Habit reversal for Tourette's disorder

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.

For habit reversal to be effective, your child must be motivated to control his or her tics. Do not assume that because you are bothered by the tics that your child is. If the tics don't bother your child, habit reversal is not appropriate.

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.

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, your child will need to practice daily at home and write about his or her progress. Set up a time and place to perform habit reversal. Your child will not be able to monitor his or her tics throughout the entire day. Your child needs praise and support to stay with the training. He or she may need help practicing in public places. Relaxation techniques may also help your child succeed with HRT.

Although many children and teens will notice a decrease in their tics within a couple of days, 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.