What Is Habit Reversal Training?

Table of ContentsView AllTable of ContentsUsesHow It WorksComponentsThings to Consider

Table of ContentsView All

View All

Table of Contents

Uses

How It Works

Components

Things to Consider

We all know that habits can be hard to break. Habit reversal training is one type of therapy that can be effective in treating troublesome behaviors and bad habits. It can be effective for changing bothersome habits, but it can also be useful for treating several different mental health conditions, such as tics and OCD.

At a GlanceHabit reversal training is a behavioral treatment that can help people reduce maladaptive behaviors and symptoms of conditions such as Tourette’s and obsessive-compulsive disorder. It teaches people to recognize their triggers, develop competing responses, and utilize relaxation techniques to deal with stress. Keep reading to learn more about how it works, how it can be used, and the main components of this treatment.

At a Glance

Habit reversal training is a behavioral treatment that can help people reduce maladaptive behaviors and symptoms of conditions such as Tourette’s and obsessive-compulsive disorder. It teaches people to recognize their triggers, develop competing responses, and utilize relaxation techniques to deal with stress. Keep reading to learn more about how it works, how it can be used, and the main components of this treatment.

What Does Habit Reversal Training Treat?

Habit reversal training can be useful in the treatment of a few different mental health conditions and body-focused repetitive behaviors.These include:

Habit reversal training can also help reduce behaviors that are disruptive or distressing such as nail biting, thumb sucking, smoking,procrastinating, and stuttering. It may also help address certain behaviors that contribute to conditions such as anxiety and depression.

How Habit Reversal Training Works

Habit reversal training gives people the coping skills they need to manage habits related to their specific disorder. During treatment, people learn to better recognize the signs when a behavior or habit is about to begin.

They also develop other behaviors that they can engage in other than the one they are trying to replace. As they cope with their condition, they also practice relaxation techniques that can reduce stress and improve their ability to manage theirtriggers.

Components of Habit Reversal Training

Habit reversal training typically involves five key elements: awareness training, development of a competing response, motivation building, relaxation training, and generalization of new skills.

What Is Awareness Training?

Awareness training is used to bring greater attention to tics and other behaviors so that the affected person can gain better self-control. Awareness training is usually carried out in a number of smaller steps:

Development of a Competing Response

Once the patient has developed a good awareness of his tic or impulsive behavior the next step is to develop a competing response—an action meant to replace the old tic or impulsive behavior.

Usually, the competing response is opposite that of the tic or impulsive behavior and is something that can be carried out for longer than just a couple of minutes.

For example, a competing response to hair-pulling might be to ball the hands into a fist and hold them rigidly alongside the body. Someone who repeatedly sticks out his tongue might purse his lips instead. Another goal of a competing response is that it is an action other people aren’t likely to notice.

Building Motivation

In addition, it can often be helpful for people to demonstrate their ability to suppress tics or impulsive behaviors to others.

Relaxation Training

People are often more likely to engage in a behavior when they are experiencing stress. For example, people with Tourette’s experience tics more frequently when they are in stressful situations. Stress can also trigger obsessions and compulsions in OCD.

When people begin to recognize the signs that a behavior will occur, they can utilize relaxation techniques to reduce the urge to engage in thosemaladaptive behaviors.

Relaxation techniques that might be used includedeep breathing,progressive muscle relaxation, andguided imagery.

Generalization of New Skills

In this phase of treatment, people are encouraged to practice their new skills in a variety of different contexts, not just those that they have mastered to date.Learning to turn off a tic in the relative safety of the doctor’s office is one thing.

More challenging is reaching a point at which it becomes easy to control impulsive behaviors where it really counts—in the real world: at home, work, school, and in other public places.

While research suggests that habit reversal training can be effective,it may not be right for everyone. Some people may benefit from other types of therapy, such ascognitive-behavioral therapy(CBT) ordialectical behavior therapy(DBT).

Habit reversal training can help people manage their symptoms. However, it is important to remember that it is not a cure for lifelong conditions like Tourette’s syndrome and obsessive-compulsive disorder. Other treatments that may also be used alongside habit reversal training include medications, othertypes of therapy, anddeep brain stimulation(DBS).

Takeaways

Evidence indicates that habit reversal training can be an effective way to treat a variety of problem behaviors and mental health conditions, including Tourette’s, OCD, skin picking, hair pulling, and nail biting. If you think this might help you, look for a trained mental health professional who has experience with habit reversal training.

How Long Does It Take to Build a Habit?

