Cognitive Behavioural Therapy for Tics(CBIT)

Behavioural interventions provide tools for helping a person learn ways to change certain behaviours. Cognitive therapies can help a person to change the way they think about tics in addition to taking certain action. Often the two forms of intervention are combined to help a person make changes to what they do and think to improve their lives. It can be useful for most people with tic disorders, although evidence suggests that it is effective for children as young as five years of age and adults.  Treatment is hard work, so it is key that the individual with tics is highly motivated to work on their tics.

CBIT 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. For example, someone who feels the urge to cough, blink, or roll their eyes can be taught techniques such as mindful breathing to help them to short-circuit the urge, and then to use a different behaviour, instead. They can also work to identify the factors in their lives that seem to trigger or exacerbate their tics and introduce techniques to help them to reduce their stress levels during those incidents. For example, a patient might notice that their tics are worse when they have to speak in public. They will benefit from using stress-reducing techniques, such as mindfulness, to lower their stress levels and thereby reduce the temptation to engage in tics.

While many people with tics can suppress their tics on their own for a period of time, this can be a very frustrating experience for them, that adds to their feelings of stress and can actually make things worse in the longer term. Instead, at Working Minds our goal of CBIT is to integrate new behaviours such that, over time, they become second nature, and therefore remove the need to engage in voluntary suppression. As the person’s ability to understand and manage their tics grows, they become more confident and self-empowered, and less inclined to react to situations that used to trigger them. Over time, the “new” behaviours that they learn to replace tics often also fade away as their ability to manage their condition develops.