A Different Way Forward With Tics
TOURETTE SYNDROME & TIC DISORDER THERAPY
For all ages | CBIT Tic Therapy: Long Beach, CA & Online
TOURETTE SYNDROME & TIC DISORDER THERAPY
When Tics Begin to Take Over
You or your child or teen may wish tics would go away for good. Tics can be frustrating, bothersome, uncomfortable, and sometimes difficult to understand. Anxiety, anger, shame, or embarrassment may show up around tics. Your or your child’s tics may change over time, increase with stress, excitement, or fatigue, or interfere with school, work, relationships, sleep, sports, and everyday activities.
I work with children, teens, and adults experiencing Tourette syndrome, persistent tic disorders, and functional tic-like symptoms.
With specialized CBIT treatment, you can develop a better understanding of your symptoms, learn practical ways to respond to urges, and reduce the ways tics interfere with your life.
UNDERSTANDING TICS
What Are Tics?
Tics are sudden, repetitive movements or sounds that can be difficult to control. They may include movements such as blinking, facial movements, head or shoulder movements, or more complex body movements, as well as vocalizations such as throat clearing, sniffing, or other sounds.
Some people experience a premonitory urge or uncomfortable sensation before a tic, while others may experience a need for something to feel “just right.”
Tourette Syndrome
Involves at least two motor tics and at least one vocal tic, with symptoms lasting for at least one year and beginning before age 18.
Persistent Tic Disorders
Involve motor tics or vocal tics that have been present for at least one year.
Functional Tic-Like Symptoms
Can look similar to typical tics but may develop and be maintained through different mechanisms.
HOW THERAPY WORKS
The Transformative Path
Therapy is active, collaborative, and individualized. We’ll work together to understand your symptoms, build practical skills, and help you respond differently so that tics have less control over your life.
Understand Your Tics
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We’ll begin by learning what tics are, how they work, and what may be influencing them. As part of CBIT, I’ll provide psychoeducation about tics and help you develop a clearer understanding of your own tic patterns.
Together, we’ll complete a functional assessment to identify what happens before, during, and after a behavior—including premonitory urges, physical sensations, thoughts, emotions, activities, and environmental factors. We’ll also look at whether a behavior is a tic, compulsion, BFRB, sensory response, or functional tic-like symptom. This includes considering overlaps such as Tourettic OCD, where behaviors may be driven by a need to relieve an uncomfortable sensation or achieve a “just right” feeling.
Understanding what’s really happening helps us determine which strategies are most appropriate and creates a treatment plan tailored to you.
Build Skills with CBIT
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Comprehensive Behavioral Intervention for Tics (CBIT) is the primary evidence-based behavioral treatment I use for Tourette syndrome and persistent tic disorders.
CBIT incorporates Habit Reversal Training (HRT), including awareness training and competing responses, along with functional assessment and environmental interventions. I’ll teach you practical strategies for responding to tics differently.
One tic at a time, you’ll learn to recognize your tic patterns, increase awareness of premonitory urges and tics, and practice a competing response that is physically incompatible with the tic.
You’ll develop skills you can use in everyday situations—not just in the therapy office.
Expand Your Treatment with CoPs
I also have training in Cognitive Psychophysiological Treatment (CoPs), a distinct approach that looks at the interaction between thoughts, behaviors, physical sensations, and physiological tension that can contribute to tic activation.
CoPs may be particularly helpful if CBIT hasn’t worked as expected, or as an additional approach when patterns such as anticipation, perfectionism, over-preparation, heightened attention to physical sensations, or unnecessary muscle tension are contributing to tic intensity.
While CBIT focuses on awareness, functional assessment, competing responses, and environmental interventions, CoPs focuses more broadly on the cognitive, behavioral, and physiological processes that can contribute to tic activation. These approaches can be used thoughtfully based on your individual needs.
Respond Differently
I may also integrate Acceptance and Commitment Therapy (ACT) and other evidence-based approaches to address the broader challenges that can accompany tic disorders.
ACT can help you respond differently to uncomfortable sensations, thoughts, and urges without having to eliminate them before moving forward.
You’ll practice responding with greater flexibility and building confidence in your ability to handle urges and discomfort while continuing to participate in the activities that matter to you.
