Center for Anxiety, OCD, and Cognitive Behavioral Therapy
Specialized Treatment for Tic Disorders and Tourette’s Syndrome in Philadelphia, Pennsylvania, and the Surrounding Region
Understanding Tic Disorders and Tourette’s Syndrome
Tic disorders are neurodevelopmental conditions characterized by sudden, rapid, recurrent movements or vocalizations that are experienced as difficult to control. These may include motor tics (such as eye blinking, facial movements, head or shoulder movements) and vocal tics (such as throat clearing, sniffing, or sounds). Tourette’s syndrome is diagnosed when both motor and vocal tics have been present for at least one year.
Tics are not “bad habits,” intentional behaviors, or signs of poor self-control. Many individuals experience uncomfortable physical sensations or internal urges that build up prior to a tic and are briefly relieved afterward. Tic severity often waxes and wanes over time and can be influenced by stress, fatigue, excitement, anxiety, and environmental demands.
At our Philadelphia-based anxiety, OCD, and trauma specialty psychology practice, we provide evidence-based, behaviorally focused treatment for tic disorders and Tourette’s syndrome in children, adolescents, and adults. Care is delivered with a balance of structure and flexibility, clinical rigor and warmth, and careful individual tailoring to each person’s symptoms, developmental stage, and goals. Services are offered through sessions that may be primarily in person at our Philadelphia office, primarily by telehealth, or through thoughtfully structured hybrid options.
Tic Disorders and Tourette’s Syndrome at a Glance
- Core features: Sudden, repetitive motor and/or vocal tics; premonitory urges or bodily sensations preceding tics; temporary relief after tic expression.
- Common experiences: Fluctuating tic severity; increased tics during stress or fatigue; heightened self-consciousness; efforts to suppress tics (often at a cost)
- Common emotions: Frustration, embarrassment, shame, anxiety, irritability, discouragement.
- Associated risks: Marked distress, functional impairment, depressed mood, and elevated risk for self-harm and suicidal thinking
- Frequently associated conditions: ADHD, obsessive-compulsive disorder (OCD), anxiety disorders, emotional regulation difficulties, sensory sensitivities.
- Most effective treatments: Comprehensive Behavioral Intervention for Tics (CBIT), Habit Reversal Training (HRT), with CBT- and ACT-informed strategies as adjuncts.
- Typical onset: Childhood (often between ages 5–10), with variable course across adolescence and adulthood.
Specialized, Evidence-Based Treatment for Tic Disorders in Philadelphia and Beyond
Effective treatment for tic disorders often focuses on reducing tic frequency and intensity, improving control over responses to urges, and increasing daily functioning, more so than attempting to eliminate all tics entirely.
At our Philadelphia-based specialty psychology Center, we provide tic disorder and Tourette’s syndrome therapy in Philadelphia, Pennsylvania, and beyond for children, adolescents, and adults. Treatment is grounded in Comprehensive Behavioral Intervention for Tics (CBIT) and Habit Reversal Training (HRT), supplemented when helpful with CBT- and ACT-based strategies to address anxiety, frustration, shame, and co-occurring concerns.
Comprehensive Behavioral Intervention for Tics (CBIT)
CBIT is considered a first-line, evidence-based treatment for tic disorders and Tourette’s syndrome. It is a structured behavioral approach that helps individuals:
- Increase awareness of tics and premonitory urges
- Learn competing responses that reduce tic expression
- Modify environmental and contextual factors that worsen tics
- Reduce patterns that unintentionally reinforce tics
CBIT is effective for many children, adolescents, and adults, and is most successful when delivered by clinicians with specific training and experience in tic disorders. Our clinicians have advanced training and extensive experience delivering CBIT and habit reversal therapy, and are frequently consulted by families, schools, and other clinicians seeking specialty-level behavioral treatment for tic disorders.
Habit Reversal Training (HRT)
Habit Reversal Training is a core component of CBIT and focuses on:
- Awareness training to recognize early signals of tics
- Development and practice of competing responses
- Building consistency and confidence in applying skills
HRT is an active, skills-based intervention that requires coaching, practice, and individual tailoring. Simply knowing the techniques is often not enough — skilled guidance makes a significant difference.
