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by Dr. Becky Spelman on 10/08/2019

What are Tics?

Tics, which often begin in childhood and persist throughout the individual’s life, can be a challenge to well-being, and a considerable cause of stress. Tics do not typically respond well to conscious, unguided efforts to repress them, and are generally made worse when sufferers are ridiculed or punished for behaviours that they have no control over.

While medication is sometimes used to treat tics, with varying degrees of success, an approach called Cognitive Behavioural Intervention for TICS (CBIT) has been clinically proven to dramatically improve the manifestation of tics in both children and adults.

We know that tics can originate in a combination of both neurological and environmental factors. Therefore, by working with environmental issues, and at the same time retraining the brain, we can dramatically reduce the extent to which individuals display tics. We know from scientific research that the human brain remains “plastic”, retaining the potential for change, throughout the lifetime, and that the interactions between the individual’s neurological make-up and the environment are complex and nuanced. This means that just because someone may have a neurological predisposition to display tics, they can still learn how to respond differently to the triggers in their environment.

There are three major elements to CBIT:

  • The patient learns how to be more aware of their tics and of the feeling that they need to engage in tic behaviour.
  • They learn how to engage in a different behaviour when they become aware of the urge to display a tic.
  • They make simple changes to their lives that can help them to reduce their symptoms.

How can CBIT help in the Treatment of Tics

While some patients have already integrated techniques to manage their condition into their lives, with varying success, CBIT takes the form of a structured therapeutic session over a fixed period of time, such as ten weeks, with a session every week. During sessions, the therapist works with the patient around the three issues highlighted above. 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, the 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.

Healthcare professionals from a range of backgrounds, including general practitioners and nurse practitioners, can offer help for people with tics, but CBIT—which offers proven long-term relief from the condition—can only be effectively provided by therapists who have been specifically trained in this field.  

Who can I speak to further about COGNITIVE BEHAVIOURAL INTERVENTION FOR TICS in London?

If you would like to talk to someone about Cognitive Behavioural Intervention for Tics, please get in touch with us at the Private Therapy Clinic by telephone at: 020 3887 1738 or by email at: info@privatetherapyclinic.com. 


Piacentini, J., Woods, D.W., Scahill L., Wilhelm, S., Peterson, A.L., Chang, S., Ginsburg, G.S., Deckersbach, T., Dziura, J., Levi-Pearl, S., Walkup J.T., 2010, “Behavior Therapy for Children with Tourette Disorder: A Randomized Controlled Trial. “Journal of the American Medical Association, 303:1929-1937.

Chang S.W., Piacentini, J. & Walkup, J.T., 2007, “Behavioral Treatment of Tourette Syndrome: Past, Present, and Future.”Clinical Psychology Science and Practice, 14(3):268-273.