Comprehensive behavioral intervention for tics – its history, present applications and effectiveness
Authors:
Marcela Šoltýsová 1,2; Zuzana Brežná 1; Lenka Macejáková 2; Ján Necpál 1
Authors‘ workplace:
Centrum pre liečbu parkinsonizmu a extrapyramídových porúch, nemocnica AGEL, Zvolen, Slovensko
1; Infanterra, Súkromné diagnosticko-terapeutické centrum, Zvolen, Slovensko
2
Published in:
Čes. a slov. Psychiat., 122, 2026, No. 3, pp. 105-112.
Category:
Review
doi:
https://doi.org/10.48095/cccsp202606
Overview
Chronic motor or vocal tic disorder and Tourette syndrome are neuropsychiatric conditions whose symptoms may have a substantial impact on patients’ functioning in both personal and occupational domains. For several decades, pharmacological treatment represented the primary therapeutic approach for tic disorders. In recent years, however, this paradigm has shifted toward comprehensive behavioral intervention for tics (CBIT), a non-pharmacological treatment whose efficacy has been shown to be comparable to that of medication, while carrying minimal risk for the patient and virtually no adverse effects. CBIT is considered suitable for children and adolescents as well as for adult patients. The origins of behavioral interventions for tic disorders date back to the 1970s. During the following decades, these interventions underwent systematic refinement into their present form; nevertheless, their broader implementation has been limited worldwide by insufficient availability of adequately trained therapists. To address this barrier and enhance treatment accessibility, alternative behavioral interventions derived from CBIT were subsequently introduced, including group-based protocols and telepsychotherapy-delivered interventions, with the aim of increasing treatment accessibility for a broader patient population. This narrative review traces the historical development of CBIT from its early conceptual origins to its contemporary clinical applications, while also providing a comprehensive overview of the intervention formats currently utilized worldwide. Although the mechanisms underlying the therapeutic effects of this treatment approach have not been fully elucidated yet, evidence from studies evaluating its efficacy supports its broad implementation in routine clinical practice. In addition to comprehensive behavioral interventions specifically targeting tic symptoms, accumulating evidence suggests that supplementary therapeutic techniques derived from traditional cognitive-behavioral therapy (CBT) may represent valuable adjunctive strategies, contributing to further improvements in treatment effectiveness and overall patient quality of life. While organic tic disorders can often be successfully managed using CBIT, the treatment of functional tic disorders remains substantially more challenging. In these cases, an integrated therapeutic approach combining core CBIT techniques with principles of so-called “third-wave” CBT appears to constitute a promising treatment alternative.
Keywords:
behavioral interventions for tics – CBIT – ERP – HRT – Tourette syndrome
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Addictology Paediatric psychiatry PsychiatryArticle was published in
Czech and Slovak Psychiatry
2026 Issue 3
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