Tic disorder myths seem to pop up everywhere, but how much of what you’ve heard is true? Misconceptions about tics and so-called natural remedies can make understanding what’s happening more difficult. Ready to separate fact from fiction and get the real story?
Key Takeaways
CBIT (Comprehensive Behavioral Intervention for Tics) is an evidence-based, non-pharmaceutical therapy endorsed by the Tourette Association of America that combines awareness training, competing responses, and lifestyle modifications.
While CBIT teaches techniques to manage tics, it often fails to address underlying root causes such as gut dysfunction, food sensitivities, nutrient deficiencies, and immune system dysregulation.
Dr. Piper Gibson’s functional approach goes beyond behavioral interventions by using comprehensive testing to identify physiological triggers contributing to tic disorders.
Many children struggle with CBIT exercises because their nervous systems are inflamed or dysregulated, making it difficult for behavioral techniques alone to be effective.
A combined approach that addresses physiological root causes and behavioral strategies often yields better results than either method alone.
Parents can take action by identifying triggers, supporting gut health, regulating the nervous system, and seeking comprehensive testing to address the underlying causes of their child’s tics.
Table of Contents
We share the frustration and concern of seeing your child experience tics. It is hard to watch a child deal with something like that. We get it. We also understand that, at times, conventional medicine doesn’t have the answers you’re looking for. What you’re left with can feel like a hodgepodge of potential solutions (many of which seem woefully under-researched or too impractical to work) or nothing at all. CBIT therapy is researched and has been proven effective in helping children manage and even reduce the number of tics they experience.
How Does CBIT Work?
CBIT works through a three-part strategy that helps children gain control over their tics instead of trying to suppress them. Think of it as teaching your child to become the conductor of their symphony rather than being overwhelmed by unexpected sounds and movements.
CBIT (Comprehensive Behavioral Intervention for Tics) helps children manage tics through three key steps:
Awareness Training: Children learn to notice the subtle sensations or urges that happen before a tic, like throat tingling before vocal tics or shoulder tension before motor tics.
Competing Responses: Once they recognize the urge, children are taught to perform an opposite movement to prevent the tic. For instance, they are trained to gently tense neck muscles in the opposite direction of a head-jerking tic.
Lifestyle Adjustments: Families identify and reduce triggers, such as stress, fatigue, or sugar. Simple changes like a steady bedtime routine can significantly decrease tics.
CBIT goes beyond traditional techniques like Habit Reversal Training by addressing environmental factors, making it a holistic approach. Parents are key to its success, helping kids notice patterns, practice strategies, and create a supportive home environment. Some parents even make it fun, like turning practice into a game. CBIT equips children with long-term, side-effect-free tools to manage tics, empowering kids and their families.
Why CBIT Therapy for Tics Often Falls Short
Even though it is being promoted as a leading intervention for tic disorders, CBIT (Comprehensive Behavioral Intervention for Tics) therapy doesn’t consistently deliver the promised results for many families.
Misconceptions About CBIT
CBIT is frequently presented as the holy grail for tic disorders—a behavioral therapy that can rewire your child’s brain and make their tics disappear. The Tourette Association of America endorses it as a first-line treatment for tics, and significant research facilities promote it heavily. Yet many parents work diligently through CBIT exercises with their children, only to see minimal improvements.
The truth is, CBIT isn’t an aid-all. While it’s been demonstrated as effective in clinical trials and shows durability of benefit over time, these studies don’t tell the whole story. CBIT teaches awareness of tics and competing responses, but it doesn’t address why the tics are happening in the first place. Parents often come away frustrated after investing significant time and emotional energy into a therapy that’s supposed to work but doesn’t deliver the expected results for their child.
Ignoring the Root Causes
The most significant limitation of CBIT is that it treats signs while completely overlooking underlying causes. Tics aren’t simply neurological habits that need behavioral correction—they’re often signs of deeper imbalances in the body. What CBIT doesn’t address:
Gut dysfunction that affects brain health
Food sensitivities that trigger inflammatory responses
Nutrient deficiencies impacting neurological function
Immune system dysregulation contributing to neuroinflammation
When a child’s nervous system is inflamed, deregulated, and exhausted, no behavioral exercises will fully resolve their tics. It’s like trying to repair a car’s exterior while ignoring the malfunctioning engine underneath. The nervous system is simply trying to survive, not optimize behavior.
This explains why many children struggle with CBIT exercises and become frustrated during the process. Their brains aren’t in a state where they can effectively carry out the competing responses that CBIT teaches. Without addressing these foundational issues first, CBIT therapy often falls short of providing the relief families desperately seek.
Dr. Piper Gibson’s Approach
A Functional Approach to Tics
While CBIT therapy focuses primarily on behavioral interventions, Dr. Gibson’s method digs deeper into the physiological factors contributing to tic disorders. Her functional approach centers on comprehensive testing that examines often-overlooked areas: gut health analysis, genetic testing, and toxin screenings. These assessments frequently reveal underlying imbalances that standard medical evaluations miss entirely.
