By Dr. Tamara Zach MD — June 29, 2026
If your child has been diagnosed with tics or Tourette syndrome and you're looking for treatment options near Phoenix, CBIT therapy is likely the first thing a neurologist will recommend. It has the strongest research support of any non-medication treatment for tics, and it works for most children who complete the program. This guide explains what CBIT is, how it works, who it's right for, and how to access it in the Phoenix area.
what CBIT stands for and what it actually involves
CBIT stands for Comprehensive Behavioral Intervention for Tics. It's a structured, evidence-based behavioral therapy developed specifically for children and adults with tic disorders, including Tourette syndrome and chronic motor or vocal tic disorder.
Despite the name, CBIT doesn't try to suppress tics by willpower or punishment. Instead, it teaches children to recognize the uncomfortable urge that comes before a tic — called the premonitory urge — and redirect the energy into a competing response that is less noticeable. Over time, the brain's association between the urge and the tic weakens.
A full CBIT program typically involves eight sessions with a trained therapist, usually spread over ten weeks. Sessions focus on:
- Awareness training — learning to notice the premonitory urge before the tic fires
- Competing response training — practicing a physical response that is incompatible with the tic Function-based intervention — identifying situations, settings, or emotional states that make tics worse, and adjusting them
- Relaxation training — reducing overall tension that can amplify tics
- Social support — coaching parents on how to respond (and not respond) to tics at home
how effective is CBIT
CBIT is considered a first-line treatment for tic disorders by major clinical guidelines, including those from the American Academy of Neurology and the Tourette Association of America. In randomized controlled trials, roughly 52% of children who completed CBIT had a clinically meaningful reduction in tic severity, compared to 19% in a control group receiving supportive therapy.
It tends to work best for children who are motivated to participate, have at least moderate tic severity, and whose tics are causing real distress or functional problems at school or home. It's less effective for very young children (under 8) who struggle with the awareness training component.
CBIT versus medication for tics
Medication and CBIT are not competing options — they can be combined. For many children, Dr. Zach recommends CBIT as the first step, particularly when tics are moderate, the child is old enough to participate, and there's a motivated family to support the home practice. Medication is added or leads the plan when:
- Tics are severe and causing significant physical discomfort
- The child is too young or cognitively unable to engage with CBIT
- CBIT was completed but produced insufficient improvement
- Co-occurring ADHD or OCD symptoms need their own treatment
First-line medications for tics include alpha-2 agonists like guanfacine and clonidine, which have a lower side effect profile than older dopamine blockers. Dr. Zach discusses these options based on each child's full picture, not a one-size-fits-all algorithm.
finding CBIT therapy near Phoenix, AZ
CBIT requires a therapist with specific training — not every psychologist or behavioral therapist is certified in it. Finding a certified CBIT therapist in Phoenix can take some searching. The Tourette Association of America maintains a provider directory at tourette.org where you can search by zip code for certified CBIT providers near Phoenix, Scottsdale, Chandler, and surrounding Valley communities.
Telehealth has expanded access significantly. Several certified CBIT therapists licensed in Arizona offer sessions via video, which removes the travel barrier for families in the East Valley, West Valley, or outer suburbs.
the role of a pediatric neurologist in CBIT treatment
A pediatric neurologist like Dr. Zach doesn't deliver CBIT — that's a therapist's role. But the neurologist plays a critical part in the process:
- Confirming the tic diagnosis and ruling out other conditions that can cause similar movements (myoclonus, chorea, stereotypies)
- Assessing whether CBIT is the right first step or whether medication needs to come first
- Coordinating with the CBIT therapist on treatment response
- Managing any co-occurring conditions — ADHD, OCD, anxiety — that affect how tics present and respond to treatment
- Adjusting the overall plan as the child grows and their tics evolve
Tic disorders often improve naturally through adolescence, and what looks severe at age 9 frequently becomes manageable by age 15. The goal of treatment isn't necessarily to eliminate every tic — it's to reduce distress and protect the child's ability to participate fully in school and social life.
scheduling a tic evaluation at Rose Medical Pavilion
If your child has tics that are causing distress or interfering with daily life, a neurological evaluation is the right first step. Dr. Tamara Zach evaluates and manages tic disorders and Tourette syndrome for children across Phoenix, Scottsdale, Chandler, Gilbert, Glendale, and the wider Phoenix metro.
At the evaluation, she'll confirm the diagnosis, assess severity, review any co-occurring conditions, and help you decide whether CBIT, medication, or both is the right path. She can also connect you with certified CBIT therapists in the Arizona network.
Call (623) 257-ROSE (7673) or schedule online. Same-week appointments are available for urgent concerns.