The Comprehensive Behavioral Intervention for Tics (CBIT) is endorsed as a first-line treatment for tic disorders, but it is not widely available. This is partially due to an enduring misconception that behavior therapy results in tic worsening, as well as the perception that treatment manuals are too inflexible for use in clinical settings. In an effort to address these concerns, the present study was conducted with two primary goals: (1) use existing clinical data to assess the effectiveness of CBIT in a pediatric clinic and (2) systematically examine similarities and differences between the CBIT protocol and clinic-based treatment in a subset of patients identified as treatment successes. We conducted a chart review of pediatric outpatients who received the CBIT intervention. Clinical characteristics, clinician symptom severity ratings, and session content data were extracted. A repeated-measures t test was used to determine whether the change in symptom severity was significant, and one-sample t tests were used to compare clinic-based treatment against the manual. Clinic-based CBIT treatment significantly reduced tic symptom severity, t(9) = 5.08, p = .001, d = 1.68. Moreover, this significant reduction was found with flexible use of the CBIT manual. While it is unclear if CBIT or other components of treatment were responsible for the treatment effects, the results suggest that for at least some pediatric patients with tic disorders, positive treatment outcomes can be achieved when CBIT is flexibly applied in a clinical setting.