If it is the right fit, and it is a child, I meet with the parents alone for 2 1/2 to 3 hours. Yes, 2 1/2 to 3 hours!.
I provide a very detailed intake in order to hear not only about the problem, but also about school/work, sports, hobbies, family, friends, etc. And then I describe my approach: what I do, how I do it, why I do it, and when I do it, because we are on “Team Jane” or “Team John,” as I like to call us. Describing my approach takes about 45 minutes to an hour!
And I want the parents to understand every step of the process.
Then I schedule long visits.
The first patient visit is usually around 2 1/2 to 3 hours. I have found that we will be able to accomplish a lot more in one visit of 150 or 200 minutes than we could ever hope to accomplish in three, four, or even five visits of 50 minutes each. If a patient has more than one tic, I have them choose the one that’s bothering them the most. And that is what we focus on.
At the end of that visit, the patient, parents, and I meet together to discuss how best to move forward.
At the patient’s second visit, I do something that no one else in the world is doing. I show them video clips of previous patients of mine. It shows them before, during, and after treatment.
I believe this is a key component to the treatment as it allows patients to realize that they are not the only ones in the world with this problem.
Furthermore, it gives them the hope and motivation that if these other individuals can gain control over their bodies and life challenges, then they can too!
The third and fourth visits are usually shorter: about an hour to an hour and a half each.
Typically, there is significant improvement in that one tic after only 1 to 3 visits.