CBIT Therapy for Tics and Tourette Syndrome, FND, and BFRB

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  • HOME
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  • BFRB
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Online OTs
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CBIT Therapy for Tics, FND, and BFRB

CBIT Habit Reversal telehealth training

Online OTs is an occupational therapy practice that specializes in CBIT Therapy for tics and Tourette Syndrome, Body-Focused Repetitive Behaviors, and Functional Neurological Disorder. All services are conducted via a HIPPA compliant Google Meet platform. We are based in Boston and licensed to provide telehealth throughout MA, NY, NH, VT, and ME.


The benefits of CBIT with Online OTs include:

  • Access to a licensed occupational therapist who is a leader in the treatment of Tic Disorders, FND, and BFRB.
  • Training in the use of CBIT Competing Responses.
  • Identification of sensory and environmental triggers.
  • Convenient scheduling options.
  • Patients are able to immediately begin using strategies.
  • Collaboration with family members, healthcare providers, and educators.

CBIT Therapy for Tics, Tourette Syndrome, BFRB, and FND

HAbit REversal training (HRT)

Tic Disorders / Tourette Syndrome

Tic Disorders / Tourette Syndrome

CBIT Therapy logo

Online OTs specializes in CBIT Therapy. 

Our Boston-based telehealth treatment includes the following components for tics and other repetitive behaviors:


Awareness training: 

  • Identifying thoughts and sensations that precede the behavior.
  • Noticing exactly when  the repetitive behavior is occurring.
  • Understanding how your muscles move while doing the behavior.
  • Identifying premonitory sensations or urges.
  • Recognizing triggers at home and in the community.


 Competing response training: 

  • Inhibiting the unwanted behavior with incompatable muscle contractions and activities.
  • Putting the urge on hold to decrease it's intensity and the frequency of unwanted actions.


Conditions addressed with CBIT Habit Reversal Training include: 

  • Functional Neurological Disorder (FND)
  • Tic Disorders (including Tourette Syndrome)
  • Body-Focused Repetitive Behaviors (BFRB)


Tic Disorders / Tourette Syndrome

Tic Disorders / Tourette Syndrome

Tic Disorders / Tourette Syndrome

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Tics are unvoluntary and repetitive sudden muscle movements (motor tics) or uttered sounds (vocal tics) which can be highly disruptive in daily life.  Tics are often very distracting, frustrating, painful, stressful, and embarrassing. Tics tend to worsen during times of anxiety, excitement, and boredom. They wax and wane  over weeks, months, and years. Some tics last a lifetime while others fade away and new ones appear. Common motor tics include repetitive blinking and unusual eye movements, shoulder shrugging, and head jerks. Common vocal tics include throat clearing, and saying words or sentences. Tics often involve complex movements and sounds such as torso twisting with facial and neck movement and a high pitched noise. CBIT Therapy is the most effective strategy to manage tics in Boston and throughout the world.


Tic Disorders include:

  • Tourette Syndrome (Tourette Disorder, Tourette's, TS)
  • Provisional Tic Disorder 
  • Persistent Tic Disorder

Functional Neurological Disorder

BODY-FOCUSED REPETITIVE BEHAVIORS (BFRB)

BODY-FOCUSED REPETITIVE BEHAVIORS (BFRB)

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Functional Neurological Disorder (FND) is a physical and / or sensory impairment that is due to an abnormality in how the brain processes information rather than structural damage in the brain. FND occurs suddenly but is often preceded by a lengthy period of heightened anxiety and loneliness. People with FND benefit from a proper diagnosis and guidance identifying and addressing stressors. Inhibiting unwanted and involuntary movements is also critical. 


Online OTs utilizes CBIT Therapy to treat patients with the following FND conditions:

  • Functional tic-like behavior
  • TikTok Tics (functional tic-like behavior related to a mass sociogenic illness spread via social media, a false belief that one has Tourette Syndrome)
  • Functional tremors - tremor-like movements

Althugh FND is common, FND hospital-based clinics are rare and wait lists are long even in major cities like New York and Boston.

BODY-FOCUSED REPETITIVE BEHAVIORS (BFRB)

BODY-FOCUSED REPETITIVE BEHAVIORS (BFRB)

BODY-FOCUSED REPETITIVE BEHAVIORS (BFRB)

Boy with curly hair sitting

Body-Focused Repetitive Behaviors (BFRB) are habitual grooming actions that cause significant physical damage to hair, skin, or nails. Online OTs utilizes two habit reversal programs (the ComB protocol and CBIT Therapy) to address unwanted repetitive behaviors. The ComB model was designed specifically for concerns such as excessive hair pulling, skin picking, and nail biting to address some of the sensory, cognitive, and emotional triggers. CBIT, which was initially used to address tics and Tourette Syndrome, enables patients and therapists a means to better understand the anatomy and physiology behind behaviors.With Online OTs, patients learn to use common household items as barriers to habitual actions and are introduced to wearable technology when appropriate. Training in CBIT Competing Responses also decreases unwanted movements and behaviors, as well as the urges that precede them.


Body-Focused Repetitive Behaviors include:

  • Excoriation (skin picking)
  • Trichotillomania (hair pulling)
  • Onychophagia (nail biting or chewing)
  • Onychotillomania (nail picking and pulling)
  • Lip Bite Keratosis (lip biting)
  • Cheek Keratosis (biting of inner cheeks)

It should be noted that some of these behaviors seem to be somewhat weather related. When the skin is exposed to colder temperatures and lower levels of moisture, it can become dry and irritation can occur. Be sure to moisturize during the long winter months in New York,Boston, and the rest of New England, Contact a dermatologist if at risk for infections or other damage to the skin.

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Insurance

Online OTs accepts private pay, Mass General Brigham Health Plan, and Blue Cross Blue Shield. Limited financial assistance is available to families who qualify based on Annual Household Income.

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  • HOME
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  • FAQ

Online OTs and CBIT Therapy

Phone: 617-221-5944 Fax: 857-202-5085

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