Tourette’s Syndrome (TS) is a neurobiological condition that is defined by multiple motor tics and one or more vocal tics. According to DSM IV, a manual of psychiatric conditions, a tic is “a sudden, rapid, recurrent, nonrhythmic, stereotyped motor movement or vocalization.” The onset has to be before the age of eighteen. To make the diagnosis, tics have to have been present for more than one year without a tic-free period lasting more than three months.
CBT involves modifying thoughts and behaviors that contribute to symptoms, problems in functioning, and quality of life. It is one of the most research-supported forms of therapy and has been used effectively to address a wide range of psychological conditions. Applying CBT to Tourette’s Syndrome has become an integral part of the treatment for many patients coping with this complex and challenging condition. CBT can be used in combination with pharmacological or allied medical therapies. It can be tailored for young children or those who have additional psychological or developmental issues.
There are many aspects of CBT that potentially benefit adults and younger individuals with TS. A well-recognized CBT method to treat tics is Habit Reversal Training (HRT) a group of techniques that include awareness training and learning to replace tics with competing movements. Cognitive restructuring is another CBT method that is often used in treating TS. This strategy, as the name implies, involves learning to modify the upsetting or rigid thinking that frequently accompanies TS. Since reducing body tension and overall reactivity is essential for those with tics, relaxation and stress management strategies are important for those with TS to learn as well. CBT strategies are also indicated to address family stress that is related to TS.
There are some factors that help determine whether an individual is a good candidate for CBT. One factor is motivational level. Similar to an exercise program or going on a diet, a high level of motivation greatly increases the chances for success. Another factor is in regard to premonitory sense. Being able to detect the thoughts, sensations, or feelings that occur right before a tic is a positive sign. However, sometimes a person can learn to develop a premonitory sense even if this does not occur naturally. In sum, management of TS can be made less difficult and stressful by consistently practicing effective CBT strategies.