Comprehensive Behavioral Intervention for Tics (CBIT)
Cognitive behavioral intervention for tics (CBIT) is an evidence-based treatment designed to help people manage tic disorders, including Tourette disorder. CBIT combines aspects of habit-reversal training (HRT) with other supportive components, including psychoeducation and functional analysis, to give individuals tools to reduce the frequency, intensity, duration, and impact of tics in daily life.
CBIT consists of several components that work together to help people understand, manage, and minimize their tics:
- Education about tics and tic disorders helps individuals and families understand why tics occur and debunks misconceptions about them. By understanding that tics are involuntary and that managing them is a gradual process, individuals and their families can approach treatment with a realistic and compassionate perspective.
- Awareness Training focuses on helping individuals become more aware of their tics, including identifying the physical sensations (premonitory urges) that occur before a tic. Developing this awareness is crucial because it allows individuals to anticipate tics and employ alternative strategies to manage them.
- A core part of CBIT, competing response training, involves teaching the individual to replace a tic with a competing response, a behavior that is physically incompatible with the tic. For example, if a person has a shoulder-jerking tic, they might learn to gently press their arms to their sides as an alternative action. The competing response needs to be a behavior that can be sustained until the urge to tic subsides.
- Functional analysis entails the identification of specific situations or environmental triggers for tics and consequences that make the tics more likely. For example, tics may be more frequent when a person is excited or when others are likely to respond to the tics. The goal is to modify these environmental factors to reduce triggers and alter reinforcing consequences.
- Techniques like deep breathing or progressive muscle relaxation can be used as an adjunct treatment to help the person relax their body.
- Supportive family members, friends, or therapists can provide encouragement, help reinforce skills learned during therapy and assist in monitoring progress.
CBIT sessions typically involve working with a trained therapist who helps the individual understand their tics and develop and practice the competing responses. CBIT often includes practice at home and generalization of skills to different settings, helping the individual learn to manage tics independently across various environments.
CBIT is a structured, evidence-based therapy that provides individuals with tools to manage and reduce tics through a combination of awareness training, competing response techniques, and environmental modifications. It offers a practical, empowering approach to tic management, helping individuals improve quality of life and gain more control over their symptoms. CBIT has been shown in research to significantly reduce tic severity in many individuals, providing relief from tics that interfere with daily activities.
