Treatment for Tourette Disorder

Tourette Disorder (TD) is a neurological condition characterized by sudden, repetitive movement or vocalizations that can be hard to control. Tics involving involve movement are called motor tics. Tics involving sounds are called vocal tics. Tics can be either simple or complex. While tics typically emerge in childhood and may fluctuate in severity, they often become less noticeable or diminish in adolescence and adulthood. However, in some cases, the symptoms can persist into adulthood, affecting social, academic, and emotional well-being.

Dr. Bastien has been trained in the gold-standard treatment for Tourette and other tic disorders, and takes a comprehensive, individualized approach to treating Tourette Disorder. Her goal is to help children and adolescents manage their tics in a way that minimizes disruption to daily life and promotes overall well-being.

1. Comprehensive Evaluation

The first step in treatment is a thorough evaluation, including an in-depth history of your child’s symptoms, family background, and any co-occurring conditions (such as ADHD, OCD, or anxiety). This allows us to develop a personalized treatment plan based on the specific needs of your child or adolescent.

2. Behavioral Therapy

Behavioral interventions can be highly effective in managing tics, especially for children and teens who are dealing with more visible or disruptive symptoms. Comprehensive Behavioral Intervention for Tics (CBIT) is an evidence-based therapy designed to help children, adolescents, and adults manage tics associated with Tourette Disorder and other tic disorders. CBIT has been proven to significantly reduce tic frequency and severity, while also enhancing overall quality of life.

CBIT is a structured, goal-oriented therapy that combines several key components to help individuals gain greater control over their tics. The treatment is typically delivered in a series of weekly sessions and is designed to be used in everyday settings, allowing patients to apply what they’ve learned in real-world situations.

The core components of CBIT include:

  1. Habit Reversal Training (HRT):
    Habit Reversal Training is the central technique of CBIT. It helps individuals become more aware of the sensations or "urges" that occur before a tic. Through HRT, individuals learn to recognize these urges and replace the tic with a more neutral or socially acceptable movement or action. Over time, this can significantly reduce the frequency and intensity of tics.

  2. Relaxation Training:
    Stress and anxiety can often trigger or worsen tics. Relaxation techniques, such as deep breathing and progressive muscle relaxation, help individuals reduce stress and improve emotional regulation, which can lead to fewer tic episodes. These skills are taught and practiced during therapy sessions and can be used throughout the day to manage tic-related anxiety.

  3. Exposure and Response Prevention (ERP):
    ERP helps individuals gradually confront situations that may trigger tics, without engaging in the tic behavior. This component builds tolerance and reduces the compulsive need to tic in certain situations, particularly those that cause anxiety or self-consciousness.

  4. Parent and Family Involvement:
    Since tics often occur in various settings, including at home and school, involving parents or caregivers is an essential part of CBIT. Dr. Bastien guides parents on how to support their child’s progress, manage tics at home, and encourage positive behavior.

Benefits of CBIT

  • Reduction in Tic Severity:
    Studies have shown that CBIT can significantly decrease the frequency and intensity of tics, making daily life more manageable.

  • Improved Emotional Well-Being:
    By gaining control over tics, individuals often experience reduced frustration, anxiety, and self-consciousness. This leads to improved self-esteem and greater overall emotional health.

  • Enhanced Social Functioning:
    As tics become less noticeable and less disruptive, children and teens often experience fewer social challenges, leading to stronger peer relationships and better social integration.

  • Long-Term Effectiveness:
    The skills learned through CBIT can be used long-term, allowing individuals to continue managing tics even after therapy ends. Many individuals maintain improvements over time.

What to Expect in a CBIT Session

Each CBIT session is 60 minutes and conducted weekly. During the session, Dr. Bastien will work with your child to identify tic patterns, trigger situations, and emotional responses. She will then guide your child through the process of developing alternative behaviors, practicing relaxation techniques, and building awareness of tic urges.

Progress is tracked throughout the course of treatment, and therapy is adapted to address the specific challenges and successes that arise. Families are encouraged to attend sessions, as their support is integral to success.

3. Supportive Interventions

Children and adolescents with Tourette Disorder often benefit from additional support to address social and emotional challenges. These may include:

  • Psychoeducation: Helping both the child and their family understand Tourette Disorder, its symptoms, and its course can reduce feelings of confusion or frustration. Knowledge can be empowering, and we provide resources to support this.

  • Social Skills Training: Some children with TD may face challenges in social situations. Social skills training can help improve peer relationships and reduce bullying or social isolation.

  • Parent Training and Support: Parents play a vital role in managing tics. We provide guidance on how to best support your child and promote coping strategies at home and school.

4. Collaborative Care

We work closely with schools, teachers, and other professionals involved in the child’s life to ensure a holistic and supportive approach. This includes providing guidance on accommodations or modifications that may be needed in educational settings, helping your child navigate social challenges, and addressing any academic difficulties that may arise as a result of tics.

5. Long-Term Management

Tourette Disorder is a lifelong condition for many individuals, but with appropriate treatment and support, children and adolescents can lead fulfilling lives. Regular follow-up visits help us track progress and make any necessary adjustments to the treatment plan as your child grows and their needs evolve.

Contact Us

If you are concerned about your child’s tics or suspect they may have Tourette Disorder, don’t hesitate to reach out. Dr. Bastien is here to guide you and your child through the process of diagnosis and treatment, offering compassionate care tailored to your family’s unique needs.

For more information or to schedule an appointment, contact us.