The foundation of Dr. Gibson’s methodology recognizes that tics often signal deeper physiological issues. By running specialized labs, she identifies specific triggers such as food sensitivities, nutrient deficiencies, gut dysfunction, and immune system irregularities that can exacerbate tic signs. This investigative process helps parents understand why their child’s body is manifesting tics in the first place.
Instead of teaching children to redirect or mask their tics, Dr. Gibson’s approach focuses on improving the body from within. Children create the biological environment necessary for improvement and reduction by addressing these foundational health issues. This comprehensive method often succeeds where other interventions have fallen short because it targets the underlying causes rather than just managing signs.
Real Results: A CBIT Therapist’s Story
When CBIT Therapy for Tics Failed
Even experts sometimes face challenges with established treatments. In an illuminating case, a mother who worked as a professional CBIT therapist was perplexed when her child developed tics. Even though months of diligent implementation of CBIT techniques—the very strategies she successfully used with her patients—her child showed virtually no improvement. This was particularly frustrating because, as a trained CBIT therapist, she applied the protocol exactly as designed, yet couldn’t understand why the therapy wasn’t producing results for her child.
The mother’s professional background made this lack of progress especially disheartening. She repeatedly questioned, “What is going on? Why isn’t this working for us?“ Her experience highlighted a vital reality: behavioral approaches sometimes fail to address deeper physiological factors driving tic behaviors. Even though she had expertise and consistently applied CBIT techniques, something fundamental was missing from the assistance approach.
Success with a Functional Approach
The breakthrough came when comprehensive testing revealed the underlying issues: her son had significant bacterial overgrowth in his gut, sensitivities to gluten and dairy, and genetic mutations affecting his detoxification pathways. These biological factors were creating an environment where behavioral therapy couldn’t gain traction—his body and brain weren’t physiologically ready to respond to CBIT techniques.
After implementing targeted protocols to address these root causes, something remarkable happened. The family began removing trigger foods from his diet, supporting gut health, and addressing the genetic detoxification challenges. As these foundational health issues improved, CBIT therapy finally started working effectively. The competing response techniques and awareness training began making a difference because his nervous system was no longer in constant inflammation and irritation.
What’s particularly noteworthy is that once these underlying physiological factors were addressed, many families report that the need for intensive behavioral therapy diminishes significantly. As the mother herself observed after experiencing success with this comprehensive approach, “You don’t need the CBIT because you can get everything back on track without having to worry about the tics.“ This case powerfully demonstrates that pairing functional improvement approaches with brain-based strategies often delivers results where either approach might fall short.
Take Action: Move Beyond CBIT Therapy for Tics
When traditional approaches fall short, it’s time to explore comprehensive solutions that address the root causes of tic disorders rather than just managing signs.
Key Insights for Parents
If CBIT therapy hasn’t worked for your child, don’t lose hope. This doesn’t mean your child is broken or that you’ve failed as a parent—it simply indicates deeper issues that need addressing. Many children with tic disorders struggle to respond to behavioral therapy because their bodies are fighting an internal battle that behavior modification alone can’t fix.
The key insight many parents miss is that you can’t outbehave inflammation. When a child’s body is caught in a cycle of inflammation or stuck in fight-or-flight mode, the most diligent practice of competing responses won’t produce lasting results. Real, sustainable change begins when you address these foundational issues:
Gut health imbalances that can trigger neurological signs
Chronic inflammation that affects brain function and nervous system regulation
Nutritional deficiencies that impair the body’s natural improvement processes
Nervous system dysregulation that keeps the body in stress mode
By calming the inflammatory fire and supporting gut health, you create an environment where the nervous system can finally rebalance. This is when the real improvement begins—not just indicator management, but addressing the underlying causes that fuel the tics.
Next Steps
Ready to move beyond behavioral approaches alone? Here are practical steps to take today:
Connect with others on the same journey. You’re not alone in this struggle. Thousands of parents worldwide are seeking alternatives when CBIT and traditional treatments don’t deliver. Finding a supportive community can provide both emotional support and practical wisdom.
Learn to identify triggers. Keep a detailed food and environment journal to track what makes tics worse. Common triggers include food additives, environmental toxins, stressful situations, and sleep disruptions.
Focus on gut health. The gut-brain connection is powerful in tic disorders. Introducing probiotic-rich foods, removing potential inflammatory foods, and supporting digestive health can significantly affect tic frequency and intensity.
Support nervous system regulation. Simple daily practices like deep breathing exercises, regular physical activity, consistent sleep schedules, and reducing screen time can help balance the nervous system and minimize tic triggers.
