Tested in two parallel multi-site randomized clinical trials, the Comprehensive Behavioral Intervention for Tics (CBIT) procedures combine elements of habit reversal training with psycho-education and function-based behavioral interventions. The results of the child study were published in 2010 in the Journal of the American Medical Association (JAMA) and showed that 52.5% of the children who received CBIT showed significant symptom improvement compared to 18.5% receiving the control treatment. The adult study was published in the journal Archives of General Psychiatry in 2012. In this study, 38% of those receiving CBIT showed significant improvement, compared to just 7% who did not receive CBIT treatment. In both studies improvement was sustained for at least 6 months after the end of the study.
Who can benefit from learning CBIT?
CBIT is most appropriate for practitioners with behavioral and clinical expertise, including physicians, psychologists, behavioral therapists, occupational therapists, social workers, and other allied health professionals.
Is CBIT for everybody who has TS or tics?
It is important to understand that not everyone will benefit from CBIT. Teaching this technique to children with untreated ADHD may be more difficult because of problems with focusing, impulsivity and low frustration tolerance. Likewise, any other psychiatric or social problem that gets in the way of participating in treatment may make CBIT more difficult. CBIT can be used without treating co-occurring conditions, but we recommend patients address any co-occurring conditions with an evaluation. These conditions or symptoms may hinder their ability to practice CBIT.
Two Options for CBIT Training for Practitioners
The Tourette Association of America offers two options for practitioners to explore CBIT: No-Cost CBIT Overview Workshops and Tourette Syndrome Behavior Training Institutes (TS-BTIs)
No-Cost Overview Workshops
In partnership with the U.S. Centers for Disease Control and Prevention (CDC), the TAA offers a no-cost program that provides an overview of TS and associated conditions and an introduction to the CBIT protocol and supportive research. Click Here to view a flyer describing the program.
Several of our program instructors for these workshops were the Principal Investigators of the original CBIT clinical trials. We would work with yourself or another designated on-site contact to host the program. We require an invitation to present and ask that you help us gather a large audience and determine the venue. We can schedule half day (3-4 hrs) or full day (6 hours) programs, and we generally recommend an audience of at least 25-30 people, though the more, the better. Click here to learn more. To request a presentation, email firstname.lastname@example.org.
Through this overview program, we do not formally offer certification to do CBIT. After attending this program we recommend participating in the Behavior Therapy Institute for intensive training in CBIT. See next section.
Recognizing the critical shortage of trained behavioral therapists for treating Tourette Syndrome (TS) and Tic Disorders, the Tourette Association has established the Tourette Syndrome Behavior Therapy Institute (TS-BTI).
Developed by members of the Tourette Association Behavioral Science Consortium, the program is designed to help increase the number and availability of therapists trained in CBIT. Programs are held at regular intervals in different locations around the country by our TAA TS-BTI Faculty.
Participants seeking to attend the TS-BTI must be licensed in one of the following professions to practice independently in their state: social workers, counselors, psychologists, marriage and family therapists, occupational therapists, clinicians, registered nurses, and educational specialists. The program registration fee is $600.00 which includes course materials and continuing education credits*.
Participants who complete the 2 day training will be required to complete 3 follow-up phone calls with their trainer, for which they will need a patient case. Upon satisfactory completion of the consultation sessions, a “TS-BTI Certificate of Completion” will be issued and the participant will be listed on the CBIT therapist referral list.
To learn more or register for a TS-BTI program, please contact Leo Neuringer at Leo.Neuringer@tourette.org or by calling 888-4-TOURET, ext. 222.
Upcoming TS-BTI Trainings:
We are monitoring the current situation related to COVID-19 in the planning of future BTI trainings. For more information, please contact Leo Neuringer at Leo.Neuringer@tourette.org.
*Continuing Education: This course is co-sponsored by Amedco and the Tourette Association of America. Amedco is approved by the American Psychological Association to sponsor continuing education for psychologists and approved by the American Social Workers Board to sponsor continuing education for social workers and counselors. Amedco maintains responsibility for this program and its content. 13 hours.
If you are an individual looking to participate in CBIT, click here.
Online CBIT Training
Unfortunately at this time there is no online training component for the CBIT protocol. However, two doctors that are closely associated with the Tourette Association are currently in the process of applying for NIH grant funding to run the second phase of a study comparing the efficacy of in-person vs. online training. We also have a contact at one of our Centers of Excellence who is looking into the possibility of developing an online training program. However, it is likely that neither of these options will be viable for at least another calendar year if not longer.
Many of the attendees to our in-person Tourette Syndrome – Behavior Therapy Institute (TS-BTI) have been able to request reimbursement from their institutions. Might this be an option for you? If you have any further queries about the details of the TS-BTI program please reach out to email@example.com and take a look at the weblink below: