Does your practice accept insurance?

We are not contracted with insurance, but many families still receive reimbursement depending on their plan. In some cases, out-of-network exceptions may allow in-network reimbursement rates.

Habit Reversal Therapy for Children and Teens in Puget Sound

Our fellowship-trained pediatric psychologists provide Comprehensive Behavioral Intervention for Tics (CBIT) and habit reversal training for children with tics, Tourette syndrome, and repetitive behaviors. We help your child build awareness, control, and confidence.

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What Is Habit Reversal Therapy?

Habit reversal therapy is an evidence-based behavioral treatment that helps children reduce unwanted tics and repetitive behaviors. Your child learns to recognize the urge before a behavior and replace it with a specific, less noticeable response.
At Children’s BMC, we deliver this through Comprehensive Behavioral Intervention for Tics (CBIT), the gold-standard protocol that builds on habit reversal with three core supports:

Awareness: Helping your child notice the urges and patterns behind each tic or habit.
Competing Response: Replacing the behavior with an action that is physically incompatible with it.
Daily-Life Support: Adjusting environment and routines at home and school to reduce triggers.

What Treatment Involves

A structured, collaborative process that meets your child where they are.

Functional Assessment

We identify the settings and emotions that influence the behavior, then tailor the plan to your child’s real life.

Awareness Training

Your child learns to recognize the urges, sensations, and situations that come right before a tic or habit.

Competing Response

Together with their therapist, your child selects an action that is physically incompatible with the behavior.

Relaxation Skills

Breathing and muscle-relaxation techniques lower overall tic severity and ease the frustration tics can cause.

Practice & Reinforcement

Between-session practice and positive reinforcement help new skills carry over into everyday situations.

Parent & Family Support

We coach caregivers to support skills at home so progress continues well beyond the therapy room.

A female specialist helping a young boy draw on a whiteboard during a learning assessment.

When Habit Reversal Therapy Can Help?

When tics or repetitive behaviors cause distress, draw unwanted attention, or interfere with school, friendships, or confidence, habit reversal therapy gives your child practical tools to regain control. We provide specialized treatment for:
Tic Disorders & Tourette Syndrome: Motor and vocal tics, including eye blinking, head jerking, throat clearing.
Body-Focused Repetitive Behaviors: Hair pulling (trichotillomania), skin picking (excoriation), chronic nail biting, and related habits.

Daily-Life Impact: Behaviors that disrupt sleep, schoolwork, social situations, or your child’s sense of self.
Whether your child has a recent diagnosis or has struggled with tics for years, we provide the structured support that helps them move forward.

Types of Support We Provide

Habit reversal therapy at Children’s BMC is built around your child and family. Depending on your needs, our clinicians may provide:

Initial consultation to confirm whether CBIT or HRT is the right fit
Individualized CBIT treatment for tics and Tourette syndrome
Habit reversal training for body-focused repetitive behaviors
Parent and caregiver coaching to reinforce skills at home
Coordination with pediatricians, neurologists, and school teams

A pediatric psychologist guiding a young child through an interactive exercise.

How to Get Started

1. Call Us

2. Your First Appointment

3. Begin Care

A member of our team will talk with you about your child’s needs, help identify the right service, and answer any initial questions. No referral needed. Call us at (253) 256-3626 or email admin@childrensbmc.com.

We begin with an intake or consultation to understand your child’s history, gather information, and learn what matters most to you and your child. Bring any school evaluations, IEP/504 plans, past evaluations, or report cards you have – but if you don’t have anything, that’s fine too.

Whether you’re starting an evaluation, therapy, or a skills group, we guide you through each step and keep you updated throughout the process. We’re collaborative from day one – a partner in your child’s journey.

If you’d like details about insurance, fees, what to expect, and frequently asked questions, you can learn more at Get Started.

Frequently Asked Questions

Here’s everything you need to know before getting started.

No. Families can contact us directly to schedule. Some insurance plans may require a referral for out-of-network reimbursement, so we recommend checking with your provider if that applies to you.

We are not contracted with insurance companies and are private pay. We provide superbills that families can submit for possible out-of-network reimbursement. Some insurance plans will approve a benefit exception that reimburses at the in-network rate. We are happy to answer any cost-related questions during your initial call.

We work with children, teens, and young adults. Habit reversal therapy typically begins around age 7 or 8, when children are developmentally ready for the awareness and competing-response components.

Yes. CBIT is recommended as a first-line treatment for tic disorders by the American Academy of Neurology, and research shows it is as effective as medication for many children, without the side effects.

Yes. Habit reversal training is effective for body-focused repetitive behaviors, including trichotillomania (hair pulling), excoriation disorder (skin picking), and chronic nail biting.

CBIT and HRT are typically delivered across 8 to 10 weekly sessions, each focused on building and refining skills. Some children benefit from periodic booster sessions afterward.

Habit Reversal Therapy for Children and Teens in Puget Sound

What Is Habit Reversal Therapy?