Tourette's Disorder: Habit Reversal Training

Topic Overview

Habit reversal is a promising behavioral therapy to help reduce tics. Habit reversal training (HRT) is a behavior therapy that has helped people who have hair pulling (trichotillomania), nail-biting, thumb-sucking, and tics associated with Tourette's disorder.

As with most therapies, it's helpful if your child agrees to treatment. Ask your child if he or she wants help to manage tics. This is a good, first step in letting your child feel that he or she has a part in treatment.

With your help, HRT may help your child:

• Notice the signs that a tic is starting.
• Become more aware of the settings in which tics are most likely to occur.
• Prevent tics.
• Do things in place of a tic. For example, instead of doing an eye blink tic, your child may learn to gently close his or her eyelids and hold them closed for several seconds.
• Learn relaxation techniques to manage stress, which if not managed, may make tics worse.

Families learn HRT from a qualified health professional who has experience with Tourette's disorder and the therapy. Do not use habit reversal training without proper guidance.

After you and your child learn what to do, you and your child will practice the techniques and responses daily at home and write about his or her progress. Set up a time and place to do habit reversal. Your child will not be able to monitor his or her tics throughout the entire day. Help your child practice in public places, if needed. Your child needs praise and support to keep doing the training. It's important to praise your child when he or she uses the treatment techniques. This way, your child receives praise for doing something he or she can control (using treatment techniques) rather than not doing something he or she cannot control (ticing). Relaxation techniques may also help your child succeed with HRT.

Many children and teens will notice a decrease in their tics within a couple of days. But the greatest change from using these habit reversal procedures occurs during the second and third month. Don't give up after only a couple of days or weeks.