--- title: "Treatment for Tic Disorder and Tourette Syndrome" slug: "challenging-behaviour-treatment-for-tic-disorder-and-tourette-syndrome" updated: 2026-06-24T18:54:06Z published: 2026-06-24T18:54:06Z canonical: "healthhub.cpcmg.net/challenging-behaviour-treatment-for-tic-disorder-and-tourette-syndrome" --- > ## Documentation Index > Fetch the complete documentation index at: https://healthhub.cpcmg.net/llms.txt > Use this file to discover all available pages before exploring further. # Tic Disorder and Tourette Syndrome ![](https://cdn.us.document360.io/a196e2c1-0707-4b9f-8164-e8201c779cd7/Images/Documentation/image(99).png?sv=2026-02-06&spr=https&st=2026-10-14T13%3A42%3A57Z&se=2026-10-14T14%3A42%3A57Z&sr=c&sp=r&sig=D%2F0Ld7GTRbYZTEp8ZTHK52YMlGi%2BnG3Ykh2mu0QYFl0%3D) [![Appointment Info](https://cdn.us.document360.io/a196e2c1-0707-4b9f-8164-e8201c779cd7/Images/Documentation/1650055438388-1650055438388.png?sv=2026-02-06&spr=https&st=2026-10-14T13%3A42%3A57Z&se=2026-10-14T14%3A42%3A57Z&sr=c&sp=r&sig=D%2F0Ld7GTRbYZTEp8ZTHK52YMlGi%2BnG3Ykh2mu0QYFl0%3D)](/v1/docs/appointments-and-contact-information) [![Care Decision Info](https://cdn.us.document360.io/a196e2c1-0707-4b9f-8164-e8201c779cd7/Images/Documentation/1654467115781-1654467115781.png?sv=2026-02-06&spr=https&st=2026-10-14T13%3A42%3A57Z&se=2026-10-14T14%3A42%3A57Z&sr=c&sp=r&sig=D%2F0Ld7GTRbYZTEp8ZTHK52YMlGi%2BnG3Ykh2mu0QYFl0%3D)](https://www.rchsd.org/wait-times/what-type-of-care-does-my-child-need/)

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 ### Children and Tics: Dr. Zupanc, CHOC Children's [YouTube video player](https://www.youtube.com/embed/rLG9U-pTsF4?si=0QOlJcB99W1tCyso) ### Partners in Kids Health -Tics and Tourette Syndrome [YouTube video player](https://www.youtube.com/embed/_SlaI42P51c?si=76k_uQu3hGS43nfX) ### Meditation and Deep Breathing Help Me Manage My Tics [YouTube video player](https://www.youtube.com/embed/EMdttGtrv-I?si=YNkF7Nb2s1wo9VGV) ## What Are Tics? - Tics are sudden, repetitive, non-rhythmic movements or vocalizations. Examples include: - eye movements/eye blinking - neck movements/head movements - shoulder movements/shrugging - throat clearing - making certain sounds or saying certain words - sniffs - quick head jerks - grimaces - hums - pursing lips - Tics are sudden, repetitive, non-rhythmic movements or vocalizations. Tics are common and may be experienced by about 10% -25% of boys, and slightly less in girls. They may run in families. Tics will wax and wane in frequency, often with no apparent reason. - Some will note that periods of stress or anxiety will worsen tics. They may be diminished during periods of relaxation or intense concentration. - It is common for tics to decrease or disappear in adolescence, though many people will continue to have tics into adulthood. - Tourette’s Syndrome is a combination of motor tics with at least one vocal tic for one year or longer. The term Tourette does not imply severe as many patients with Tourette have mild tics. - Usually, tics are completely harmless. However, sometimes tics are bothersome or painful; in such situations, treatment may be needed. - Medications can be prescribed to reduce the tics. Your healthcare provider may discuss a medication option called guanfacine. - Your healthcare provider may recommend referral to a specialist, such as a Neurologist or Psychiatrist. - Please see additional information below for therapists, psychologists, and psychiatrists who treat tics. - Behavioral Therapy