Tics and Tourette Disorder

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I am a certified in CBIT (Comprehensive Behavioral Intervention for Tics) treatment by the Tourette Association of America.  CBIT is the first-line treatment for tic disorders.  Please read a brief overview of CBIT here.

About 6 kids in 1000 are affected by chronic motor and vocal tics.  These disorders tend to peak in early adolescence, a time when many kids are very sensitive to others’ opinions about them.  Kids may react with lowered self-esteem or “play into” peers’ reactions in an unhealthy way.  Tics can also make it more difficult to focus.  Sometimes tics persist into adulthood.

CBIT is a behavioral treatment that teaches kids and adults to replace the tics with specific “competing behaviors”.  The client and I work together to identify to find the most effective CB.   Parents are involved  for support, encouragement and reinforcement, if the client is a child.  Using a competing behavior is different than suppressing the tic, which is stressful.  Competing behaviors are much less noticeable than the tics themselves, and help children and adults manage their illness successfully.

We also work on minimizing exposure to situations which reinforce tic expression.  Parents are coached in paying attention to competing behaviors rather than the tics themselves.  If appropriate, we may also provide education about tics to a child’s peers, to minimize their reactions and reduce stigma.

CBIT sounds simple, but like other behavioral treatments, needs to be done in a specific way by a trained professional in order to be effective.  It is not a long-term treatment.  Most clients are seen for 6-12 sessions.  I am happy to coordinate with therapists whom the client sees for other issues.

Very few providers are certified in CBIT.  It may be possible to negotiate a “single case agreement” by which your insurance would pay for tic disorder treatment.  (I am in-network for BCBS.)   Please call to enquire about this.  Also, it may be possible to arrange “teletherapy” through a Skype-like HIPPA-compliant video system, if you live or can arrange a private space for therapy in Massachusetts, where I am licensed.