Cognitive Behavioral Therapy (CBT) and Acceptance and Commitment Therapy (ACT)
While CBIT and HRT directly target tic behaviors, CBT- and ACT-informed strategies often play an important supporting role, particularly when:
- Anxiety or social fears amplify tic expression
- Shame, frustration, or self-criticism become prominent
- Suppression efforts increase distress or rebound effects
- OCD-like thinking or rigid control strategies are present
CBT helps individuals examine unhelpful beliefs about visibility, control, and consequences of tics, while ACT supports greater flexibility, urge tolerance, and engagement in meaningful activities, even when tics are present.
Adjunctive Cognitive and Behavioral Approaches for Tic Disorders and Tourette Syndrome
In addition to primary, evidence-based behavioral treatments for tic disorders and Tourette syndrome, such as Comprehensive Behavioral Intervention for Tics (CBIT) and Habit Reversal Training (HRT), we may incorporate adjunctive cognitive and behavioral strategies when helpful. These approaches can support children, teens, and adults whose tics are worsened by stress, anxiety, shame, or emotional reactivity.
Adjunctive strategies may include mindfulness-based skills to increase awareness of premonitory urges, compassion-focused approaches to reduce self-criticism related to visible tics, and DBT-informed emotion regulation skills when strong emotions intensify tic frequency or severity. These methods are used to more effectively manage internal triggers and reduce functional impairment, not to force suppression of tics, and are thoughtfully integrated alongside CBIT-based treatment.
Medication Management for Tic Disorders and Tourette Syndrome
Medication can be helpful for some individuals with tic disorders or Tourette syndrome, particularly when tics are severe, painful, or significantly impairing, or when there are co-occurring conditions such as ADHD, OCD, or anxiety disorders. Commonly prescribed medications may include alpha-2 agonists (such as guanfacine or clonidine) or other neurologically informed options, depending on the individual presentation.
Our Center does not prescribe medication. However, we regularly collaborate with psychiatrists and psychiatric nurse practitioners to support coordinated, evidence-based care. For many patients, medication is most effective when combined with behavioral treatment for tics, such as CBIT, rather than used as a standalone intervention.
Comprehensive and Integrated Care for Children, Teens, and Adults with Tic Disorders and Tourette Syndrome
Tic disorders and Tourette syndrome commonly co-occur with conditions such as ADHD, obsessive-compulsive disorder (OCD), anxiety disorders, social anxiety, emotional regulation difficulties, and academic or school-related challenges. Because of this overlap, treatment is most effective when it addresses the full clinical picture rather than focusing on tics alone.
Our Philadelphia-based psychologists specialize in tic disorder and Tourette syndrome therapy for children, adolescents, and adults. We integrate CBIT and HRT with CBT-, ERP-, and ACT-informed approaches when anxiety, OCD, avoidance, or perfectionism are also present. We also work closely with parents and families of children and teens with these challenges, providing guidance on responding to tics in supportive, non-reinforcing ways and navigating school, peer, and social situations.
Our approach is to use individualized, developmentally informed, and collaborative forms of evidence-based therapy, with attention to tic severity, co-occurring conditions, family context, and quality of life. You can learn more about how we individualize evidence-based care across anxiety-related and neurodevelopmental conditions through our broader treatment model.
Tic Disorders in Children and Teens
Treating tic disorders in children and adolescents requires a developmentally informed, evidence-based, and often family-inclusive approach. Tics frequently emerge in childhood, fluctuate over time, and can be influenced by stress, attention, fatigue, and environmental demands. Effective treatment focuses not on “stopping” tics at all costs, but on reducing distress, improving functioning, and supporting confidence and self-regulation over time.