5 SourcesVerywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Moritz S, Penney D, Bruhns A, Weidinger S, Schmotz S.Habit reversal training and variants of decoupling for use in body-focused repetitive behaviors. A randomized controlled trial.Cognit Ther Res. 2023;47(1):109-122. doi:10.1007/s10608-022-10334-9Heinicke MR, Stiede JT, Miltenberger RG, Woods DW.Reducing risky behavior with habit reversal: A review of behavioral strategies to reduce habitual hand-to-head behavior.J Appl Behav Anal. 2020;53(3):1225-1236. doi:10.1002/jaba.745Mcguire JF, Ung D, Selles RR, et al.Treating trichotillomania: a meta-analysis of treatment effects and moderators for behavior therapy and serotonin reuptake inhibitors.J Psychiatr Res.2014;58:76-83. doi:10.1016/j.jpsychires.2014.07.015Pile V, Lau JYF, Topor M, Hedderly T, Robinson S.Interoceptive accuracy in youth with tic disorders: Exploring links with premonitory urge, anxiety and quality of life.J Autism Dev Disord. 2018;48(10):3474-3482. doi:10.1007/s10803-018-3608-8Nissen JB, Kaergaard M, Laursen L, Parner E, Thomsen PH.Combined habit reversal training and exposure response prevention in a group setting compared to individual training: a randomized controlled clinical trial.Eur Child Adolesc Psychiatry. 2019;28(1):57-68. doi:10.1007/s00787-018-1187-z

5 Sources

Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Moritz S, Penney D, Bruhns A, Weidinger S, Schmotz S.Habit reversal training and variants of decoupling for use in body-focused repetitive behaviors. A randomized controlled trial.Cognit Ther Res. 2023;47(1):109-122. doi:10.1007/s10608-022-10334-9Heinicke MR, Stiede JT, Miltenberger RG, Woods DW.Reducing risky behavior with habit reversal: A review of behavioral strategies to reduce habitual hand-to-head behavior.J Appl Behav Anal. 2020;53(3):1225-1236. doi:10.1002/jaba.745Mcguire JF, Ung D, Selles RR, et al.Treating trichotillomania: a meta-analysis of treatment effects and moderators for behavior therapy and serotonin reuptake inhibitors.J Psychiatr Res.2014;58:76-83. doi:10.1016/j.jpsychires.2014.07.015Pile V, Lau JYF, Topor M, Hedderly T, Robinson S.Interoceptive accuracy in youth with tic disorders: Exploring links with premonitory urge, anxiety and quality of life.J Autism Dev Disord. 2018;48(10):3474-3482. doi:10.1007/s10803-018-3608-8Nissen JB, Kaergaard M, Laursen L, Parner E, Thomsen PH.Combined habit reversal training and exposure response prevention in a group setting compared to individual training: a randomized controlled clinical trial.Eur Child Adolesc Psychiatry. 2019;28(1):57-68. doi:10.1007/s00787-018-1187-z

Moritz S, Penney D, Bruhns A, Weidinger S, Schmotz S.Habit reversal training and variants of decoupling for use in body-focused repetitive behaviors. A randomized controlled trial.Cognit Ther Res. 2023;47(1):109-122. doi:10.1007/s10608-022-10334-9Heinicke MR, Stiede JT, Miltenberger RG, Woods DW.Reducing risky behavior with habit reversal: A review of behavioral strategies to reduce habitual hand-to-head behavior.J Appl Behav Anal. 2020;53(3):1225-1236. doi:10.1002/jaba.745Mcguire JF, Ung D, Selles RR, et al.Treating trichotillomania: a meta-analysis of treatment effects and moderators for behavior therapy and serotonin reuptake inhibitors.J Psychiatr Res.2014;58:76-83. doi:10.1016/j.jpsychires.2014.07.015Pile V, Lau JYF, Topor M, Hedderly T, Robinson S.Interoceptive accuracy in youth with tic disorders: Exploring links with premonitory urge, anxiety and quality of life.J Autism Dev Disord. 2018;48(10):3474-3482. doi:10.1007/s10803-018-3608-8Nissen JB, Kaergaard M, Laursen L, Parner E, Thomsen PH.Combined habit reversal training and exposure response prevention in a group setting compared to individual training: a randomized controlled clinical trial.Eur Child Adolesc Psychiatry. 2019;28(1):57-68. doi:10.1007/s00787-018-1187-z

Heinicke MR, Stiede JT, Miltenberger RG, Woods DW.Reducing risky behavior with habit reversal: A review of behavioral strategies to reduce habitual hand-to-head behavior.J Appl Behav Anal. 2020;53(3):1225-1236. doi:10.1002/jaba.745

Mcguire JF, Ung D, Selles RR, et al.Treating trichotillomania: a meta-analysis of treatment effects and moderators for behavior therapy and serotonin reuptake inhibitors.J Psychiatr Res.2014;58:76-83. doi:10.1016/j.jpsychires.2014.07.015

Pile V, Lau JYF, Topor M, Hedderly T, Robinson S.Interoceptive accuracy in youth with tic disorders: Exploring links with premonitory urge, anxiety and quality of life.J Autism Dev Disord. 2018;48(10):3474-3482. doi:10.1007/s10803-018-3608-8

Nissen JB, Kaergaard M, Laursen L, Parner E, Thomsen PH.Combined habit reversal training and exposure response prevention in a group setting compared to individual training: a randomized controlled clinical trial.Eur Child Adolesc Psychiatry. 2019;28(1):57-68. doi:10.1007/s00787-018-1187-z

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At a Glance#

What Does Habit Reversal Training Treat?#

How Habit Reversal Training Works#

Components of Habit Reversal Training#

What Is Awareness Training?#

Development of a Competing Response#

Building Motivation#

Relaxation Training#

Generalization of New Skills#

Takeaways#