Consider comprehensive testing. Work with a tic disorder expert who understands the connection between body systems and tic disorders. Testing for food sensitivities, nutrient deficiencies, gut dysbiosis, and immune dysfunction can reveal important information that standard medical evaluations might miss.
Remember, improvement is rarely linear. Some days will be better, but with a consistent, holistic approach addressing the root causes, many families see significant improvements in tics and overall well-being. Taking these steps now can set your child on a path toward natural improvement beyond what behavioral therapy alone can achieve.
Frequently Asked Questions
CBIT is an evidence-based therapy for managing tic disorders, including Tourette Syndrome. It consists of three main components: awareness training (helping children recognize premonitory urges), developing competing responses (physical movements that prevent tics), and making lifestyle adjustments to reduce triggers. The Tourette Association of America endorses CBIT as a non-pharmaceutical approach to tic management.
Studies show CBIT helps approximately 40-87% of patients manage their tics better, with many maintaining improvements six months after treatment. However, effectiveness varies significantly between individuals. CBIT is not a cure but a management strategy that teaches skills to reduce tic frequency and severity. Results depend on consistent practice and the absence of underlying physiological issues that may hinder progress.
CBIT may be ineffective when the underlying root causes aren’t addressed. Many children with tic disorders have physiological issues like gut dysfunction, food sensitivities, nutrient deficiencies, or immune system dysregulation. These foundational problems can prevent children from successfully implementing CBIT techniques, no matter how diligently they practice. Addressing these biological factors often improves CBIT‘s effectiveness.
Gut health significantly impacts tic disorders through the gut-brain connection. Research shows that many children with tics have gut inflammation, dysbiosis, or food sensitivities contributing to neurological symptoms. These gut issues can increase inflammation throughout the body, including the brain, potentially triggering or worsening tics. Addressing gut health is often a crucial step in comprehensive tic management.
Dr. Gibson’s approach focuses on identifying and treating the root causes of tics rather than just managing symptoms. She employs comprehensive testing to uncover underlying issues like gut dysfunction, nutritional deficiencies, and environmental triggers that conventional treatments often miss. By addressing these foundational health factors, her methodology creates an environment where the body can heal, potentially reducing tics more effectively than behavioral interventions alone.
Yes, dietary modifications can significantly impact tic severity in many children. Removing inflammatory foods, particularly gluten, dairy, and artificial additives, often reduces tic frequency and intensity. Food sensitivities can trigger inflammation that affects the nervous system and worsens tics. An anti-inflammatory, nutrient-dense diet supports proper brain function and may complement other treatments like CBIT by creating a physiological environment more conducive to tic reduction.
If CBIT isn’t effective, consider comprehensive functional testing, including: stool analysis to evaluate gut microbiome health; food sensitivity testing; nutritional panels to identify deficiencies; organic acid testing to assess metabolic function; and environmental toxin screening. These tests often reveal underlying physiological imbalances contributing to tics and must be addressed before behavioral therapies can work effectively.
Conclusion
While CBIT therapy offers valuable behavioral strategies for managing tics, actual improvement often requires looking deeper. For many families struggling with tic disorders, addressing the underlying physiological factors, like gut health, inflammation, and nutritional deficiencies, can be the missing piece of the puzzle.
Taking a holistic approach doesn’t mean abandoning CBIT techniques, but rather enhancing their effectiveness by creating the optimal biological environment for success. By combining targeted lifestyle changes with appropriate functional testing, we can support the body and brain toward meaningful improvement.
Remember, each child’s journey is unique, and progress takes time. With patience and the right comprehensive approach, families can find relief beyond indicator management and move toward lasting wellness for their children.
References:
Capriotti, M., Wellen, B., Young, B., Himle, M., Conelea, C., Espil, F., Simpson, H., & Mathews, C. (2023). Evaluating the feasibility, acceptability, and preliminary effectiveness of tele-comprehensive behavior therapy for tics (teleCBIT) for Tourette syndrome in youth and adults.. Journal of telemedicine and telecare, 1357633X231189305 . https://doi.org/10.1177/1357633X231189305.
Greenberg, E., Albright, C., Hall, M., Hoeppner, S., Miller, S., Farley, A., Silverman, M., Braddick, V., Sprich, S., & Wilhelm, S. (2022). Modified Comprehensive Behavioral Intervention for Tics: Treating Children With Tic Disorders, Co-Occurring ADHD, and Psychosocial Impairment.. Behavior therapy, 54 1, 51-64 . https://doi.org/10.1016/j.beth.2022.07.007.
Kohler, K., Rosen, N., & Piacentini, J. (2024). Description, Implementation, and Efficacy of the Comprehensive Behavioral Intervention for Tics as First-Line Treatment for Tourette and Other Tic Disorders.. Journal of child and adolescent psychopharmacology. https://doi.org/10.1089/cap.2024.0023.