Specialist Psychological Interventions for Tic Disorders
Twelve Neuroscience provides specialist assessment and psychological interventions for adults with tic disorders and Tourette Syndrome. Interventions are individually formulated and can include Habit Reversal Training (HRT) and Exposure and Response Prevention (ERP).
London · Online
Understanding Tic Disorders
Tics are repeated movements or sounds that can feel difficult to control. They may occur automatically or be preceded by a premonitory urge – an uncomfortable sensation, pressure or feeling that builds before the tic.
Performing the tic can temporarily reduce this sensation, reinforcing the urge → tic → relief cycle. Awareness of urges varies considerably between individuals and between different tics.
Habit Reversal Training
Habit Reversal Training (HRT) is a behavioural intervention that helps people develop greater awareness of tics and the sensations or situations that precede them. When an urge or early sign of a tic is noticed, a competing response is used — an action that is physically incompatible with the tic. With practice, this can help weaken the established urge → tic pattern.
Exposure and Response Prevention
Exposure and Response Prevention (ERP) involves deliberately experiencing premonitory urges without immediately performing the tic. Rather than repeatedly responding to the urge, the person practises allowing the sensation to be present while resisting or delaying the tic. Over time, this can help change the established relationship between urge and response.
When Tics Are Difficult to Identify or Interrupt
Some people experience frequent or rapidly changing tics, with limited awareness of the sensations that precede them. This can make it difficult to identify a clear urge → tic sequence.
Assessment can help identify earlier signals and determine how HRT, ERP or other psychological strategies should be adapted to the individual.
When Tic Disorders and OCD Overlap
Tic disorders and obsessive-compulsive disorder (OCD) can overlap in ways that make individual behaviours difficult to classify. A repetitive action may be influenced by a premonitory urge, obsessive fear, sense of incompleteness or “not just right” experience, or a combination of these.
Assessment considers what precedes the behaviour, what the person is trying to achieve, and what happens when they resist it.
Where symptoms overlap, psychological intervention can be individually formulated using elements of Habit Reversal Training (HRT) and Exposure and Response Prevention (ERP) where appropriate.
Assessment
Assessment focuses on understanding the person’s tics, premonitory urges and the factors influencing when and how tics occur. Where relevant, obsessive-compulsive symptoms and repetitive behaviours are also considered.
Assessment can be completed in person in London or online and is used to develop an individual formulation and determine how psychological intervention should be structured.
About Dr. Patel
Dr. Dipesh Patel is an HCPC-registered Practitioner Psychologist with specialist experience in psychological interventions for tic disorders and obsessive-compulsive symptoms.
He currently works within the Tourette Syndrome service at the National Hospital for Neurology and Neurosurgery (NHNN) and is undertaking PhD research at the UCL Queen Square Institute of Neurology investigating behavioural interventions for individuals with co-occurring tic disorders and obsessive-compulsive symptoms.
His clinical and research work focuses on understanding the relationship between tics, premonitory urges, compulsions and repetitive behaviours, and on developing individually formulated behavioural interventions using approaches including Habit Reversal Training (HRT) and Exposure and Response Prevention (ERP).
Appointments
Appointments are available in person in London and online. If you would like to discuss whether an assessment may be appropriate, please get in touch.
