Habit Reversal Therapy for Tics , FND, and BFRB
Tics are purposeless, involuntary, and repetitive movements and vocalizations. Common tics include head jerks, blinking, and throat clearing, They are often preceded by a nagging thought or feeling called a premonitory urge that demands a specific rapid action. Tics can be very simple and unnoticeable to others or involve multiple muscle groups and be extremely obvious. Tics can cause great frustration, embarrassment, and physical pain. At times, tics also can make it difficult to communicate with others and complete daily tasks. Excessive attention to the tics from peers and family members often exaceerbates the tics.
Tics initially develop one at a time, perhaps starting with blinking and then months or years later involving a neck movement or shoulder shrug or other movements or sounds. Some people just have motor (movement) tics and some people just have vocal (sound) tics. The frequency and intensity varies from person to person, day to day, and over periods of time. Provisional Tic Disorder is common in young children and is defined as motor or vocal tics occurring for less than one year. After one year of motor or vocal tics, neurologists tend to make a diagnosis of Chronic Tic Disorder. People with both motor and vocal tics lasting for more than one year are typically diagnosed with Tourette Syndrome, aka Tourette's, Tourette Disorder, or TS. Many people who have Tourette's also have concerns related to anxiety, depression, Autism, OCD, ADHD, gender dysphoria, handwriting, and executive functioning. Some people with Tourette's also have Body Focussed Repetitive Behaviors (BFRB) such as skin picking or biting and hair pulling (trichotillomania).
People with tics also are known to be very bright and empathetic and to have amazing skills in areas including math, music, art, science, sports, medicine, and education. In fact, people with tics are often very driven to succeed and live highly productive and meaningful lives.
CBIT is the leading intervention strategy for Tic Disorders and Tourette's. CBIT is provided by licensed and certified health professionals with extensive training in physical dysfunction, and mental health support. With CBIT Therapy our services include the following components:
Many children and adults are able to quickly reduce the intensity and frequency of their tics by practicing CBIT therapy strategies. Progress is dependent on motivation to manage tics, tic severity, and family support. Click here for a brief video about how CBIT helps to manage tics.
Warning:
This video is about Tourette Syndrome and viewing it may trigger tics in some people.
Neurology Clinic, University Campus
55 Lake Avenue North
Worcester, MA 01655
Tel: 508-334-2527
Marisela Dy-Hollins, E., M.D.
Wang Ambulatory Care Center
15 Parkman Street, 7th Floor, Room 720
Boston, MA 02114
Tel: 617-724-9234
Kinga Tomczak, MD, PhD
Attending Physician in Neurology
Director, Tic Disorders and Tourette Syndrome Program
Department of Neurology
Boston Children’s Hospital
Harvard Medical School
Tel: 781-216-2525 (Waltham) 617-355-2063 (Boston)
University of Vermont
2 Colchester Avenue
Burlington, Vermont 05405
Tel: 802-656-2661
Christy Stine MD, PhD
Pediatric Neurology
33 Lyman St, Ste 400
Westborough, MA 01581
Tel: 508-898-0055
Fax: 508-898-0035
Explaining CBIT, tics, and Tourette Syndrome to a child and their friends is easier with the help of a social story.
Educate others about tics and Tourette Syndrome in a quick and effective way. Prepare an elevator pitch, email, text, or put your message on a business card. You can also click here for the TAA "I have TS" card.
Join with others who have Tourette Syndrome and other tic disorders to make connections and new friends. Learn about CBIT, camps, social events and more resources on tics. Click here to contact a local chapter in Boston and other cities across America.
Practical strategies and accommodations are help for students with Tourette Syndrome and tics of all kinds to thrive in school settings. Learn more by contacting CBIT Therapy or the Tourette Association of America.
Know your rights. Reach out to the Job Accommodation Network (JAN) for free and confidential guidance on how to manage Tourette Syndrome and other conditions related related to tics while on the job and when seeking new work. Your skills are needed and valuable.
Our name says it all. We specialize in CBIT therapy and are passionate about supporting our patients and their families so that they can better manage Tourette Syndrome and other conditions related to tics. Services are provided by a licensed occupational therapist certified in CBIT.
Some people with Tourette Syndrome experience blocking phenomena, which is an inability to move. Patients tend to get stuck in awkward and painful positions that can be highly debilitating.
Although some people with Tourette Syndrome experience brief times when their bodies are locked in awkward and debilitating positions, prolonged and highly agonizing periods of immobility also occur in some patients. Despite how emotionally and physically disabling this experience can be, research on the cause and treatment is highly limited.
Blocking is thought to be related to tics, OCB/OCD or a Functional Neurological Disorder. People who suffer from blocking may also have more than one of these conditions.
CBIT Therapy is developing strategies to prevent and interrupt freezing postures caused by blocking phenomena. Above all it is important to keep the patient safe. At times this may involve helping them to the floor so they do not fall. Tensing muscles more may help to release the body. Practicing tensing and relaxing during stable times is important. Slowly gazing up and down when the rest of the muscles are stuck may also be useful to break the grip.
The most effective strategy for blocking seems to be managing preceding tics with CBIT.
Please contact us for more information about blocking phenomena, Tourette Syndrome, and tics.
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