At our Philadelphia-based specialty Center for Anxiety, OCD, and Cognitive Behavioral Therapy, our clinicians work closely with children, teens, and parents to:
- Reduce unhelpful attention, monitoring, or accommodation around tics
- Support skill practice (e.g., HRT or CBIT strategies) without pressure, criticism, or shame
- Address school-related challenges, classroom accommodations, and peer concerns
- Help children and teens develop confidence, resilience, and flexibility as symptoms change over time
Because tic disorders commonly co-occur with ADHD, anxiety disorders, and obsessive-compulsive disorder (OCD), treatment is often integrated and transdiagnostic, addressing overlapping attention, anxiety, compulsive urges, and emotion-regulation difficulties in a coordinated way.
Supporting Parents, Families, and Loved Ones
Tic disorders affect more than the individual alone. Parents, caregivers, partners, and teachers often feel uncertain how to respond—wanting to be supportive without accidentally increasing tics, distress, or self-consciousness.
Families commonly struggle with questions such as:
- Should we point out the tic or ignore it?
- Are we reinforcing symptoms by accommodating?
- How do we support school success without adding pressure?
- What do we say when others comment or ask questions?
At our Philadelphia specialty anxiety and OCD center, we provide education, consultation, and guidance for parents and families, helping loved ones develop responses that are:
- Supportive without reinforcing tic cycles
- Calm, consistent, and developmentally appropriate
- Aligned with evidence-based behavioral treatment principles
We also offer parent- and family-focused consultation, even when the individual with tics is hesitant about therapy, overwhelmed, or ambivalent. Helping families respond differently often reduces overall stress and creates conditions that support improvement over time.
Comprehensive Tic Disorder and Tourette’s Treatment at Our Philadelphia Center
At the Center for Anxiety, OCD, and Cognitive Behavioral Therapy, we understand the complexity and variability of tic disorders and Tourette’s syndrome. Our approach reflects both specialty-level behavioral expertise and careful individual tailoring.
Our work with tic disorders includes:
- Individualized treatment plans:
Thoughtfully designed based on tic type, severity, developmental stage, insight, co-occurring conditions, and family context. - Evidence-based behavioral interventions:
Including Comprehensive Behavioral Intervention for Tics (CBIT), Habit Reversal Training (HRT), and CBT- and ACT-informed strategies to address urges, attention, anxiety, and emotional responses to tics. - Integrated care and collaboration:
When appropriate, we coordinate with pediatricians, neurologists, psychiatrists, schools, and other providers to support comprehensive, well-aligned care.
Care is offered through sessions that may be primarily in person, primarily via telehealth, or a thoughtfully structured hybrid of both, depending on clinical fit, patient needs, and availability.
Tic Disorders and Tourette’s Syndrome: Common Questions
Do tics mean someone is doing it on purpose?
No. Tics are involuntary and often preceded by uncomfortable urges. Efforts to suppress them usually increase distress.
Can anxiety or stress make tics worse?
Yes. While tic disorders and Tourette’s syndrome are neurobiological, stress, anxiety, fatigue, excitement, and social pressure often increase tic frequency or intensity for many people. This is one reason we find that effective tic disorder treatment often addresses not only the tics themselves, but also co-occurring anxiety and emotional reactivity. Many individuals benefit from an integrated approach that draws on behavioral treatment for tics alongside strategies commonly used in anxiety disorder treatment when stress or worry is amplifying symptoms.
Do tic disorders overlap with OCD or social anxiety?
Very often. Many children, teens, and adults with tic disorders also experience obsessive-compulsive disorder (OCD), social anxiety, or performance-related fears, including in some cases concerns about being noticed, judged, or misunderstood because of visible tics. When these conditions overlap, treatment is most effective when it integrates tic-specific behavioral therapy with evidence-based approaches used in OCD therapy and social anxiety disorder treatment, rather than treating each concern in isolation.
Are tic disorders something children “grow out of”?
For many individuals, tics improve over time, especially after adolescence. However, this is not always the case. And waiting alone is not always the best strategy, particularly when tics cause distress, physical strain, academic difficulty, or social impairment. Specialized behavioral treatment can help children and teens reduce tic severity, improve coping, and prevent secondary difficulties, regardless of whether tics fully remit.
Should parents tell children to stop their tics?
