What is Comprehensive Behavioral Intervention for Tics (CBIT)?
Tourette syndrome is a neurological condition beginning in childhood where people have tics that change over time. Tics are a kind of repeating movement and / or sound.
CBIT is a scientifically established therapy that teaches people to gain control over and reduce tics. Research on CBIT has been done with children and adults with Tourette syndrome.
CBIT is based on three simple observations about tics:
- Tics may get better in some situations and worse in others.
- Tics are often done in response to a feeling or urge.
- Tics can often be stopped or postponed.
What Is Involved in CBIT?
For CBIT to be successful, the child or adult needs to:
- Attend (in person or virtual) therapy training sessions
- Practice suppressing tics, as instructed by the therapist
How Does CBIT Work?
CBIT is based on these simple actions, which teach people to tic less:
Action |
What To Do |
Homework |
|
Change the situation |
Notice situations where tics are better or worse. |
Change the situation to reduce tics. |
|
Watch the tic |
Break the tic down into each step. Watch for any urge inside you that may occur before the tic starts. |
Watch each step of your tic and know the steps of the urge / tic. |
|
Refuse to give in to the urge / tic |
Talk about the steps to fight back against the urge / tic and to put off doing the urge / tic. |
Relax, fight back the urge, and put off doing the tic. |
|
Change the bad tics |
Make up and practice “competing responses” (a movement that is the reverse of the tic) for the most bothersome tics. For example, in place of a loud vocal tic, do a quiet mouth movement or breathing sound. |
Practice daily when the most bothersome tic is occurring, remember to do the competing responses that you made up in therapy. |
Who Can Teach CBIT?
Any person who has had CBIT training can perform this treatment, such as a doctor, nurse, social worker or psychologist / counselor. The number of visits can be different for each person.
Where Can I Get This Treatment?
The Cincinnati Children's Movement Disorders Clinic offers and collaborates with CBIT providers in the Department of Psychology. The doctor or nurse practitioner seeing your child will help decide if this treatment is right for your child.
To Get More Information about CBIT Therapy at Cincinnati Children’s
- If you have never been seen at Cincinnati Children’s for tics, call 513-636-4222, option No. 1 and ask for a new patient appointment in the Movement Disorder Clinic. You will need to be seen in the clinic first for an exam so that we can decide if CBIT would be helpful.
- If you are a current patient at Cincinnati Children’s and have been seen in the Movement Disorder Clinic for tics, please send us a MyChart message or call 513-636-4222 and ask for the movement disorder nurse.
Additional Resources for CBIT
- Visit the Tourette Association of America (TAA).
- Managing Tourette Syndrome: A Behavioral Intervention Workbook, Parent Workbook. Douglas W. Woods, John Piacentini, Susanna Chang, Thilo Deckersbach, Golda Ginsburg, Alan Peterson, Lawrence D. Scahill, John T. Walkup, Sabine Wilhelm. Oxford University Press.
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