Tic Disorder / CBIT Specialty

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Wellness Solutions, LLC provides specialty care for client with Tic Disorders utilizing Comprehensive Behavioral Intervention for Tics (CBIT). Laura Stark LPC-S NCC is one of a few therapists certified and trained in CBIT treatment. Wellness Solutions, LLC is excited to provide this expertise and specialty to our clients. 

Tourette Syndrome and Tic Disorders

Tic Disorders are neurobiological conditions that are characterized by the existence of a single or multiple involuntary motor movement and/or a single or multiple involuntary vocalization. There are three types of Tic Disorders: Transient Tic Disorder (TTD), Chronic Tic Disorder (CTD), and Tourette Syndrome (TS). TS is the most complex of the three disorders. TS and Tic Disorders were thought to be uncommon conditions; however, research has shown that they are not as rare as once believed. It has been reported that in the United States, approximately 1 in 100 children have a tic disorder and 1 in every 160 children have TS. The age of onset of TS is typically between the ages of 5-7. Tourette affects all races, ethnic groups, and ages, but is 3 to 4 times more common in boys than in girls. 

What causes TS and other Tic Disorders?

Currently, the origin of TS and other Tic Disorders remain uncertain. Studies have shown that the disorders are hereditary, therefore, genetics undoubtedly play a role. Other factors can contribute to these disorders including environmental and developmental influences. At present, TS and Tic Disorders are likely to be affected by complex interactions between genetic and other factors that may vary in different individuals. 

Common Co-Occurrences of Tourette Syndrome**

TS commonly co-occurs with a number of other neurodevelopmental and neuropsychiatric conditions. Studies have shown that some of these conditions may be present before and cause more impairment than the tics themselves. The most common co-occurring conditions include the following:

  • Attention Deficit Hyperactivity Disorder (ADHD) — Problems with concentration, hyperactivity, and impulse control.
  • Obsessive-Compulsive Disorder [or Behaviors] (OCD/OCB) — Repetitive, unwanted or intrusive thoughts and/or repetitive behaviors. There are many types of obsessive thoughts or urges, including excessive concerns about doing something “just right,” as well as intrusive religious, sexual, or aggressive thoughts. These thoughts lead to compulsions, which are unwanted behaviors that the individual feels he/she must perform over and over or in a certain way.
  • Learning difficulties — Difficulties related to reading, writing (dysgraphia), mathematics, Executive Function Challenges, and/or processing information that are not related to general intelligence.
  • Behavior problems — Aggression, rage, oppositional defiance or socially inappropriate acts disinhibition.
  • Anxiety — Excessive worries or fearfulness, including excessive shyness and separation anxiety.
  • Mood problems — Periods of depression or elevated mood that result in a change in behavior or functioning, which may be significantly different from the child’s usual self.
  • Social skills deficits and social functioning — Trouble developing social skills; maintaining social relationships with peers, family members, and other individuals; and acting in an age-appropriate manner.
  • Sleeping problems — Difficulty falling or staying asleep, bedwetting, walking or talking while asleep.

**Referenced from the Tourette Association of America 

What is CBIT?

CBIT (Comprehensive Behavioral Intervention for Tics) is an evidence-based treatment consisting of three essential components:

  • Tic Awareness-training the patient to be more aware of tics
  • Developing Competing Responses-this involves training patients to establish and execute a competing behavior when they feel the urge to tic
  • Making modifications to daily activities that can be helpful in reducing tics

What does CBIT involve?

CBIT is a structured therapy that most often occurs in a therapist’s office on a weekly basis. The treatment typically involves 8 sessions over a 10 week period. However, treatment can be adjusted to be longer or shorter depending on the needs of the patient and their supports during treatment.