Alternative Behaviors for Suppressing Tics?

So, here we were going back to our 3rd appointment with the Behavior Health Specialist that the neurologist had referred us to for this "Tic Reversal Therapy".  While one of Thumper's big tics was swallowing and gulping loudly, this doctor had him trying out an "alternative behavior" to try to stop the tic.  

Every time he was to gulp, he was supposed to put his teeth together and by doing so it would make it too difficult to tic.  So, did this work?

Well, for the first few days he gulped nonstop.  I don't know if it was because he was keeping track in this little notebook and that was exciting for him, but Thumper was gulping, biting, and tallying all week.  It was crazy.  He would come up to me and show me how many hundreds of tally marks he was making in his notebook.  Was I supposed to say "Good job!"?  I didn't know.  

But then, after a while, he wasn't ticking so much.  If it was the alternative behavior that had helped or just that his tics were waxing and waning, I wasn't sure.  

We went back to the specialist to report.  She wanted him to continue with this alternative behavior but then she also wanted him to count how long he could go before the urge to tic would go away.  So now he again would be biting his teeth and tallying in his notebook, but then he had to write numbers of how many seconds it took to relieve the tic.  OK, more focusing on the tics.  Again, I felt like this wasn't right to draw so much attention on them all the time.  Hmmm....

Thumper had two main tics.  He gulped and swallowed, but then his other big tic was a physical tic of scrunching up his face and nose and making a little ooh face and winking his eye.  All of the facial tics seemed to stem from the nose scrunch and then build off of it from there.  

This specialist had addressed the gulping and swallowing with a teeth biting alternative behavior, and now she wanted to address the facial tics. She gave him a new alternative behavior to stop the nose scrunching.  She wanted him to press his lips together every time he did the nose scrunch tic.  This was to stop him from being able to scrunch up his face.  Did it really?  I didn't see how pressing your lips together stopped any nose scrunching, but Thumper seemed to think it did, so we added this to the alternative behavior list and we were sent on our way.  Thumper was to record both tics and alternative behaviors and how often he was ticking and how long it would take him to stop after doing the alternative behaviors.  

This all seemed like a lot to me, as for the next few weeks he carried around this little notebook tallying and counting as he ticked, bit, pressed lips, and recorded.  Again, why were we trying to make him so aware of his tics?  While the doctors didn't think he had any big OCD issues that often coincide with Tourette's, it seemed as if now he might be getting a little obsessive with all this tic recording he was doing!  

Was all this really worth it?  I thought we were just supposed to be going to one or two appointments and learning some "relaxation techniques" as what the neurologist had told us.  It seemed like we were in this never ending follow ups with keeping track of tics.  I don't know if it was helping or not, but we kept our appointment and went back once more.