called Comprehensive Behavioral Intervention for Tics (CBIT) may be helpful in certain circumstances. - Complete elimination of tics is not the goal of treatment, and it is not realistic to expect all tics to disappear with treatment. - Attention Defecit Disorder (ADD) anxiety, and obsessive-compulsive symptoms occur frequently with Tourette’s Syndrome or tics. Often these associated conditions may be much more problematic than the tics, and medications or behavioral therapy for these conditions may be needed instead of or in addition to treatment for tics themselves. - Sometimes medications used to treat ADHD can worsen tics in some patients. However, ADHD symptoms may be much more problematic than the tics, so discontinuation of ADHD medications may not be a good option. In such cases, changing to a different class of ADHD medication or addition of a medication that can calm tics can be considered. - People with Tourette’s Syndrome are treated the same way as others with tics: if the tics are persistently bothersome or painful, medication or other intervention may be used. - If tics are not bothersome, then it is recommended to ignore them, not ask about them, not bring them to attention, as doing so may actually worsen tics. ## Treatments for Tics and Tourette Syndrome Comprehensive Behavioral Intervention for Tics (CBIT) is an effective form of behavior therapy for treatment of tic disorder and Tourette Syndrome (TS). It is a recommended first line of treatment of TS per the American Academy of Neurology. It is not a cure but can be a tool that can help a patient with tic disorder or TS better manage your tics. It consists of three important parts: - Trains the patient to become more aware of their tics and urges to tic - Trains the patient to use “competing” behaviors (ex. Something to do instead of the tics to provide similar level of release and relief) when they feel the urge to tic - Make changes in their day to day activities and environment whenever possible to reduce the tics or urges to tic These strategies can be taught and optimized by behavior therapists who specialize in tic disorders and TS. Severe cases may need medications in addition to therapy but both would be needed to achieve the best possible outcome. ### **Helpful Website for Parents** [**Tourette Association of America**](https://tourette.org/) ### **Therapists Who Treat Tic Disorders and Tourette Syndrome** [**Please click here to see therapists in the San Diego area from the Tourette Association of America.**](https://tourette.org/find-a-provider/?fwp_providers_zip_search=32.715738%2C-117.1610838%2C25%2CSan%2520Diego%252C%2520CA%252C%2520USA&fwp_providers_age_group=children) ****Three23Therapy**** **Therapist:** Emily Reid, OT **Treatment Available For:** Tourette syndrome, tic disorder, anxiety **Services:** CBIT, Family-based therapy, Parent Coaching **Ages:** Children (age 7+ yo), Adolescents **Contact:** [https://three23therapy.com](https://three23therapy.com) ****Intricate Mind Institute, LLC**** **Therapist:** Mary Baker-Ericzen, MA, Ph.D. **Treatment Available For:** Tourette syndrome, tic disorder **Services:** CBIT, CBT, ABA, Social Skills training, diagnostic assessments **Ages:** Children, Adolescents **Contact:** 6336 Greenwich Drive, Suite G500, San Diego, California 92122 Ph: 858-205-9809 [office@intricatemindinstitute.com](mailto:office@intricatemindinstitute.com) [www.intricatemindinstitute.com](https://intricatemindinstitute.com/) ****Resilience