Cognitive Behavioral Intervention for Tics (CBIT)

Tourette syndrome is a neurological condition beginning in childhood where people have tics that change over time. Tics are a kind of repeating movement. 

What Is Cognitive Behavioral Intervention for Tics (CBIT)?

CBIT is an established therapy that teaches people to change their behavior over time and tic less. Research on CBIT has been done with children and adults with Tourette syndrome.  

CBIT is based on three simple observations about tics:

  1. Tics can get better and worse on their own.  
  2. Tics are often done in response to a feeling or an urge.
  3. Tics can often be stopped, at least for a short time.

For CBIT to be successful, the child or adult has to be willing to: 

  • Work with a therapist
  • Do homework
  • Attend therapy training sessions

CBIT is based on these simple actions, which teach people to tic less: 


What To Do


Change the situation

Try to be aware of the situations where tics are better / worse.

Change the situation to reduce tics.

Watch the tic

Break the tic down into each step. You may have an urge inside before the tic starts, so watch for that.

Watch each step of your tic and know the steps of the urge / tic.

Refuse to give in to the urge / tic

Talk about the steps to fight back against the urge / tic and to put off doing the urge / tic.

Try to relax and fight back the urge and put off doing the tic.

Change the bad tics

Make up and practice “Competing Responses” (a movement that is the reverse of the tic). For example, in place of your hand coming up, you would push it down.

When the tics occur, try to remember to do the competing responses that you made up in therapy. 

Any person who has had the right training can do CBIT. This may be a doctor, nurse or psychologist / counselor. The number of visits may be different with each person.

The Tourette syndrome program at Cincinnati Children’s offers CBIT. The doctor or nurse seeing your child will be able to help decide if this treatment is right for your child.

Call the Movement Disorder Clinic in the Division of Neurology at 513-636-4222, option 1.

  • If you have never been seen at Cincinnati Children’s for tics: Ask for a new patient appointment in the Movement Disorder Clinic with a doctor. The child / adult would need to be seen in clinic first for an exam so that we can decide if CBIT would be helpful.
  • If you are a current patient at Cincinnati Children’s: Call 513-636-4222, option 3, and ask for Libby Cox, RN, or Sheila Perry, RN, or email:
  • Visit the National Tourette Syndrome Association website
  • Managing Tourette Syndrome: A Behavioral Intervention Workbook, Parent Workbook. Douglas W. Woods, John Piacentini, Susanna Chang, Thilo Deckersbach, Golda Ginsburg, Alan Peterson, Lawrence D. Scahill, John T. Walkup and Sabine Wilhelm. Oxford University Press.
  • Nix Your Tics! Eliminate Unwanted Tic Symptoms: A How-To Guide For Young People. B. Duncan McKinley, PhD. Life’s A Twitch!® Publishing.

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