In most cases, no. In general, this strategy tends not to be effective. And in some cases, repeatedly drawing attention to tics or asking a child to suppress them can actually increase distress and unintentionally worsen symptoms.
In evidence-based tic disorder treatment for children and teens, parents can learn how to respond calmly, support children in working on the tics, reduce unhelpful patterns of attention or accommodation, and support skill use without pressure or criticism. This approach helps protect confidence and functioning while supporting long-term improvement.
When should someone seek specialty treatment?
Specialty care is recommended when tics interfere with daily functioning, cause distress, or have not improved with general therapy approaches.
What makes specialty treatment different from general therapy?
Behavioral treatment for tic disorders, especially Comprehensive Behavioral Intervention for Tics (CBIT) and Habit Reversal Training (HRT), requires specific training and experience. General therapy that focuses only on emotions or insight is often insufficient.
At our Philadelphia-based anxiety, OCD, and trauma focused psychology Center, tic disorder treatment is provided by psychologists with advanced training in anxiety-, OCD-, and tic-related conditions, allowing for careful individualization and coordination when concerns overlap.
Are HRT and CBIT effective via telehealth?
For some individuals, yes. Telehealth can be effective when delivered by experienced clinicians and when clinically appropriate.
Is medication required for tic disorders?
Behavioral therapy strategies like CBT and HRT, sometimes in combination with related interventions, tend to be helpful for tic disorders. Medication is not required for everyone, and many individuals benefit from behavioral treatment alone. When medication is part of care, we collaborate with prescribing providers.
Do you collaborate with pediatricians, neurologists, and schools?
Yes, we can. With appropriate consent, we regularly collaborate with pediatricians, child neurologists, psychiatrists, school counselors, school psychologists, and special education teams to support consistent, evidence-based care. This may include guidance around classroom accommodations, reducing unhelpful attention to tics, coordinating behavioral and medical care, or supporting families navigating school-related challenges.
We also provide professional consultation services for clinicians and schools seeking guidance related to tic disorders, Tourette’s syndrome, anxiety, and OCD, including consultation around CBIT, differential diagnosis, and treatment planning.
When should pediatricians or schools refer for specialty tic disorder treatment?
Referral to a specialty psychology practice is recommended when tics persist beyond several months, cause distress or functional impairment, or interfere with school performance, peer relationships, or emotional well-being. Referral is also appropriate when tics co-occur with anxiety, ADHD, OCD, or social avoidance, or when families feel unsure how to respond without making symptoms worse.
At our Philadelphia-based specialty psychology practice, we provide evidence-based tic disorder and Tourette’s syndrome treatment using Comprehensive Behavioral Intervention for Tics (CBIT) and Habit Reversal Training (HRT), with developmentally informed adaptations for children, adolescents, and adults.
Start Your Path Toward Progress with Tic Disorders
If you or your child is struggling with tic disorders or Tourette’s syndrome, specialized behavioral therapy can help.
At the Center for Anxiety, OCD, and Cognitive Behavioral Therapy, we provide individualized, evidence-based care for children, teens, and adults using CBIT, HRT, CBT, and ACT-informed approaches. Services are offered through sessions that may be primarily in person at our Philadelphia office, primarily via telehealth, or through thoughtfully structured hybrid options, depending on clinical fit and patient needs.
To learn more or to explore whether working with our team may be a good fit, we invite you to contact us to schedule a brief initial consultation.
Learn More About Tics and Discover Helpful Resources in Philadelphia and Beyond
- Explore Our Tic Resources: Dive into our curated list of Tic and Cognitive and Behavioral Therapy resources, including websites, informative books, quizzes, and helpful treatment forms.
- Discover more on our blog: For additional insights into tics and related topics, check out our extensive blog articles.
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As an independent Philadelphia-based anxiety, OCD, and trauma specialty psychology practice, our Center is honored to serve as a practice within the National Social Anxiety Center (NSAC) network. NSAC is committed to offering the highest quality, evidence-based anxiety therapy services for social anxiety and related conditions to those in need. We actively contribute to this mission through research, collaboration, dissemination to clinicians, and public education. For more information, please visit NSAC here.