Counseling**** **Therapist:** Katherine Pica LCSW, Kayla Norman, AMFT, Natasha Mills, AMFT **Treatment Available For:** OCD, Anxiety, Panic Attacks, Tic Disorder, Tourette Syndrome, Trichotillomania, Body-Focused Repetitive Behavior (BFRB), Trauma/PTSD, Tourette syndrome, tic disorder **Services:** CBT, DBT, CBIT, ERP, EMDR, ComB, Christian counseling (if requested) **Ages:** Children (10+ yo), Adolescents, Young Adults, Adults **Contact:** (858) 768-8737 **Location:** 12396 World Trade Drive, Suite 117, San Diego, CA 92128 and Virtual Self-pay, not in-network [info@counselingca.com](mailto:info@counselingca.com) [www.counselingca.com](/docs/www.counselingca.com) ****Child Psych San Diego**** **Therapist:** Diana Robbins, Ph.D. **Treatment Available For:** Anxiety, OCD, Phobias, Tourette syndrome, tic disorder, Trichotillomania, Body-focused Repetitive Behaviors (BFRBs), Body Dysmorphic Disorder (BDD), Misophonia, ADHD, Behavioral problems **Services:** CBT, ERP, CBIT, SPACE, neuropsychological assessment **Ages:** Children, Adolescents **Contact:** 4036 3rd Ave, San Diego, California 92103 Ph: 619-314-8833 [info@childpsychsandiego.com](mailto:info@childpsychsandiego.com) [https://www.childpsychsandiego.com](https://www.childpsychsandiego.com) ****Center for Mental Wellness**** **Therapist:** Eunice Kim, Ph.D. **Treatment Available For:** Anxiety, OCD, Eating Disorders, Tourette syndrome, tic disorder **Services:** CBT, DBT, ERP, CBIT, family therapy **Ages:** Children (5+ yo), Adolescents **Contact:** 12625 High Bluff Drive, Suite 105, San Diego, CA 92130 Ph: 858-461-9409 [ekim@socalmentalwellness.com](mailto:ekim@socalmentalwellness.com) [www.socalmentalwellness.com](https://socalmentalwellness.com/) ****Achieve Medical Concierge**** **Treatment Available For:** Depression, Anxiety, Trauma/PTSD, ADHD, OCD, Tourette syndrome, tic disorder **Services:** CBT **Ages:** Children, Adolescents **Contact:** 858-221-0344 and/or coordinator@achieveconcierge.com **Location:** 9204 Genesee Ave Suite 340 La Jolla, CA 92037 [https://achieveconcierge.com](https://achieveconcierge.com) **Self-Pay Pricing** Diagnostic Evaluations: $1,200 Psychiatry (Physician): Initial / 1-hour follow-up: $700 30-minute follow-up: $400 Physician Assistant: Initial / 1-hour follow-up: $450 30-minute follow-up: $150 Therapy Services: $200–$250 per session ****Pacific Beach Therapy By The Sea**** **Therapist:** Lori L. Pele, MS, LCSW **Treatment Available For:** Anxiety, Depression, Trauma/PTSD, Tourette syndrome, tic disorder **Services:** CBIT, telehealth **Ages:** Children, Adolescents **Contact:** 4603 Mission Blvd, Suite 217, San Diego, CA 92109 Ph: 619-379-8482 [https://www.loripele.com/](https://www.loripele.com/) ****The ADHD Center for Success**** **Therapist:** Lori Rappaport, Ph.D. **Treatment Available For:** ADHD, Anxiety, Depression, Tourette syndrome, tic disorder, Trichotillomania, BFRB **Services:** CBT, EMDR, CBIT, telehealth **Ages:** Children, Adolescents **Contact:** 12625 High Bluff Drive, Suite 201, San Diego, CA 92130 Ph: 858-481-2188 [drlorirap@gmail.com](mailto:drlorirap@gmail.com) [www.lorirappaportphd.com](https://lorirappaportphd.com/) ****Ariane Myers Psychology**** **Therapist:** Ariane Myers, Ph.D. **Treatment Available For:** Anxiety, Depression, OCD, Tourette syndrome, tic disorder, Autism, ADHD, Body-Focused Repetitive Behavior (BFRB) **Services:** CBIT, telehealth **Ages:** Children (5+ yo), Adolescents **Contact:** 415 N. Highway 101, Suite