Comprehensive Behavioral Intervention for Tics
People with tics usually have an urge that is relieved when they have the tic—like scratching an itch. During CBIT, the therapist helps individuals with tics learn to become more aware of the tics and the urge to tic. Once a person is more aware of their tics and urges, they learn how to perform a different behavior instead of the tic. The new behavior (competing response) needs to be something that makes it difficult to perform the tic. For example, a child with a frequent throat clearing tic could be taught to engage in slow rhythmic breathing whenever he or she felt the urge to clear his or her throat. In order for this to work, the new behavior has to be carefully chosen and practiced over and over. This "new behavior" helps reduce and, in some cases, even eliminate the tic.
Tics can also be brought on or made worse by stressful situations or how other people react to the person with a tic. An important part of the CBIT treatment is for the person with the tic and their families to learn how to identify these situations and try to change them so the tics aren't made worse. For example, someone whose tics get worse when doing homework or before a presentation at work would learn how to manage their stress before and during these situations; they may take a walk, listen to calming music, or do some breathing exercises before they begin their homework or presentation.