Comprehensive Behavioral Interventions for tics (CBIT) and Habit Reversal Therapy (HRT) for BFRBs

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Evidence-Based Treatment for Tics, Tourette Syndrome, and Compulsive Habits

 

Comprehensive Behavioral Intervention for Tics (CBIT) and Habit Reversal Training (HRT) are gold-standard, research-supported therapies for individuals living with tics, Tourette Syndrome, and Body-Focused Repetitive Behaviors (BFRBs) like trichotillomania (hair pulling), dermatillomania (skin picking), and nail biting.

 

These therapies help individuals gain control over involuntary movements and repetitive behaviors—without judgment or shame—by teaching practical skills to reduce symptoms and increase awareness.

 

At Compassionate Healing Institute, we offer specialized CBIT and HRT services for children, teens, and adults in a supportive and personalized environment.

 

 

What Is CBIT?

CBIT (Comprehensive Behavioral Intervention for Tics) is a structured, evidence-based treatment for tics and Tourette Syndrome. CBIT builds on Habit Reversal Training (HRT) and includes multiple components that work together to reduce tic severity and improve quality of life.

 

CBIT focuses on:

 

• Awareness training: Becoming more aware of the urge or trigger before a tic occurs

• Competing response training: Learning and practicing a behavior that is incompatible with the tic

• Function-based intervention: Identifying situations that worsen tics and developing strategies to modify them

• Relaxation and stress-management tools: Helping regulate emotional and physical triggers

 

CBIT empowers individuals to gain better control over their tics without relying on medication.

 

 

What Is HRT?

Habit Reversal Training (HRT) is a behavioral therapy originally developed to treat tics and now widely used to treat Body-Focused Repetitive Behaviors (BFRBs) such as:

 

• Trichotillomania (hair pulling)

• Excoriation Disorder (skin picking)

• Nail biting and cheek chewing

• Thumb sucking or knuckle cracking

 

HRT includes three core components:

 

1. Awareness training: Recognizing the situations, emotions, or body sensations that trigger the behavior

2. Competing response training: Practicing a substitute behavior that prevents the urge from becoming an action

3. Motivation and support: Building insight, accountability, and family or peer involvement when helpful

 

These strategies help individuals interrupt habitual behaviors and replace them with healthier coping mechanisms.

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Conditions We Treat with CBIT & HRT

Our clinicians specialize in the treatment of:

 

• Tics and Tourette Syndrome

• Provisional tic disorder

• Trichotillomania (hair pulling disorder)

• Excoriation disorder (skin picking disorder)

• Nail biting and other BFRBs

• Complex motor and vocal tics

• Tic-related anxiety or distress

• Co-occurring conditions such as OCD, ADHD, and anxiety disorders

 

We work with children, teens, and adults, and our treatment plans are tailored to developmental stage, symptom severity, and personal goals.

 

 

How CBIT and HRT Work

Our treatment approach is structured, collaborative, and evidence-based. Therapy usually includes:

 

1. Assessment and Goal Setting

We start with a thorough assessment of the tic or BFRB behaviors, their triggers, and impact. We’ll also explore co-occurring symptoms, such as anxiety or compulsions, to ensure holistic care.

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2. Awareness and Tracking

You’ll learn to recognize the early signs—known as premonitory urges or emotional triggers—that occur before the behavior, increasing your ability to respond rather than react.

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3. Competing Responses

We’ll teach and practice competing responses—specific physical actions that are incompatible with the tic or BFRB. These responses are practiced regularly and in real-life situations.

 

4. Environmental and Emotional Support

We address the role of stress, environment, and habits in maintaining behaviors. Family members or caregivers may be involved to reinforce progress and reduce judgment or shame.

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5. Skill Building and Relapse Prevention

As symptoms improve, we focus on generalizing skills across settings and preparing for long-term success, even during periods of stress or transition.

 

 

Why Choose CBIT and HRT?

These treatments are:

 

• Backed by decades of research

• Non-medication-based approaches with lasting results

• Suitable for children, teens, and adults

• Highly customizable to individual needs and lifestyles

• Effective in in-person or telehealth formats

 

Unlike traditional talk therapy, CBIT and HRT focus on behavioral change, skill development, and empowerment—not just insight.

 

 

Are CBIT and HRT Effective?

Yes—CBIT and HRT are considered first-line treatments by organizations like the Tourette Association of America and The Trichotillomania Learning Center (TLC Foundation for BFRBs).

 

Many people experience:

 

• Significant reduction in tics or repetitive behaviors

• Improved emotional regulation and body awareness

• Better concentration and reduced shame or social withdrawal

• Increased confidence and quality of life

 

When delivered by trained professionals, CBIT and HRT often lead to meaningful improvement in just 8–12 sessions.

 

 

Supportive, Judgment-Free Care

At Compassionate Healing Institute, we understand that tics and BFRBs are not just habits—they’re complex, often misunderstood conditions. We meet you with empathy, compassion, clinical expertise, and a plan tailored to your needs and goals.

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Start CBIT or HRT Therapy Today

If you or your loved one is struggling with tics or repetitive behaviors, you don’t have to manage it alone. CBIT and HRT therapy can help you take control—gently, step by step.

 

We offer in-person sessions and secure telehealth appointments. Whether you’re newly diagnosed or have been managing symptoms for years, our team is here to support your progress.

 

Contact us today to schedule a consultation or learn more about CBIT and HRT therapy.

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