E, Solana Beach, CA 92075 240 9th Street, Del Mar, CA 92014 2918 Emerson Street, San Diego, CA 92106 Ph: 858-367-0119 [amyers@arianemyers.com](mailto:amyers@arianemyers.com) [https://www.psychologytoday.com/us/therapists/ariane-myers-del-mar-ca/776843](https://www.psychologytoday.com/us/therapists/ariane-myers-del-mar-ca/776843) ****Neurometabolic Medicine/UCSD**** **Therapist:** Gail Reiner, DNP, FNP-C **Treatment Available For:** Tourette syndrome, tic disorder **Services:** CBIT, telehealth **Ages:** Children (9+ yo), Adolescents **Contact:** 200 West Arbor Drive, Suite 8465, San Diego, CA 92103 Ph: 858-966-5819, 619-471-9134 [gereiner@health.ucsd.edu](mailto:gereiner@health.ucsd.edu) ****Rady Children’s Hospital Tic/Tourette Clinic**** **Therapist:** Neurology **Treatment Available For:** Tourette syndrome, tic disorder **Services:** CBIT, telehealth **Ages:** Children, Adolescents **Contact:** Nelson Pavilion, 3rd Floor 8001 Frost Street, San Diego, CA 92123 Ph: 858-966-5819 [https://www.rchsd.org/programs-services/neurology/services/tictourette-center/](https://www.rchsd.org/programs-services/neurology/services/tictourette-center/) ### **Psychiatrists Who Treat Tic Disorders and Tourette Syndrome** ****Joshua D. Feder, MD**** **Treatment Available For:** ADHD, Anxiety, Depression, Autism, OCD, Bipolar Disorder, PTSD, Tourette syndrome, tic disorder **Services:** CBIT, telehealth **Ages:** Children, Adolescents **Contact:** 415 N. Highway 101, Suite E, Solana Beach, CA 92075 Ph: 619-417-7506 [https://www.joshuafedermd.com](https://www.joshuafedermd.com) ****Rady Children’s Hospital/Jennifer R.L. Friedman, MD**** **Treatment Available For:** Tourette syndrome, tic disorder **Services:** CBIT, telehealth **Ages:** Children, Adolescents **Contact:** 8010 Frost Street, Suite 400, San Diego, CA 92123 Ph: 858-966-5819 ****Mindpath Health/Michael E. McManus, MD**** **Treatment Available For:** Tourette syndrome, tic disorder **Services:** CBIT, telehealth **Ages:** Children, Adolescents **Contact:** 1550 Hotel Circle North, Suite 450, San Diego, Ca 92108 Ph: 619-692-1581, 619-457-4410 ****Deborah G. Mishek, MD (Developmental/Behavioral Pediatrician)**** **Treatment Available For:** Tourette syndrome, tic disorder **Services:** CBIT, telehealth **Ages:** Children, Adolescents **Contact:** 12625 High Bluff Drive, Suite 302, San Diego, CA 92130 Ph: 858-581-5053 [dmishek@dsscteam.com](mailto:dmishek@dsscteam.com) [https://dsscteam.com/](https://dsscteam.com/) ****Aneita High, MD**** **Treatment Available For:** **Ages:** Children, Adolescents **Contact:** 3003 Armstrong Street, San Diego, CA 92111 Ph: 619-890-8872 [arashford@hotmail.com](mailto:arashford@hotmail.com) ****Deeann Y. Wong, MD**** **Treatment Available For:** Anxiety, Panic Disorder, Depression, OCD, ADHD, Bipolar Disorder, Eating Disorders, PTSD, Tourette syndrome, Tic Disorder, Trichotillomania **Ages:** Children, Adolescents **Contact:** 1011 Devonshire Drive, Suite D, Encinitas, CA 92024 Ph: 760-753-2600 [http://www.deeannwongmd.com](http://www.deeannwongmd.com) ****So Cal Psychiatric Care/Sanjoy Sathpathy, MD**** **Treatment Available For:** ADHD, Anxiety, Depression, Autism, Bipolar Disorder **Ages:** Children, Adolescents **Contact:** 9888 Carroll Center Road, Suite 218, San Diego, CA 92126 Ph: 858-324-5339 --- Information about tics adapted from Rady Children’s Neurology Guideline for Patients with Tics. Reviewed by Patient Education Committee, JW MD Reviewed by PL, MD 2/2026