longer than others however the newest treatment available, has seen tremendous results.
Habit Reversal Therapy:
Habit Reversal Therapy is the most researched validated behavioural therapy for Tourette's to date, the research stems back to the 1970's. 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 to do 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 break through.
HRT is hard work and takes time and lots of 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, be done with no props, can be actioned for more than 1 minute, it must be incompatible with the tic and should be more socially acceptable.
Exposure Response Prevention:
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 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 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 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.
A deeper look into how CBiT works