Tic Disorder Therapy & CBIT for Children, Teens, and Young Adults in Portland, OR

What Are Tics?

Tics are sudden, involuntary movements or sounds that occur repeatedly. Common motor tics include blinking, facial movements, shoulder shrugging, or head movements, while vocal tics may include throat clearing, sniffing, coughing, or other sounds. Tics often begin in childhood and can change over time in frequency, intensity, or type. Some children experience mild tics that have little impact on daily life, while others may experience discomfort, embarrassment, social challenges, or difficulty concentrating at school.

Tics are not a sign of defiance, poor self-control, or intentional behavior. Many children describe feeling a strong urge or sensation before a tic occurs, followed by temporary relief after performing the tic. Stress, excitement, fatigue, illness, and anxiety can sometimes make tics more noticeable.

Evidence-Based Tic Treatment

As a child and adolescent psychologist in Portland, OR, I provide evidence-based treatment for children, teens, and young adults with tic disorders and Tourette Syndrome.

The gold-standard behavioral treatment for tics is Comprehensive Behavioral Intervention for Tics (CBIT). CBIT helps individuals become more aware of tic urges and learn practical strategies to reduce the frequency and impact of tics. Rather than trying to force tics to stop through willpower alone, CBIT teaches skills that work with the body's natural processes in supportive and effective ways.

CBIT includes education about tics, identification of situations that make tics more likely to occur, and training in competing responses, which are alternative behaviors that can be used when the urge to tic arises. Treatment is collaborative, developmentally appropriate, and tailored to each child's goals and daily life.

I also incorporate Acceptance and Commitment Therapy (ACT) when helpful. ACT can help children and teens respond more flexibly to uncomfortable sensations, frustration, embarrassment, or anxiety related to their tics while focusing on activities and relationships that are important to them.

Parents and caregivers are often involved in treatment and learn strategies to support their child's progress while reducing stress and increasing confidence at home, school, and in social settings.

What to Expect During Therapy

Therapy begins with a comprehensive assessment to understand your child's tic history, current symptoms, strengths, and goals. We will explore factors that may influence tic severity, including stress, sleep, anxiety, school demands, or environmental triggers.

Treatment focuses on building awareness of tic urges, learning CBIT strategies, increasing confidence, and reducing the impact that tics have on daily functioning. Depending on your child's needs, therapy may also address anxiety, social concerns, teasing, emotional regulation, or related challenges.

The goal of therapy is not necessarily to eliminate every tic. Instead, treatment helps children and teens feel more comfortable, confident, and in control so that tics interfere less with their daily lives, relationships, and activities.