Habit Reversal Therapy for Tourette Disorder

The repetitive behaviors, such as tics, caused by Tourette disorder can sometimes be controlled with behavioral therapy and tend to become less severe over time, particularly as children and teenagers reach adulthood. Experts at the Child Study Center, part of Hassenfeld Children’s Hospital at NYU Langone, offer several types of treatment to ease symptoms if they are a source of stress, cause pain or injury, or interfere with school, work, or the child’s social life.

For mild to moderate Tourette disorder in children and adolescents, habit reversal therapy is usually recommended as the first treatment option. This method works to increase the child’s awareness of the tics and teaches him or her how to use a socially appropriate behavior instead of the tic. For example, instead of a coughing tic, a person may learn to take a deep breath or quietly perform a breathing exercise.

Habit reversal is practiced in outpatient treatment sessions with a psychiatrist or psychologist, focusing on one type of tic at a time. It’s typically completed in eight to 16 weekly sessions.

Children and adolescents with tics may be asked to monitor the frequency of tics and factors that cause them. It helps to keep a log or record of each time the behavior occurs. The log should also include the places and times of day when a tic occurs, so that the child can learn to recognize situations in which the behavior is more likely to happen. Parents or caregivers can assist with record-keeping by helping the child to maintain awareness of tics and by ensuring these are recorded.

Family members also play a role in the habit reversal process. Our psychiatrists and psychologists provide family members with the tools they need to help a child practice these control techniques in different settings. They can also offer tips on how to encourage and support the child throughout therapy.

Other behavioral therapies, such as cognitive behavioral therapy, may also be used to treat the symptoms of conditions associated with Tourette disorder, such as obsessive-compulsive disorder and attention deficit hyperactivity disorder.