Move Forward
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The goal is to help you or your child feel less controlled by your symptoms and more able to participate fully in your life.
Many of my clients report a significant decrease in their tics by the end of treatment. Clients may also experience greater confidence in their ability to manage urges, less interference from tics, and more freedom to participate in school, work, sports, relationships, and everyday activities.
The skills you develop in therapy are designed to support long-term relief and greater independence in managing tics, so you can continue using what you’ve learned well beyond the therapy office.
WHO I WORK WITH
Support for every age
Therapy is active, collaborative, and individualized. We’ll work together to understand your symptoms, build practical skills, and help you respond differently so that tics have less control over your life.
Tic Therapy for Children & Teens
Tics can be particularly challenging for children and teens. They may worry about being noticed, teased, judged, or singled out at school.
A supportive parent or other support person is often involved in the therapy process to support progress. When CBIT is appropriate, parents and caregivers can also play an important role in supporting practice and progress outside of therapy. Therapy is adapted to your child’s developmental level, personality, and needs. I often incorporate games and other creative ideas to make treatment skills easier to understand and more fun.
The goal is to help children and teens participate more fully in school, friendships, sports, and the activities they enjoy.
Tic Therapy for Adults
You may have lived with tics for many years and developed strategies to hide, suppress, or work around them, or perhaps your tics are newer or went away and came back years later.
CBIT therapy can help you better understand your tic patterns, develop practical strategies for responding to urges, and reduce the ways tics interfere with your work, relationships, activities, and everyday life.
Treatment can also address the thoughts, physical sensations, habits, and patterns that may contribute to tic intensity or make tics more difficult to manage.
TAKE THE FIRST STEP
You Don’t Have to Let Tics Define Your Life.
Tics may be part of your experience, but they don’t have to determine what you do, where you go, or how you live.
At Transformative Path Therapy, you’ll develop a greater understanding of your tics and new ways of responding so you can spend more of your energy doing the things that matter to you.
If you are ready to seek help for yourself or your child or teen’s tics, please click below to schedule your free 15-minute phone consultation for in-person CBIT treatment in Long Beach or online throughout the state of California. Looking forward to connecting!
Common Questions
FAQS
How long is treatment for tics and Tourette?
The length of CBIT varies from person to person depending on the number and type of tics being targeted, motivation, developmental age and awareness, practice between sessions, co-occurring conditions and individual treatment goals. In research studies, CBIT is typically delivered in 8 sessions across roughly 10 weeks. Some people may benefit from fewer sessions, while others may need additional sessions or occasional booster sessions to support and maintain progress. In my experience, with a focused treatment approach, some clients have made meaningful progress in as little as 3–4 sessions.
Because we begin with a thorough assessment and build a treatment plan around your needs, we’ll talk through what to expect during your free consultation and revisit the plan together as we go. Practicing skills between sessions is an important part of treatment.
What is the youngest age for CBIT treatment?
There isn’t one strict age cutoff for CBIT. It is used with school-age children, teens, and adults, and whether it is a good fit depends on a child’s developmental level, tic awareness, motivation, ability to participate in learning and practicing the strategies, and how much the tics are interfering with daily life or bothering your child.
For younger children, a developmentally adapted approach called CBIT-JR may be appropriate, generally for children ages 5–8. CBIT-JR was developed specifically for younger children and incorporates greater parent or caregiver involvement, along with developmentally appropriate games, visuals, and creative activities. Treatment is tailored to the child’s age, abilities, motivation, and needs.
If you’re unsure whether your child can benefit from CBIT, a free consultation is a good place to start.
Do you use the same treatment for functional tics?
Treatment for functional tics is different from traditional CBIT for Tourette syndrome or chronic tic disorders. Some principles of CBIT, such as increasing awareness of triggers, body sensations, and patterns around symptoms, may still be helpful, but the approach is modified to address the factors contributing to and maintaining functional tic symptoms.
Depending on the individual, I may incorporate modified CBIT along with ACT, CBT, and DBT-informed strategies. Treatment may focus on changing responses to sensations and symptoms, building emotional regulation and distress-tolerance skills, reducing avoidance and symptom-focused attention, and helping the nervous system respond more flexibly.