Tic Disorders and Tourette’s Syndrome Therapy in Saratoga/San Jose

At the Cognitive Behavior Therapy Center of Silicon Valley in Saratoga/San Jose, we offer cognitive behavior therapy (CBT) for children, teens and adults with tic disorders and tourette syndrome. Our approach is practical, goal-oriented, compassionate, and scientifically-based while focusing on your individual needs. We are located in Saratoga on the border of San Jose and Saratoga just 1/2 mile from Hwy 85 and serve the Silicon Valley communities of San Jose, Saratoga, Mountain View, Santa Clara, Sunnyvale, Los Gatos, Monte Sereno, Palo Alto, Los Altos, Cupertino, Campbell.

What is a Tic Disorder/Tourette Syndrome?

Tic Disorders and Tourette Syndrome are neurological disorders associated with motor or vocal tics that can be embarrassing and disruptive. A tic is a sudden, rapid, recurrent, nonrhythmic, stereotyped motor movement or vocalization. Tics typically begin in childhood, peak in early adolescence and often decrease by adulthood. For some adults, the tics persist and cause substantial impairment.

Tourette Syndrome is defined as both multiple motor and vocal tics while a Tic Disorder involves motor or vocal tics but not both. For tic disorders and tourette syndrome, the tics may occur many times a day (usually in bouts), nearly every day or intermittently throughout a period of more than one year, and during this period there was never a tic-free period of more than 3 consecutive months.

The first symptoms usually are involuntary movements (tics) of the face, arms, limbs or trunk. These tics are frequent, repetitive and rapid. The most common first symptom is a facial tic (eye blink, nose twitch, grimace), and is replaced or added to by other tics of the neck, trunk, and limbs. Verbal tics (vocalizations) usually occur with the movements. Verbal tics may include grunting, throat clearing, shouting and barking. Despite widespread publicity, the involuntary use of obscene or socially inappropriate words is uncommon with tic disorders.

The term “involuntary” can be confusing since most people with tics do have some control over their symptoms. Many individuals with tic disorders describe an unwanted urge or sensation prior to the tic that is relieved only by performing the tic. Typically, tics increase as a result of tension or stress, and decrease with relaxation or when focusing on an absorbing task. It is common for people with tic disorders to have co-occurring conditions, particularly attention-deficit/hyperactivity disorder (ADHD) and obsessive compulsive disorder (OCD).

Symptoms of Tic Disorders/Tourette Syndrome

Tics may vary in type, frequency and severity; worsen if you’re ill, stressed, anxious, tired or excited; occur during sleep; and may evolve into different tics over time. The types and variety of tics are diverse, and there’s no typical case. While tics may be involuntary, many people experience premonitory urges before the tic comes. Other symptoms such as touching, repetitive thoughts and movements and compulsions can occur. Tics are classified as either:

  • Simple tics: sudden, brief and repetitive, involving a limited number of muscle groups
  • Complex tics: distinct, coordinated patterns of movements that involve several muscle groups

Common motor and vocal tics include:

  • Motor tics: eye blinking, touching the nose, head jerking, touching other people, shoulder shrugging, smelling objects, eye darting, obscene gesturing, finger flexing, flapping the arms, sticking the tongue out, or hopping.
  • Vocal tics: hiccuping, using different tones of voice, yelling, repeating one’s own words or phrases, throat clearing, repeating others’ words or phrases, barking, or using vulgar, obscene or swear words.

Cognitive Behavioral Model of Tic Disorders/Tourette Disorder

Tic disorders and tourette syndrome are neurological disorders. Current research indicates that tic disorders may result from the abnormal activity of the brain chemical called dopamine. Other neurotransmitters, such as serotonin, may be involved as well. Recent research shows that behavior therapy can help children and adults learn to tolerate their urges and suppress their tics without rebound effects. In the CBT model, the goal is to increase awareness of premonitory urges so the person with tics can gain some feeling of control by  learning to tolerate the discomfort of urges without having to give into the urge as well as learning competing responses to the tic. In addition, managing environmental contingencies and stressors can help reduce the frequency of tics.

Cognitive Behavior Treatment of Tic Disorders/Tourette Syndrome in San Jose

The two primary evidence-based treatments for tic disorders are Habit Reversal and Comprehensive Behavioral Intervention for Tics (CBIT).

    • Habit Reversal: Habit reversal has two main parts: awareness training and competing response training. In the awareness training part, you will learn to identify each tic out loud. In the competing response part, you will learn to do a new behavior that cannot happen at the same time as the tic. For example, if you have a tic that involves touching a body part such as head rubbing, a new behavior might be to place your hands on your knees, or to cross your arms so that the tic cannot take place.
    • Comprehensive Behavioral Intervention for Tics (CBIT): CBIT teaches children and adults new ways to manage the urge to tic. CBIT includes habit reversal in addition to other strategies, including education about tics and relaxation techniques. In CBIT, your therapist will work with you to better understand the types of tics you are having and to understand the situations in which the tics are at their worst. If you are seeking treatment for your child, we will include you (the parent) in the treatment to support your child.

CBIT is based on the following principles:

  • Change the situation: We’ll teach you to be aware of the situations where tics are better or worse. We will develop strategies to change the situation or influence the environment to reduce tics.
  • Observe the urge/tic: We will teach you how to break the tic down into each step. You may have an urge before the tic starts, so we will teach you to watch each step of the urge/tic.
  • Tolerate the urge: We will teach you ways to resist the urge by learning to tolerate the discomfort and stop or delay doing the tic. You will learn relaxation skills and other behavioral responses to resist the urges and tics.
  • Change the tics: We will make up and practice “competing responses” (a movement that is the opposite of the tic). For example, when you feel your hand coming up to engage in a tic, you would push it down. When the tics occur, you’ll remind yourself to do the competing responses that you developed in therapy.
How to Get Help for Tics Disorders/Tourette Syndrome in San Jose

You and/or your child can get better by learning behavioral skills to manage tics. The skills can be learned with practice, with the help of an experienced therapist, and with the support and encouragement of those close to you or your child. At the Cognitive Behavior Therapy Center of Silicon Valley, we provide evidence-based treatments for Tic Disorders and Tourette Syndrome.

We are located in Saratoga on the border of San Jose and Saratoga just 1/2 mile from Highway 85. With our convenient location near highway 85, we serve the Silicon Valley communities of San Jose, Saratoga, Mountain View, Santa Clara, Sunnyvale, Los Gatos, Los Altos, Cupertino and Campbell, CA. Contact us at (408) 384-8404 for more information on how we can help you and/or your child learn to manage tics.

Serving the Silicon Valley communities of San Jose, Saratoga, Los Gatos, Monte Sereno, Cupertino, Campbell, Mountain View, Los Altos, Sunnyvale and Santa Clara, CA

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