Tic management Group or Individual  Treatment Fact Sheet

Sometimes people just want to be able to stop better – they want their brakes to work like everyone else’s do! In this service we provide evidence-based treatment for tics (Tourette Syndrome or diagnosed Tic Disorder) called Comprehensive Behavioural Intervention for Tics (CBIT)

Who is this service for?

  • Children and adolescents feeling distressed or impaired by tic symptoms
  • Those looking for an alternative or enhancement to pharmaceutical treatment of tic symptoms
  • Symptoms Targeted For Treatment:
    • tics (what we call, “leaky brakes over movements and sounds”) & the premonitory urges that cause them

How this service can help to, "Empty your beaker":

  • “Full Beakers” are how we describe feelings of being overloaded with too many pressures, demands or stresses unique to having leaky brakes. When a beaker overflows this can take the form of unmanageable anxiety, tearful “meltdowns”, or rage.
  • Tics that are embarrassing, inconvenient, disruptive, or painful are beaker-fillers. Fighting to ‘hold in’ these tics, or dealing with the reactions of others to these tics, also contributes to a full beaker.
  • Learning to manage, decrease, and eliminate bothersome tic symptoms can decrease beaker levels by decreasing negative reactions to, or negative consequences of, tics.
  • Evidence suggests that treatment responders also enjoy decreased anxiety, disruptive behaviours, and family strain, as well as improved social functioning six months post- treatment (Woods et al., 2011).

What happens in this service?

  • Through various “T(r)IC(k)S” (relaxation techniques, competing responses, symptom analysis, symptom negotiation, social support), clients are able to choose the tic symptoms most bothersome to themselves and decide whether they wish to decrease these symptoms, change them, or eliminate them altogether. Various ‘tic-talks’, occurring spontaneously throughout the sessions, serve to also make this service an educational, validating, and fun experience for clients who perhaps used to feel very isolated and alone in their struggles.

Where is the service held?

  • CPRI campus (Crombie Building; check in at switchboard and go to waiting room) or via video-conferencing using a local Ontario Telemedicine Network (OTN) site.
  • For families travelling long distances, ‘virtual’ options (e.g. participating via teleconference or webcam) can be explored.

Who will participate in this service?

  • Brake Shop Club Members & Caregivers
  • With the caregiver consent and client agreement, significant others invested in supporting the client (e.g. a sibling, a grandparent, school staff, a residential worker) are welcome to attend.

What if I decline this service?

  • Various ‘how-to’ guides and tic management workbooks are available for loan in the Family Resource Centre
  • Various medications may also be tried to manage tic symptoms
  • Left untreated, tic symptoms generally decrease (but don’t disappear) into adulthood
  • Families on the wait-list for facility treatment will be transferred to the home (virtual) treatment option if facility treatment service is offered and declined on three occasions. The hope is that a virtual treatment delivery approach will be a better 'fit' for families with long-term barriers to facility treatment, and ensures that these families still receive the service they’ve been referred for and have indicated is an important need.

What are the requirements to be in this service?

  • Diagnosis of a tic disorder; significant problems with tic symptoms
  • At least one tic symptom is distressing to the client, and at least some insight into these symptoms exists
  • ‘problems’ with tic symptoms at least in part related to symptom presentation itself (e.g. difficulty reading, headaches, scratched corneas, muscle pain, self-injurious behaviour) and not solely due to people’s reactions to tics or an individual’s acceptance of tics
  • A high motivation on the part of the client to change at least one tic symptom
  • Client can commit to scheduling specific times for practicing assignments each week
  • Overall cognitive functioning within the broad range of Average (IQ score > 80)
  • A mental age of at least eight years (wait times will be extended until this criterion is met)
  • Guardians can commit to attend all sessions, to support the client in treatment, and to read/watch various educational materials provided
  • Client & family/guardians are prepared for a possible brief, initial increase in tics, and to discuss tic symptoms in a confidential format
  • Any ADHD symptomatology already treated

*Medications are to remain stable for the duration of treatment. If this creates a problem, please notify the Tic Management Treatment Clinician to discuss.

Referrals to all Brake Shop treatment services are requested & arranged through your Brake Shop Case Coordinator.

For more information on tics or tic management please visit the Frequently Asked Questions section of our website.

Important Telephone Numbers: